Dataset Information

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.

SUBMITTER: Jiang K

PROVIDER: S-EPMC6619810 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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

Jiang Kai K Ferguson Christopher M CM Abumoawad Abdelrhman A Saad Ahmed A Textor Stephen C SC Lerman Lilach O LO

PloS one 20190710 7

<h4>Objectives</h4>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).<h4>Methods</h4>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 ...[more]

PMID: 31291361

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Project description:PurposeRenal dynamic contrast-enhanced (DCE) MRI provides information on renal perfusion and filtration. However, clinical implementation is hampered by challenges in postprocessing as a result of misalignment of the kidneys due to respiration. We propose to perform automated image registration using the fat-only images derived from a modified Dixon reconstruction of a dual-echo acquisition because these provide consistent contrast over the dynamic series.MethodsDCE data of 10 hypertensive patients was used. Dual-echo images were acquired at 1.5 T with temporal resolution of 3.9 s during contrast agent injection. Dixon fat, water, and in-phase and opposed-phase (OP) images were reconstructed. Postprocessing was automated. Registration was performed both to fat images and OP images for comparison. Perfusion and filtration values were extracted from a two-compartment model fit.ResultsAutomatic registration to fat images performed better than automatic registration to OP images with visible contrast enhancement. Median vertical misalignment of the kidneys was 14 mm prior to registration, compared to 3 mm and 5 mm with registration to fat images and OP images, respectively (P = 0.03). Mean perfusion values and MR-based glomerular filtration rates (GFR) were 233 ± 64 mL/100 mL/min and 60 ± 36 mL/minute, respectively, based on fat-registered images. MR-based GFR correlated with creatinine-based GFR (P = 0.04) for fat-registered images. For unregistered and OP-registered images, this correlation was not significant.ConclusionAbsence of contrast changes on Dixon fat images improves registration in renal DCE MRI and enables automated postprocessing, resulting in a more accurate estimation of GFR. Magn Reson Med 80:66-76, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Project description:BackgroundThe presence of a few renal cysts is considered of little relevance in healthy adults, although acquired renal cystic disease occurs in advanced kidney failure. The objective of this study was to detail renal cystic and solid lesions and identify any association with clinical characteristics.Study designClinical-pathologic correlation.Setting & participantsPotential kidney donors undergoing a standardized evaluation at the Mayo Clinic in 2000-2008.PredictorsAge, kidney function, and chronic kidney disease risk factors.MeasurementsRenal cystic and solid lesions by contrast-enhanced computed tomographic images.OutcomesCyst number, diameter, and location.ResultsAfter excluding 8 with cystic disease, 7 of whom had autosomal dominant polycystic kidney disease, there were 1,948 potential kidney donors (42% men; mean age, 43 years). A cortical, medullary, or parapelvic cyst ≥5 mm was present in 12%, 14%, or 2.8%. For ages 19-49 years, 39%, 22%, 7.9%, and 1.6% had a cortical or medullary cyst ≥2, ≥5, ≥10, and ≥20 mm in diameter. For ages 50-75 years, 63%, 43%, 22%, and 7.8% had a cortical or medullary cyst ≥2, ≥5, ≥10, and ≥20 mm in diameter. The 97.5th percentile for number of cortical and medullary cysts ≥5 mm increased with age (10 for men and 4 for women in the 60- to 69-year group). After age and sex adjustment, cortical and medullary cysts ≥5 mm were associated with higher 24-hour urine albumin excretion, as well as increased body surface area, hypertension, and higher glomerular filtration rate in some analyses. Angiomyolipomas, hyperdense cysts, and enhancing masses or cysts with concerning features for malignancy occurred in 2.2%, 1.2%, and 0.6% and were associated with older age (P ≤ 0.05 for each).LimitationsPersons with known chronic kidney disease were excluded.ConclusionsRenal cysts are common, particularly in older men, and may be a marker of early kidney injury because they associate with albuminuria, hypertension, and hyperfiltration.

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

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

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