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

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aims to determine whether contrast-enhanced (CE)-magnetic resonance imaging (MRI) is comparable to CE-computed tomography (CT) for estimation of split renal function (SRF). For this purpose, two different kidney volumetry methods, the renal cortex volumetry (RCV) and modified ellipsoid volume (MELV), are compared for both acquisition types (CT vs. MRI) with regard to accuracy and reliability, subsequently referred to as RCVCT/RCVMRI and MELVCT/MELVMRI.

Methods

This retrospective study included 29 patients (18 men and 11 women; mean age 62.8 ± 12.4 years) who underwent CE-MRI and CE-CT of the abdomen within a period of 3 months. Two independent readers (R1/R2) performed RCV and MELV in all datasets with corresponding semiautomated software tools. RCV was performed with datasets in the arterial phase and MELV in the venous phase. Statistics were calculated using one-way ANOVA, two-tailed Student’s t test, Pearson´s correlation, and Bland–Altman plots with p ≤ 0.05 being considered statistically significant.

Results

In all datasets, SRF was almost identical for both volumetry methods with a mean difference of < 1%. Bland–Altman analysis comparing RCV in CT and MRI showed very good agreement for R1/R2. Interreader agreement was strong for RCVCT and good for RCVMRI (r = 0.89; r = 0.69). MELVCT/MRI interreader agreement was only moderate (r = 0.54; r = 0.50) with a high range of values. Intrareader agreement was excellent for all measurements, except MELVMRI which showed a high mean bias and range of values (RCVCT: r = 0.93, RCVMRI: r = 0.98, MELVCT: r = 0.89, MELVMRI: r = 0.54).

Conclusion

Renal volumetric estimates of SRF are almost as accurate and reliable with CE-MRI as with CE-CT using RCV method. In distinction, the calculation of SRF using MELV was inferior to RCV with respect to accuracy and reliability. Thus, RCV method is recommended to estimate SRF, primarily using CT datasets. However, RCV with MRI datasets for kidney volumetry allows for comparable accuracy and reliability while sparing patients and healthy donors of unnecessary radiation exposure.

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Abbreviations

CE:

Contrast-enhanced

CI:

Confidence interval

eGFR:

Estimated glomerular filtration rate calculated with the “chronic kidney disease epidemiology collaboration” (CKD-EPI) formula

LKD:

Living kidney donation

LoA:

Limits of agreement

MELV:

Modified ellipsoid volume

MELVCT :

MELV measurements performed using venous-phase images acquired with CE-CT

MELVMRI :

MELV measurements performed using venous-phase images acquired with CE-MRI

MIP:

Maximum intensity projection

NASCET:

The North American Symptomatic Carotid Endarterectomy Trial

RCV:

Renal cortex volumetry

RCVCT :

RCV measurements performed using arterial-phase images acquired with CE-CT

RCVMRI :

RCV measurements performed using arterial-phase images acquired with CE-MRI

ROI:

Region of interest

SRF:

Split renal function

TKV:

Total kidney volume

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany

    Florian Siedek, Stefan Haneder, Jonas Dörner, David Maintz & Christian Houbois

  2. St. John’s Medical Center, 1923 South Utica Ave, Tulsa, OK, 74104, USA

    John N. Morelli

  3. General, Visceral, and Cancer Surgery, University Hospital Cologne, Cologne, Germany

    Seung-Hun Chon

Authors
  1. Florian Siedek
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  2. Stefan Haneder
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  3. Jonas Dörner
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  4. John N. Morelli
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  5. Seung-Hun Chon
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  6. David Maintz
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  7. Christian Houbois
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Correspondence to Christian Houbois.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Siedek, F., Haneder, S., Dörner, J. et al. Estimation of split renal function using different volumetric methods: inter- and intraindividual comparison between MRI and CT. Abdom Radiol 44, 1481–1492 (2019). https://doi.org/10.1007/s00261-018-1857-9

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  • DOI: https://doi.org/10.1007/s00261-018-1857-9

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