Can parenchymal volume analysis replace nuclear renal scans for split renal function before and after partial...

Area of Science:

• Nephrology
• Urology
• Radiology
• Medical Imaging

Background:

• Assessing split renal function (SRF) before and after partial nephrectomy (PN) is critical for patient management.
• Nuclear renal scan (NRS) is a traditional method for SRF assessment but involves radioactivity concerns.
• Parenchymal volume analysis (PVA) is an alternative, but its efficacy in evaluating SRF after PN with warm ischemia is unclear.

Purpose of the Study:

• To evaluate the potential of PVA as a substitute for NRS in assessing SRF before and after PN with warm ischemia.
• To compare SRF measurements obtained by PVA and NRS in patients undergoing PN.

Main Methods:

• A retrospective study of 318 patients who underwent unilateral PN with warm ischemia.
• Both PVA (using Mimics software) and NRS were performed pre- and post-PN (1-12 months).
• Correlation and concordance analyses (Pearson, Friedman, Bland-Altman, Kendall) were used to compare SRF estimations.

Main Results:

• Preoperatively, PVA-derived SRF showed strong correlation (r=0.89) and minimal bias (-0.36%) with NRS.
• Postoperatively, PVA-derived SRF correlated well (r=0.87) with NRS but showed a non-negligible bias (2.19%).
• PVA tended to slightly overestimate ipsilateral SRF compared to NRS in the post-PN phase.

Conclusions:

• PVA is a promising non-radioactive alternative to NRS for preoperative SRF assessment before PN.
• Caution is advised when using PVA for postoperative SRF evaluation due to potential overestimation of renal function.