title: A simple method for determining split renal function from dynamic (99m)Tc-MAG3 scintigraphic data.
abstract: OBJECTIVE
  Commonly used methods for determining split renal function (SRF) from dynamic scintigraphic data require extrarenal background subtraction and additional correction for intrarenal vascular activity. The use of these additional regions of interest (ROIs) can produce inaccurate results and be challenging, e.g. if the heart is out of the camera field of view. The purpose of this study was to evaluate a new method for determining SRF called the blood pool compensation (BPC) technique, which is simple to implement, does not require extrarenal background correction and intrinsically corrects for intrarenal vascular activity.
  
  
  METHODS
  In the BPC method SRF is derived from a parametric plot of the curves generated by one blood-pool and two renal ROIs. Data from 107 patients who underwent (99m)Tc-MAG3 scintigraphy were used to determine SRF values. Values calculated using the BPC method were compared to those obtained with the integral (IN) and Patlak-Rutland (PR) techniques using Bland-Altman plotting and Passing-Bablok regression. The interobserver variability of the BPC technique was also assessed for two observers.
  
  
  RESULTS
  The SRF values obtained with the BPC method did not differ significantly from those obtained with the PR method and showed no consistent bias, while SRF values obtained with the IN method showed significant differences with some bias in comparison to those obtained with either the PR or BPC method. No significant interobserver variability was found between two observers calculating SRF using the BPC method.
  
  
  CONCLUSIONS
  The BPC method requires only three ROIs to produce reliable estimates of SRF, was simple to implement, and in this study yielded statistically equivalent results to the PR method with appreciable interobserver agreement. As such, it adds a new reliable method for quality control of monitoring relative kidney function.
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada, S7N 0W8.
authors.forename: Michal J
authors.initials: MJ
authors.lastname: Wesolowski
authors.affiliation: Department of Radiology, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Conrad
authors.affiliation: Department of Nuclear Medicine, First Faculty of Medicine, Charles University Prague & the General University Hospital in Prague, CZ-120 00, Praha 2, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Šámal
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada, S7N 0W8.
authors.forename: Gage
authors.initials: G
authors.lastname: Watson
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada, S7N 0W8.
authors.forename: Surajith N
authors.initials: SN
authors.lastname: Wanasundara
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada, S7N 0W8.
authors.forename: Paul
authors.initials: P
authors.lastname: Babyn
authors.affiliation: Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada, S7N 0W8. carl.wesolowski@gmail.com.|Department of Radiology, Memorial University of Newfoundland, St. John's, NL, Canada. carl.wesolowski@gmail.com.
authors.forename: Carl A
authors.initials: CA
authors.lastname: Wesolowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007668:Kidney / Q000000981:diagnostic imaging*; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011786:Quality Control; D011866:Radioisotope Renography / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000737:chemistry*; D012044:Regression Analysis; D015203:Reproducibility of Results; D017263:Technetium Tc 99m Mertiatide / Q000737:chemistry*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide
keywords: 99mTc-MAG3 scintigraphy; Blood pool compensation; Kidney function; Radionuclide renography; Split renal function