title: Determination of split renal function using dynamic CT-angiography: preliminary results.
abstract: OBJECTIVE
  To determine the feasibility of a dynamic CT angiography-protocol with regard to simultaneous assessment of renal anatomy and function.
  
  
  METHODS
  7 healthy potential kidney donors (58 ± 7 years) underwent a dynamic computed tomography angiography (CTA) using a 128-slice CT-scanner with continuous bi-directional table movement, allowing the coverage of a scan range of 18 cm within 1.75 sec. Twelve scans of the kidneys (n = 14) were acquired every 3.5 seconds with the aim to simultaneously obtain CTA and renal function data. Image quality was assessed quantitatively (HU-measurements) and qualitatively (grade 1-4, 1 = best). The glomerular filtration rate (GFR) was calculated by a modified Patlak method and compared with the split renal function obtained with renal scintigraphy.
  
  
  RESULTS
  Mean maximum attenuation was 464 ± 58 HU, 435 ± 48 HU and 277 ± 29 HU in the aorta, renal arteries, and renal veins, respectively. The abdominal aorta and all renal vessels were depicted excellently (grade 1.0). The image quality score for cortex differentiation was 1.6 ± 0.49, for the renal parenchyma 2.4 ± 0.49. GFR obtained from dynamic CTA correlated well with renal scintigraphy with a correlation coefficient of r = 0.84; P = 0.0002 (n = 14). The average absolute deviation was 1.6 mL/min. The average effective dose was 8.96 mSv.
  
  
  CONCLUSIONS
  Comprehensive assessment of renal anatomy and function is feasible using a single dynamic CT angiography examination. The proposed protocol may help to improve management in case of asymmetric kidney function as well as to simplify evaluation of potential living kidney donors.
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Helck
authors.affiliation: Department of Internal Medicine IV, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Schönermarck
authors.affiliation: Transplant Center Munich, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Habicht
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Notohamiprodjo
authors.affiliation: Department of Surgery, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Stangl
authors.affiliation: Siemens Healthcare, Computed Tomography, Forchheim, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Klotz
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Department of Nuclear Medicine, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: la Fougère
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Dirk Andrè
authors.initials: DA
authors.lastname: Clevert
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.affiliation: Institute for Clinical Radiology, University Hospital Grosshadern (LMU), Munich, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Becker
mesh_terms: D000368:Aged; D000465:Algorithms; D000792:Angiography; D005919:Glomerular Filtration Rate; D064368:Healthy Volunteers; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*; D007677:Kidney Function Tests / Q000379:methods*; D008875:Middle Aged; D008954:Models, Biological; D012307:Risk Factors; D014057:Tomography, X-Ray Computed