A modified two-compartment model for measurement of renal function using dynamic contrast-enhanced computed tomography.

Abstract

OBJECTIVES:

To validate and adapt a modified two-compartment model, originally developed for magnetic resonance imaging, for measuring human single-kidney glomerular filtration rate (GFR) and perfusion using dynamic contrast-enhanced computed tomography (DCE-CT).

METHODS:

This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Thirty-eight patients with essential hypertension (EH, n = 13) or atherosclerotic renal artery stenosis (ARAS, n = 25) underwent renal DCE-CT for GFR and perfusion measurement using a modified two-compartment model. Iothalamate clearance was used to measure reference total GFR, which was apportioned into single-kidney GFR by renal blood flow. Renal perfusion was also calculated using a conventional deconvolution algorithm. Validation of GFR and perfusion and inter-observer reproducibility, were conducted by using the Pearson correlation and Bland-Altman analysis.

RESULTS:

Both the two-compartment model and iothalamate clearance detected in ARAS patients lower GFR in the stenotic compared to the contralateral and EH kidneys. GFRs measured by DCE-CT and iothalamate clearance showed a close match (r = 0.94, P<0.001, and mean difference 2.5±12.2mL/min). Inter-observer bias and variation in model-derived GFR (r = 0.97, P<0.001; mean difference, 0.3±7.7mL/min) were minimal. Renal perfusion by deconvolution agreed well with that by the compartment model when the blood transit delay from abdominal aorta to kidney was negligible.

CONCLUSION:

The proposed two-compartment model faithfully depicts contrast dynamics using DCE-CT and may provide a reliable tool for measuring human single-kidney GFR and perfusion.

• Authors: Kai Jiang, Christopher M Ferguson, Abdelrhman Abumoawad, Ahmed Saad, Stephen C Textor, Lilach O Lerman
• Journal: PloS one (PLoS One) Vol. 14 Issue 7 Pg. e0219605 ( 2019) ISSN: 1932-6203 [Electronic] United States
• PMID: 31291361 (Publication Type: Journal Article, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Validation Study)

Chemical References

• Contrast Media

Topics

• Aged
• Atherosclerosis (complications)
• Contrast Media (administration & dosage)
• Essential Hypertension (diagnosis, physiopathology)
• Female
• Glomerular Filtration Rate (physiology)
• Humans
• Image Processing, Computer-Assisted (methods)
• Kidney (blood supply, diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Models, Biological
• Prospective Studies
• Renal Artery Obstruction (diagnosis, etiology, physiopathology)
• Renal Circulation (physiology)
• Reproducibility of Results
• Tomography, X-Ray Computed (methods)