Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors.
OBJECTIVE
To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors.


METHODS
Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA).


RESULTS
All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv.


CONCLUSIONS
MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors.
Knox
Matthew K
MK
Faculty of Medicine, UME Office, Health Sciences Centre, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1.
Rivers-Bowerman
Michael D
MD
Bardgett
Harry P
HP
Cowan
Nigel C
NC
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage; D007668:Kidney / Q000000981:diagnostic imaging* / Q000502:physiology; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals; D012077:Renal Artery / Q000000981:diagnostic imaging; D012082:Renal Veins / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D007479:Iopamidol