Use of contrast-enhanced computed tomography to measure clearance per unit renal volume: A novel measurement of renal function and fractional vascular volume

Tsushima, Yoshito; Blomley, Martin; Kusano, Shoichi; Endo, Keigo

doi:10.1016/s0272-6386(99)70230-1

Cited by 42 publications

(64 citation statements)

References 31 publications

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“…Patlak plot CT-GFR has been validated in normal humans, pigs and dogs, and reported to a limited extent in various renal diseases. Patlak plot CT-GFR measurements are significantly lower than GFR estimates by other methods (5,6,13,14). Conversely, Patlak plot CT-GFR can overestimate actual GFR in diseases causing enlarged interstitial space, as this introduces a third compartment (15).…”

Section: Introductionmentioning

confidence: 93%

Patlak plot analysis CT‐GFR for the determination of renal function: comparison of normal dogs with autologous kidney transplant dogs

Alexander

Authier

Castillo

et al. 2010

Contrast Media & Molecular

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Glomerular filtration rate (GFR) can be determined using Patlak plot analysis with single-slice dynamic computed tomography (CT). Acute autologous graft failure has several causes, all of which induce a measurable decrease in glomerular filtration rate. This study demonstrated in an experimental model of canine autologous renal transplant that CT-derived renal plasma clearance was significantly lower (p = 0.002) in dogs having undergone transplant (0.077 +/- 0.058 ml min(-1) ml renal tissue(-1)) compared with control dogs (0.396 +/- 0.139 ml min(-1) ml renal tissue(-1)). A significant negative curvilinear relationship was seen between serum creatinine and total renal plasma clearance (R(2) = 0.84, p = 0.0001). Alterations in renal time attenuation curve shape in dogs having undergone transplant may have been related to increased renal vascular resistance related to tubular necrosis. CT-GFR may be a useful experimental tool in the evaluation of renal dysfunction in transplant models.

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Section: Introductionmentioning

confidence: 93%

Patlak plot analysis CT‐GFR for the determination of renal function: comparison of normal dogs with autologous kidney transplant dogs

Alexander

Authier

Castillo

et al. 2010

Contrast Media & Molecular

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“…On average, the ellipsoid method slightly underestimated 3D volumes, but almost all were accurate within 30%. Given the established relationship between renal volume and function, [4][5][6][7][8][9][10][11][12][13][14][15][16] our findings suggest 3D volume software analysis is not necessary when estimating differential renal function.…”

Section: Discussionmentioning

confidence: 82%

“…[1][2][3] In addition, renal volume estimated by CT also correlates with renal function [4][5][6][7][8][9][10][11] and permits concurrent evaluation of differential renal function. [12][13][14][15][16] Unfortunately, renal volume estimates using CT are time-consuming or require specialized 3D volumetric software, 12,13,15,17,18 which has rarely been made available for use in comparative studies.…”

Section: Introductionmentioning

confidence: 99%

A simple method to estimate renal volume from computed tomography

Breau

Clark

Bruner

et al. 2013

CUAJ

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Introduction: Renal parenchymal volume can be used clinically to estimate differential renal function. Unfortunately, conventional methods to determine renal volume from computed tomography (CT) are time-consuming or difficult due to software limitations. We evaluated the accuracy of simple renal measurements to estimate renal volume as compared with estimates made using specialized CT volumetric software. Methods: We reviewed 28 patients with contrast-enhanced abdominal CT. Using a standardized technique, one urologist and one urology resident independently measured renal length, lateral diameter and anterior-posterior diameter. Using the ellipsoid method, the products of the linear measurements were compared to 3D volume measurements made by a radiologist using specialized volumetric software. Results: Linear kidney measurements were highly consistent between the urologist and the urology resident (intraclass correlation coefficients: 0.97 for length, 0.96 for lateral diameter, and 0.90 for anterior-posterior diameter). Average renal volume was 170 (SD: 36) cm 3 using the ellipsoid method compared with 186 (SD 37) cm 3 using volumetric software, for a mean absolute bias of -15.2 (SD 15.0) cm 3 and a relative volume bias of -8.2% (p < 0.001). Thirty-one of 56 (55.3%) estimated volumes were within 10% of the 3D measured volume and 54 of 56 (96.4%) were within 30%. Conclusion: Renal volume can be easily approximated from contrast-enhanced CT scans using the ellipsoid method. These findings may obviate the need for 3D volumetric software analysis in certain cases. Prospective validation is warranted.

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“…The degree of enhancement can be quantified by measuring the change in the average HU of a region of the kidney. If a given region in the kidney is scanned sequentially, the increase in attenuation value can be plotted against time and thus curves of relative concentration of contrast against time can be obtained [10]. Several parameters can be calculated using these figures.…”

Section: Functional Ctmentioning

confidence: 99%

“…The method which was derived from the two-point Patlak plot estimating perfusion in brains [12] can be used to calculate perfusion, the proportion of the kidney that is blood, the rate of change of contrast in the renal tubules and extracellular fluid, filtration rate in ml/min per ml of renal tissue and renal blood flow. Studies have shown that functional CT using non-ionic contrast material is an accurate method to measure GFR normalized to renal volume [10, 11]. However, plasma clearance of contrast is notidentical to GFR in a strict sense, as very small amounts ofnon-ionic x-ray contrast medium are excreted by hepatocytes intobile.…”

Section: Functional Ctmentioning

confidence: 99%

Applications of Computed Tomography in Renal Imaging

Read

Allen²,

Hare³

2006

Nephron Clin Pract

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There have been huge advances in CT technology since its introduction more than 30 years ago. Modern, multislice CT scanners are fast and produce truly volumetric data, allowing it to be reconstructed in almost any plane. In this article, we explore the impact of these developments on the use of CT in imaging of the renal tract. Whilst it may take the radiologist longer to review and process the increased amount of data that is produced, diagnostic accuracy is unquestionably improved and new and exciting challenges are presented to the radiologist as he learns to manipulate and interpret the data in a way that he has never done before.

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Use of contrast-enhanced computed tomography to measure clearance per unit renal volume: A novel measurement of renal function and fractional vascular volume

Cited by 42 publications

References 31 publications

Patlak plot analysis CT‐GFR for the determination of renal function: comparison of normal dogs with autologous kidney transplant dogs

Patlak plot analysis CT‐GFR for the determination of renal function: comparison of normal dogs with autologous kidney transplant dogs

A simple method to estimate renal volume from computed tomography

Applications of Computed Tomography in Renal Imaging

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