title: Comprehensive comparative study of computed tomography-based estimates of split renal function for potential renal donors: modified ellipsoid method and other CT-based methods.
abstract: OBJECTIVE
  To investigate a new modified computed tomographic (CT) ellipsoid method of split renal function and to compare results from this method with other CT-derived metrics.
  
  
  METHODS
  Thirty-eight potential renal donors with both CT and nuclear renography were retrospectively evaluated for estimated split function using 6 CT methods to determine accuracy. For the CT methods, correlation, reproducibility, ease in image post-processing, and the ability of CT-derived methods to determine the dominant kidney before renal transplantation were evaluated using a nuclear renography reference standard.
  
  
  RESULTS
  Four of the 6 CT methods (split renal volume, modified ellipsoid method, parenchymal area, attenuation capacity) showed similar strong correlation (r = 0.84-0.79). Bland-Altman analysis revealed similar performance in differences (SDs <3.0%) between those CT measures and reference standard, as well as good interobserver agreement for the modified ellipsoid and parenchymal area methods. The technically simpler methods had inferior performance. Post-processing time for the modified ellipsoid method was significantly shorter than semiautomated split renal volume or parenchymal area method (P < 0.01). Each CT-based method showed excellent agreement (100% or 97.4%) with renography regarding the determination of dominant kidney.
  
  
  CONCLUSIONS
  Excellent correlation with nuclear split renal function supports the use of CT alone for the imaging assessment for many potential renal donors, including the decision of which kidney to harvest. Among the CT-based methods, the modified ellipsoid method can be performed rapidly with high accuracy and reproducibility.
authors.affiliation: Applied Imaging Science Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Soga
authors.forename: Scott
authors.initials: S
authors.lastname: Britz-Cunningham
authors.forename: Kanako Kunishima
authors.initials: KK
authors.lastname: Kumamaru
authors.forename: Sayeed Khan
authors.initials: SK
authors.lastname: Malek
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Tullius
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007668:Kidney / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D011856:Radiographic Image Enhancement / Q000379:methods; D011866:Radioisotope Renography / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media