Correlation between computed tomography volumetry and nuclear medicine split renal function in live kidney donation: a single‐centre experience

Abstract

BackgroundPotential live renal donors undergo both renal computed tomography angiogram (CTA) and nuclear imaging dimercaptosuccinic acid (DMSA) scans. Each kidney's renal function and vascular anatomy influences the choice of donor side. Although DMSA measures differential blood flow, it is a surrogate for renal function and nephron mass. Computed tomography techniques can provide volumetry information. The aim of this study was to determine the relationship between measured split renal volumes on computed tomography versus renal volumes derived from DMSA split function in live donors.MethodsProspective data of live kidney donors assessed at a single Australian centre from 2014 to 2017 were reviewed. All patients had pre‐operative CTA and DMSA imaging. Renal volume was determined via semi‐automated software calculation from CTA three‐dimensional image reconstructions by one investigator. Measured split renal volume was compared against calculated renal volume using measured DMSA split function (percentage split function multiplied by total renal volume).ResultsFifty‐three patients were included in the study. Split renal volumes on three‐dimensional CTA images correlate to calculated split volumes determined from DMSA (Pearson coefficient 0.95 for right renal volume, 0.95 for left). The decision of which kidney to remove can be achieved with CTA only. Omitting a DMSA scan would reduce the radiation load by 0.70 mSv (35 chest X‐rays) and potential cost saving of AU$1062.00 per donor.ConclusionCTA technology allows accurate assessment of renal volumes that correlate well with DMSA split function. Avoiding a DMSA scan results in cost and radiation reduction in the assessment of a live kidney donor.

Computed Tomography Renal Volumetry Better Predicts Postoperative Donor Renal Function in Live Kidney Donor Transplantation than Renal Scintigraphy: A Comparative Study

“…Finally, while RS was based on two methods, DTPA and MAG3, we deemed it reasonable to treat them equally when determining SRF. This decision was made due to the common utilization of both imaging tests in previous reports for measuring segmental renal function [6][7][8][9][10][11][12][13][14].…”

“…Recent advances in imaging technology have facilitated and improved volume measurement by computed tomography (CT) and magnetic resonance imaging (MRI) [9][10][11][12][13][14]. Several studies have shown that SRF can be more accurately determined by CT volumetry with automated measurement software than by RS [3, [12][13][14].…”

“…Recent advances in imaging technology have facilitated and improved volume measurement by computed tomography (CT) and magnetic resonance imaging (MRI) [9][10][11][12][13][14]. Several studies have shown that SRF can be more accurately determined by CT volumetry with automated measurement software than by RS [3, [12][13][14]. However, while Babas et al [12] provided an example of the discrepancy between RS and CT volumetry, there has been no comparison of the practicality of these two methods.…”

Three-Dimensional Visualization With Virtual Reality Facilitates Complex Live Donor Renal Transplant

“…Regarding volume measurements, 3D reconstruction and VR viewing allow for more precise volume measurements than 2D imaging can reliably provide. 12 With traditional 2D imaging, length, width, and depth of each kidney may be measured and multiplied to approximate the kidney's gross volume. Nuclear medicine imaging can be performed to measure the split function of each kidney but requires additional costly or inconvenient testing.…”