title: Determination of Glomerular Filtration Rate with CT Measurement of Renal Clearance of Iodinated Contrast Material versus99mTc-DTPA Dynamic Imaging "Gates" Method: A Validation Study in Asymmetrical Renal Disease.
abstract: Purpose To validate a computed tomographic (CT) glomerular filtration rate (GFR) measurement and compare it with renal dynamic imaging GFR obtained by using the "Gates" method, with dual plasma sampling technetium 99m (99mTc) diethylenetriaminepenta-acetic acid (DTPA) clearance ("true GFR") as the reference standard. Materials and Methods This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Forty-two patients with unilateral renal disease were included. Single-kidney CT GFR was calculated as excretory phase whole-kidney CT number enhancement divided by the area under the time-attenuation curve for the aorta, multiplied by (1 - hematocrit level). The CT GFR was then obtained by summing the result of the two sides. The true GFR and the Gates GFR were measured by using a single injection of99mTc-DTPA. The CT GFR and Gates GFR were respectively compared with the true GFR by using a paired t test and linear regression analysis. Results The difference between CT GFR (mean ± standard deviation, 96.02 mL/min ± 23.11) and true GFR (90.50 mL/min ± 21.46) was 5.51 mL/min ± 6.96 (P < .001), demonstrating 6.09% systemic overestimation. The difference between Gates GFR (93.93 mL/min ± 26.97) and true GFR was 3.42 mL/min ± 16.10 (P = .176). Linear regression findings confirmed the association between CT GFR (y-axis) and true GFR (x-axis) and between Gates GFR (y-axis) and true GFR (x-axis) (P < .001 for both). Both regression lines paralleled the diagonal (intercept = 0 and slope = 1) (P = .599 and P = .945, respectively). The 95% confidence interval of the former was above the diagonal, confirming the systemic overestimation. The standard deviations of residuals of both linear regressions were 7.02 mL/min and 16.30 mL/min, respectively, demonstrating smaller deviation of the CT GFR (P < .001). Conclusion The proposed CT GFR measurement was validated in this study and was proved to be more accurate than the Gates method despite slight (6.09%) systemic overestimation.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: XiaoDong
authors.initials: X
authors.lastname: Yuan
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: Ke
authors.initials: K
authors.lastname: Tang
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: ChangBin
authors.initials: C
authors.lastname: Quan
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: Yuan
authors.initials: Y
authors.lastname: Tian
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: GuoKun
authors.initials: G
authors.lastname: Ao
authors.affiliation: From the Departments of Radiology (X.Y., J.Z., C.Q., Y.T., H.L., G.A.) and Neurosurgery (K.T.), the 309th Hospital of Chinese People's Liberation Army, 17 Heishanhu Rd, Haidian District, Beijing 100091, People's Republic of China; and Department of Nuclear Medicine, Peking University People's Hospital, Beijing, People's Republic of China (L.Q.).
authors.forename: Liheng
authors.initials: L
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011866:Radioisotope Renography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate