Mp24-08 real-Time Estimation of Nephron Activity With a Linear Measurement System (Renal-Ms) Obviates the Need for Nuclear Medicine Scans to Predict Glomerular Filtration Rate After Nephrectomy

Schober, Jared P.; Loecher, Matthew; Strauss, David; Cho, Eric; Bigalli, Alberto Castro; Ginsburg, Kevin; Kutikov, Alexander; Strother, Marshall

doi:10.1097/ju.0000000000002563.08

Cited by 1 publication

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“…The first approach relies on linear LWH measurements that are obtained from axial and coronal views on CT/MRI. This technique is adapted from Feder et al and Schober et al, who utilized such measurements to obtain differential renal parenchymal areas 8 , 9 . Our modified LWH approach, while similar in philosophy, has the advantage of quantifying a 3D anatomical structure with a volumetric measurement rather than with a 2D area measurement.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, the linear measurements can be readily obtained from tools present in the CT/MRI user interface at point of care. In a recent, limited study of 60 patients, this method appeared to be equivalent to NRS in terms of predicting NBGFR after RN 8 .…”

Section: Introductionmentioning

confidence: 99%

“…A simplified approach to estimate parenchymal volumes and SRF based on linear length, width, and height measurements (LWH) has also been proposed 8 , 9 This method incorporates average measurements of renal parenchymal length and thickness in different axes to provide an estimate of the relative parenchymal volumes. Of note, the linear measurements can be readily obtained from tools present in the CT/MRI user interface at point of care.…”

Section: Introductionmentioning

confidence: 99%

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Point of care parenchymal volume analyses to estimate split renal function and predict functional outcomes after radical nephrectomy

Rathi

Attawettayanon

Yasuda

et al. 2023

Sci Rep

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Accurate prediction of new baseline GFR (NBGFR) after radical nephrectomy (RN) can inform clinical management and patient counseling whenever RN is a strong consideration. Preoperative global GFR, split renal function (SRF), and renal functional compensation (RFC) are fundamentally important for the accurate prediction of NBGFR post-RN. While SRF has traditionally been obtained from nuclear renal scans (NRS), differential parenchymal volume analysis (PVA) via software analysis may be more accurate. A simplified approach to estimate parenchymal volumes and SRF based on length/width/height measurements (LWH) has also been proposed. We compare the accuracies of these three methods for determining SRF, and, by extension, predicting NBGFR after RN. All 235 renal cancer patients managed with RN (2006–2021) with available preoperative CT/MRI and NRS, and relevant functional data were analyzed. PVA was performed on CT/MRI using semi-automated software, and LWH measurements were obtained from CT/MRI images. RFC was presumed to be 25%, and thus: Predicted NBGFR = 1.25 × Global GFRPre-RN × SRFContralateral. Predictive accuracies were assessed by mean squared error (MSE) and correlation coefficients (r). The r values for the LWH/NRS/software-derived PVA approaches were 0.72/0.71/0.86, respectively (p < 0.05). The PVA-based approach also had the most favorable MSE, which were 120/126/65, respectively (p < 0.05). Our data show that software-derived PVA provides more accurate and precise SRF estimations and predictions of NBGFR post-RN than NRS/LWH methods. Furthermore, the LWH approach is equivalent to NRS, precluding the need for NRS in most patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%