Abstract
ObjectivesThis study was to assess the feasibility of a modified multiphasic CT scan protocol combined with homemade software measurements of glomerular filtration rate (CT-GFR) and explore the effect of renal tumor volume on the calculation of CT-GFR.Materials and MethodsProspective observational study comparing three methods of GFR measurement from February 2017 to December 2017, 91 patients with unilateral renal tumor underwent both a modified multiphasic CT scans of kidney and serum creatinine (Scr) tests preoperatively, of which 15 cases underwent additional radionuclide examination. Total and split CT-GFR, with or without renal tumor, were quantified by the homemade software in early and late renal parenchymal phases, respectively. The volume of renal tumor was quantified by the homemade software. Correlation and difference between CT-GFR and traditional methods of GFR measurement, including estimated GFR (eGFR) from Scr concentration and split GFR using of radionuclide examination (R-GFR), were performed.ResultsThere is a strong correlation between CT-GFR with renal tumor and eGFR (r = 0.90, p < 0.001) in early renal parenchymal phase. The relative CT-GFR in early renal parenchymal phase was highly correlated with the relative R-GFR (r = 0.88, p < 0.001). Renal tumor volume significantly correlated with the value of CT-GFR that determined by subtracting the CT-GFR measurement without renal tumor from CT-GFR measurement with renal tumor (r = 0.89, p < 0.001).ConclusionA modified multiphasic CT scan protocol combined with homemade software might be an alternative technique for the evaluation of renal function for the patients with unilateral renal tumor.
Highlights
Glomerular filtration rate (GFR) is still considered as the best indicator in clinical assessment of renal function
We introduced a modified multiphasic CT scan protocol of whole kidney in combination with a homemade software for measuring GFR based on the technique of Patlak plot
Renal tumor volume significantly correlated with the value of CT-GFR that determined by subtracting the CT-GFR measurement without renal tumor from CT-GFR measurement with renal tumor (r = 0.89, p < 0.001)
Summary
Glomerular filtration rate (GFR) is still considered as the best indicator in clinical assessment of renal function. Inulin clearance is considered a gold standard for total GFR determination. It can not be applied widely in clinical practice because of its technical complexity and time-consuming procedure (Ingelfinger and Marsden, 2013). Radionuclide examination has several disadvantages including exposure to radioisotopes, short length of patient isolation following the study, and can not estimate the effect of volume of renal tumor on the accuracy of renal function measurement (Kerl and Cook, 2005). Few studies have reported GFR measurement using CT in patients with renal tumor, and few studies have explored the effect of the tumor itself on renal function
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