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First published online September 13, 2006
British Journal of Radiology (2006) 79, 935-942
© 2006 British Institute of Radiology
doi: 10.1259/bjr/53140218
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Short communication

A simple processing method allowing comparison of renal enhancing volumes derived from standard portal venous phase contrast-enhanced multidetector CT images to derive a CT estimate of differential renal function with equivalent results to nuclear medicine quantification

J C Fowler, MA, FRCR, MSc, C Beadsmoore, MBBS, MRCP, FRCR, M T G Gaskarth, MA, FRCS, FRCR, H K Cheow, MBChB, FRCR, MSc, R Bernal, MD, MSc, P Hegarty, FRCS (Urol), MCh, K N Bullock, MD, FRCS, H Taylor, MA, MRCP, FRCR, A K Dixon, MD, FRCR, FMedSci and A M Peters, MD, FRCR, FMedSci

Departments of Radiology, Nuclear Medicine and Urology, Addenbrooke's Hospital and the University of Cambridge, Cambridge, UK

Correspondence: Dr J Charlotte Fowler, Department of Diagnostic Imaging, Luton and Dunstable NHS Trust, Luton LU4 0DZ, UK. E-mail: charlotte.fowler{at}ldh.nhs.uk

As iodinated contrast medium is cleared by glomerular filtration, it should be possible to apply the same principles utilized in radionuclide studies to derive differential renal function by comparison of enhancing renal volumes derived from contrast enhanced multidetector CT (CEMDCT). Having established a technique iteratively which appeared successful, a retrospective study was performed using 25 consecutive patients with a wide range of urological conditions who had undergone both CEMDCT, including the renal area in the portal venous phase, and nuclear medicine (NM) assessment of renal function with no urological intervention between the studies. Proprietary volume software was used to quantify the volume and attenuation of each kidney, the products of which (after subtraction of soft tissue attenuation derived from a region of interest over psoas) gave right and left enhancing renal volumes. The contribution by each kidney as a percentage of total renal enhancing tissue was derived. Comparison with NM studies resulted in excellent correlation of relative renal function by CEMDCT and NM assessments having a regression of near unity and a Pearson's correlation coefficient of 0.96. Bland Altman and Passing Bablock tests confirmed good agreement between the two methods with no bias. This is a simple, practicable processing technique using standard portal venous phase CEMDCT images to quantify differential function. This technique may allow a one-stop CT assessment of both anatomy and function.






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