Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique

Abstract

Objectives

To develop a convenient and rapid single-kidney CT-GFR technique.

Methods

One hundred and twelve patients referred for multiphasic renal CT and 99mTc-DTPA renal dynamic imaging Gates-GFR measurement were prospectively included and randomly divided into two groups of 56 patients each: the training group and the validation group. On the basis of the nephrographic phase images, the fractional renal accumulation (FRA) was calculated and correlated with the Gates-GFR in the training group. From this correlation a formula was derived for single-kidney CT-GFR calculation, which was validated by a paired t test and linear regression analysis with the single-kidney Gates-GFR in the validation group.

Results

In the training group, the FRA (x-axis) correlated well (r = 0.95, p < 0.001) with single-kidney Gates-GFR (y-axis), producing a regression equation of y = 1665x + 1.5 for single-kidney CT-GFR calculation. In the validation group, the difference between the methods of single-kidney GFR measurements was 0.38 ± 5.57 mL/min (p = 0.471); the regression line is identical to the diagonal (intercept = 0 and slope = 1) (p = 0.727 and p = 0.473, respectively), with a standard deviation of residuals of 5.56 mL/min.

Conclusion

A convenient and rapid single-kidney CT-GFR technique was presented and validated in this investigation.

Key Points

• The new CT-GFR method takes about 2.5 min of patient time.

• The CT-GFR method demonstrated identical results to the Gates-GFR method.

• The CT-GFR method is based on the fractional renal accumulation of iodinated CM.

• The CT-GFR method is achieved without additional radiation dose to the patient.