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Estimation of split renal function using different volumetric methods: inter- and intraindividual comparison between

Florian Siedek1, Stefan Haneder1, Jonas Dörner1

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Summary

Contrast-enhanced magnetic resonance imaging (CE-MRI) offers comparable accuracy to contrast-enhanced computed tomography (CE-CT) for estimating split renal function (SRF) using the renal cortex volumetry (RCV) method. This finding suggests CE-MRI as a viable alternative, reducing radiation exposure for patients.

Keywords:
KidneyLiving kidney donationModified ellipsoid volumeRenal cortex volumetrySplit renal function

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Area of Science:

  • Radiology and Imaging Science
  • Nephrology and Urology
  • Medical Physics

Background:

  • Accurate estimation of split renal function (SRF) is crucial for diagnosing and managing various kidney conditions.
  • Contrast-enhanced computed tomography (CE-CT) is a common modality for SRF estimation, but involves ionizing radiation.
  • Contrast-enhanced magnetic resonance imaging (CE-MRI) offers a radiation-free alternative, necessitating comparison for SRF assessment.

Purpose of the Study:

  • To evaluate the comparability of CE-MRI versus CE-CT in estimating SRF.
  • To compare the accuracy and reliability of two kidney volumetry methods: renal cortex volumetry (RCV) and modified ellipsoid volume (MELV), using both CE-CT and CE-MRI datasets.

Main Methods:

  • Retrospective analysis of 29 patients who underwent both CE-MRI and CE-CT within three months.
  • Two independent readers performed RCV on arterial phase datasets and MELV on venous phase datasets using semi-automated software.
  • Statistical analysis included ANOVA, Student's t-test, Pearson's correlation, and Bland-Altman plots to assess agreement and reliability.

Main Results:

  • SRF estimates were nearly identical (<1% difference) between RCV and MELV methods across both imaging modalities.
  • Bland-Altman analysis showed very good agreement between RCV-CT and RCV-MRI.
  • Interreader agreement was strong for RCV-CT (r=0.89) and good for RCV-MRI (r=0.69), while moderate for MELV-CT/MRI (r=0.54/0.50). Intrareader agreement was excellent for RCV-CT/MRI and MELV-CT, but only moderate for MELV-MRI.

Conclusions:

  • The renal cortex volumetry (RCV) method provides accurate and reliable SRF estimates comparable between CE-MRI and CE-CT.
  • The modified ellipsoid volume (MELV) method demonstrated inferior accuracy and reliability compared to RCV for SRF calculation.
  • RCV is recommended for SRF estimation, with CE-MRI offering a valuable, radiation-sparing alternative to CE-CT for kidney volumetry.