Gadofosveset-enhanced MR imaging for the preoperative evaluation of potential living kidney donors: correlation with intraoperative findings

Rofo. 2010 Nov;182(11):1001-9. doi: 10.1055/s-0029-1245685. Epub 2010 Oct 4.

Abstract

Purpose: The purpose of this study was to evaluate the blood pool contrast agent gadofosveset for MR angiography (MRA) of the renal vasculature in living kidney donors (LKD).

Materials and methods: Of the 28 consecutive potential LKDs (13 men, 15 women; mean age 55.14 years ± 11.97) initially included in this prospective study, 20 patients underwent surgery and were considered for further evaluation. 7 acquisitions of a 3D T 1-weighted FLASH sequence were performed following administration of gadofosveset for the assessment of the vascular anatomy and collecting system at predefined time points at 1.5 T. All MR exams were prospectively analyzed by 2 radiologists in consensus mode prior to surgery. In addition, ROI-based relative SNR measurements were performed in the vena cava inferior and abdominal aorta.

Results: MR image acquisition was completed in all 20 potential living donors. In 8 donors an additional CT scan was available for further comparison with the collateral anatomy, resulting in a total of 28 analyzed kidneys. MRA disclosed 36 renal arteries, since 8 accessory arteries were found in 8 subjects. One accessory artery and one case of fibromuscular dysplasia were missed by MRA. The venous anatomy and the collecting system were assessed correctly with MRI. In addition, MRI diagnosed two renal cell carcinomas. The overall sensitivity and positive predictive value of gadofosveset-enhanced MRI on a per kidney basis were 92.9 % and 100 %, respectively.

Conclusion: Gadofosveset enables accurate evaluation of potential LKDs.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aorta, Abdominal / pathology
  • Carcinoma, Renal Cell / diagnosis
  • Contrast Media*
  • Female
  • Fibromuscular Dysplasia / diagnosis
  • Gadolinium*
  • Hemangioma / diagnosis
  • Humans
  • Image Enhancement*
  • Image Processing, Computer-Assisted / standards*
  • Imaging, Three-Dimensional / standards*
  • Incidental Findings
  • Kidney / blood supply*
  • Kidney / pathology*
  • Kidney Neoplasms / diagnosis
  • Kidney Transplantation*
  • Living Donors*
  • Magnetic Resonance Angiography / standards*
  • Male
  • Middle Aged
  • Organometallic Compounds*
  • Reference Standards
  • Renal Artery / pathology
  • Renal Artery Obstruction / diagnosis
  • Sensitivity and Specificity
  • Statistics as Topic
  • Tomography, Spiral Computed / standards
  • Urography / standards
  • Vena Cava, Inferior / pathology

Substances

  • Contrast Media
  • Organometallic Compounds
  • Gadolinium
  • gadofosveset trisodium