title: Feasibility of triphasic CT with a modified two-point Patlak plot to determine spit kidney glomerular filtration rate in clinical practice.
abstract: To investigate whether triphasic CT with a simplified Patlak plot can be used in clinical practice for the estimate of split kidney glomerular filtration rate (SKGFR).
  
  
  
  The animal experiment included 15 rabbits that underwent 40 dynamic contrast-enhanced CT scans of the kidneys with 1.5 s time interval. Patlak-derived SKGFR was obtained using standard forty-point, two-point (unenhanced phase, arterial phase tα,and portovenous phase tβ), and a modified two-point (MTP) (unenhanced, tα, tβ, and a virtual tτ[tτ= (tα+ tβ)/2]) image data, respectively. The MTP-Patlak plot approach was then validated in 13 patients who underwent a triphasic renal contrast-enhanced CT examination. SKGFR measured by 99mTc-DTPA clearance was as a standard reference.
  
  
  
  MTP-Patlak significantly reduced input function errors than two-point Patlak (21.1 ± 16.2 % vs 30.8 ± 15.2 %, p < 0.01) and showed good concordance with standard Patlak for measurement of SKGFR in animal experiment (1.20 ± 0.38 mL/g/min vs 1.51 ± 0.43 mL/g/min; linear correlation coefficient r = 0.87, p < 0.001). Human study showed that mean SKGFR was 45.7 mL/min (range, 26.5-86.2 mL/min) obtained from 99mTc-DTPA, and 38.2 mL/min (range, 18.6-79.3 mL/min) obtained from triphasic CT using MTP-Patlak plot. Linear correlation between the two methods was r = 0.75 (p < 0.01). The mean difference between SKGFRs as determined with the two methods was 7.4 ± 9.0 mL/min.
  
  
  
  The MTP-Patlak approach, featured with simplicity, is feasible in a clinically indicated CT examination for the evaluation of split renal function.
authors: Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China. njmu_zyd@163.com.
authors: Yu-Dong
authors: YD
authors: Zhang
authors: Department of Nuclear Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210009, China.
authors: Chen-Qi
authors: CQ
authors: Xue
authors: Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China.
authors: Chen-Jiang
authors: CJ
authors: Wu
authors: Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210009, China.
authors: Jun
authors: J
authors: Tao
authors: Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210009, China.
authors: Wan-Li
authors: WL
authors: Zhou
authors: Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China.
authors: Hai-Bin
authors: HB
authors: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011817:Rabbits; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: CT; Patlak plot; Split kidney glomerular filtration rate