Novel prediction model of renal function after nephrectomy from automated renal volumetry with preoperative multidetector computed tomography (MDCT)

Isotani, Shuji; Shimoyama, Hirofumi; Yokota, Isao; Noma, Yasuhiro; Kitamura, K.; China, Toshiyuki; Saito, Keisuke; Hisasue, Shin‐ichi; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Ukimura, Osamu; Gill, Inderbir S.; Horie, Shigeo

doi:10.1007/s10157-015-1082-6

Cited by 14 publications

(17 citation statements)

References 21 publications

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“…Isotani et al demonstrated a significant correlation between percent eGFR alteration and percent renal parenchymal volume preservation in 60 cases treated with RN using SYN-APSE VINCENT. 14 Although there was no significant association between renal parenchymal change and post-PN renal global function, our study is the first to demonstrate the significant post-PN compensatory hypertrophy in contralateral kidney using sophisticated film technology, SYNAPSE VINCENT. Outside of the urological field, the usefulness of SYNAPSE VINCENT as the image-supported navigation has also been reported in thoracic and hepatic surgical fields.…”

Section: Renal Global Function Is the Summation Of Ipsilateral Renal mentioning

confidence: 49%

Comprehensive Analysis of Factors Affecting Post-partial Nephrectomy Renal Global Function

et al. 2017

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Background To explore new factors that are predictive of post-partial nephrectomy (PN) renal global function, we analyzed various clinico-pathological factors with a special focus on renal volume measured via three-dimensional imaging technology and histopathological parameters in non-neoplastic parenchyma. Methods Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scan were examined pre-and 6 months. post-operatively in 52 patients treated by PN. The post-operative percent eGFR decline was employed as the measure of global renal functional deterioration. The novel factors analyzed included the percent renal parenchymal volume decline of the diseased side, contralateral and bilateral sides and the global glomerulosclerosis (GS) extent in non-neoplastic parenchyma. Renal parenchymal volumetry by CT scan was performed using SYNAPSE VINCENT (Fujifilm). Additional factors analyzed included patient demographics and comorbidities, surgical factors and tumor pathology. All factors demonstrating significant tendencies (P < 0.1) in univariate analyses were subjected to multivariate logistic regression analysis. Results Two groups were categorized according to the degree of eGFR decline. Groups A and B were categorized as less than 15% and greater than 15% decline, respectively. Pre-operative eGFR was significantly lower in group B than in group A. Greater than 10% global GS extent in non-neoplastic parenchyma, male gender and proteinuria were significantly more frequent in in group B than in group A. The renal volume change was not statistically significant. In multivariate logistic regression analysis, greater than 10% global GS extent in non-neoplastic parenchyma was the sole independent affecting factor for Group B. Conclusion Our study suggested that host factors rather than surgical factors may be useful for the prediction of post-PN renal global function. The evaluation of the global GS extent in non-neoplastic parenchyma is a promising biomarker of post-PN renal global function.

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Section: Renal Global Function Is the Summation Of Ipsilateral Renal mentioning

confidence: 49%

Comprehensive Analysis of Factors Affecting Post-partial Nephrectomy Renal Global Function

et al. 2017

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“…In this study, sophisticated film technology, Synapse Vincent, was used for the soft volumetric analysis. The employment of Synapse Vincent demonstrated that it had a significant correlation between percent eGFR alteration and percent RPV preservation in 60 cases treated with RN [22]. The finding in this study that postoperative contralateral RPV was significantly larger than preoperative RPV suggests that compensatory renal hypertrophy (CRH) of the contralateral side likely occurs 6 month postoperatively.…”

Section: Discussionmentioning

confidence: 65%

Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy

Sejima¹,

Masago²,

Yumioka³

et al. 2019

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Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scans were examined pre-and 6 months postoperatively. Renal global functional deterioration after PN was assessed by postoperative percent of eGFR decline. Pre-and postoperative renal parenchymal volume (RPV) was measured by the Synapse Vincent volumetric analyzer which creates a reconstructed image from a CT scan. Additional factors that were analyzed included patient demographics, comorbidities, surgical factors and tumor pathology. All factors demonstrating statistical tendencies (P < 0.1) in univariate analyses were subjected to multivariate logistic regression analysis. Two groups were categorized according to the degree of eGFR decline. Groups A and B were categorized as less than 15% and greater than 15% declines, respectively. Results: The case distributions of hypertension (HTN) and male gender were significantly shifted in group B. Significant compensatory renal hypertrophy of the contralateral side occurred postoperatively. The percent increment of RPV in the contralateral side in group B was significantly lower than that in group A. In multivariate analysis, HTN was the sole independent associated factor in group B. Conclusions: Host factors, rather than surgical factors, may be associated with postoperative renal global functional deterioration in PN. Surgeons should consider medical problems in addition to surgical skills especially in HTN patients.

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“…In these patients, preoperative CT based RPV measurements were found to be independently associated with the development of CKD after surgery. Isotani et al reported similar results in their cohort of 60 patients undergoing radical nephrectomy who underwent renal volumetry using CT and GFR measurement by MDRD equation (r=0.54) (20). Besides Kuru et al, only three more studies have correlated MRI renal volumetry with renal function/GFR for patients undergoing nephrectomy ( Table-2) (21-23).…”

Section: Discussionmentioning

confidence: 77%

Role of preoperative MR volumetry in patients with renal cell carcinoma for prediction of postoperative renal function after radical nephrectomy and nephron sparing surgery

et al. 2020

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Purpose: Preoperative computed tomography or magnetic resonance (MR) imaging are commonly used for radiological evaluation of renal cell carcinoma (RCC) before radical nephrectomy or nephron sparing surgery(NSS). This study aimed to assess the role of MRI for predicting postoperative renal function by preoperative estimation of renal parenchymal volume and correlation with glomerular fi ltration rate (GFR). Materials and Methods: A prospective observational study was conducted from February 2015 to October 2016 at a tertiary care hospital in northern India. MR imaging was done on 3 Tesla MR scanner (Signa Hdxt General Electrics, Milwaukee, USA). MR volumetry was used to estimate the renal parenchymal volume. GFR was measured in all patients using Tc99m Diethyl-triamine-penta-acetic acid using Russell's algorithm. Such measurement was done preoperatively, and postoperatively 3 months after surgery. Results: 30 patients with suspected RCC underwent NSS (n=10) and radical nephrectomy (n=20). Median tumour volume was 175.7cc (range: 4.8 to 631.8cc). The median volume of the residual parenchyma on the affected side was 84.25±41.97cc while that on the unaffected side was 112.25±26.35cc. There was good correlation among the unaffected kidney volume and postoperative GFR for the radical nephrectomy group (r=0.83) as well as unaffected kidney volume, total residual kidney volume and residual volume of affected kidney with postoperative GFR for the NSS group (r=0.71, r=0.73, r=0.79 respectively; P <0.05). Conclusion: Preoperative residual parenchymal volume on MR renal volumetry correlates well with postoperative GFR in patients with RCC undergoing radical nephrectomy or NSS.

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Novel prediction model of renal function after nephrectomy from automated renal volumetry with preoperative multidetector computed tomography (MDCT)

Abstract: Combining MDCT renal volumetry and clinical indices might yield an important tool for predicting postoperative renal function.

Cited by 14 publications

References 21 publications

Comprehensive Analysis of Factors Affecting Post-partial Nephrectomy Renal Global Function

Comprehensive Analysis of Factors Affecting Post-partial Nephrectomy Renal Global Function

Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy

Role of preoperative MR volumetry in patients with renal cell carcinoma for prediction of postoperative renal function after radical nephrectomy and nephron sparing surgery

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