Estimation of renal function using kidney dynamic contrast material-enhanced CT perfusion: accuracy and feasibility

Abdom Radiol (NY). 2021 May;46(5):2045-2051. doi: 10.1007/s00261-020-02826-7. Epub 2020 Oct 22.

Abstract

Purpose: To measure glomerular filtration rates (GFRs) using kidney dynamic contrast material-enhanced (DCE)-CT perfusion scans and correlate them with estimated GFRs (eGFRs).

Materials and methods: Split-bolus CT urography, including pre-contrast and nephrographic-excretory phase imaging, was performed with a kidney DCE-CT perfusion scan protocol. We analysed 55 patients with suspected renal disease. All CT acquisitions were obtained on a 256-slice CT scanner for 3.5 min continuously with shallow breathing. Renal volume, perfusion and permeability values were calculated using a dedicated prototype software. Based on Patlak plots, split and total renal GFR values were determined. Paired t-tests, Pearson's correlation analysis and Bland-Altman plots were used for comparisons between kidney DCE-CT perfusion scan-derived GFR (CT-GFR) and the corresponding eGFR value. The p values < 0.05 were considered statistically significant.

Results: The mean CT-GFR was 91.19 ± 20.71 mL/min/1.73 m2. The eGFR values based on the CKD-EPI and MDRD equations were 89.64 ± 19.74 mL/min/1.73 m2 and 89.50 ± 24.89 mL/min/1.73 m2, respectively. No statistically significant differences were found between CT-GFR and eGFRs (p > 0.05). Excellent correlation and agreement between CT-GFR and eGFRs (correlation coefficient r = 0.91 for CKD-EPI and 0.84 for MDRD equations, respectively) were confirmed.

Conclusion: Kidney DCE-CT perfusion is an accurate and feasible technique to assess renal function.

Keywords: Glomerular filtration rate; Perfusion imaging; Spiral computed; Tomography; X-ray computed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contrast Media*
  • Feasibility Studies
  • Glomerular Filtration Rate
  • Humans
  • Kidney* / diagnostic imaging
  • Perfusion
  • Tomography, X-Ray Computed

Substances

  • Contrast Media