A New Approach for Split Renal Function Assessment Based on 3D-Models Generated from Contrast-enhanced Multi-slice Computed Tomography (Msct) Scans and Mathematical Analysis: A Pilot Study

Abstract

Introduction: Instrumental methods of examination may alter the course of treatment and patients’ management: from minimally invasive nephron-sparing procedures to radical operations. Objective:to present preliminary data on split kidney function assessment (in a kidney volume, e.g. segment) in patients with urological diseases.
Materials and methods: A prospective study was launched in aResearch Institute for Uronephrology and Reproductive Health from November, 2015 to February, 2017. 31 patients were enrolled into the study: 15 with stone kidney disease, 2 with kidney anomalies, 14 with renal tumors. Contrast-enhanced CT with 3D-models and
mathematical analysis were performed in all patients. Correlation between CT-based and renal scintigraphy-based measures of split renal function was estimated.


Results: CT-based methods for the calculation of split renal function with 3D-models showed correlation with renal scintigraphy (p<0.004, ttest). Conclusion: A new approach for split kidney function assessment based on contrast-enhanced CT with 3D-models and mathematical analysis allows for both acquiring detailed data on clinical anatomy and evaluation of renal function to promote preoperative decision-making.

References
[1] El-Diastya M T, Gaballab G, Gadc H M, Borgb M A, Abou-Elgharc M E, Sheirc K Z and El- Diastyc T A 2016 Evaluation of CT perfusion parameters for assessment of split renal function in healthy donors The Egyptian Journal of Radiology and Nuclear Medicine 47-4 1681–88


[2] Lin K-J, Huang J-Y and Chen Y-S 2011 Fully Automatic Region of Interest Selection in Glomerular Filtration Rate Estimation from 99mTc-DTPA Renogram Journal of Digital Imaging24(6) 1010-23


[3] Fiev D N 2015 Virtual modelling for preoperative decision-making in kidney deseases(Moscow) pp 3-42


[4] Wesolowski C A, Wanasundara S N, Wesolowski M J, Erbas B and Babyn P S Eur2016 J Nucl Med Mol Imaging 43: 550.


[5] Nilsson H., Wadström J., Andersson L.‐G., Raland H. and Magnusson A. Measuring split renal function in renal donors: can computed tomography replace renography? Acta Radiologica 45-4, pp. 474 – 480


[6] Alyaev Yu G et al 2014 3D technology for kidney surgery: from virtual to real surgeryedP V Glybochko and Yu G Alyaev(Moscow: GEOTAR)pp 5-280


[7] Veenboer, P. W., Hobbelink, M. G. G., Ruud Bosch, J. L. H., Dik, P., van Asbeck, F. W. A., Beek, F. J. A. and de Kort 2015 Diagnostic accuracy of Tc-99m DMSA scintigraphy and renal ultrasonography for detecting renal scarring and relative function in patients with spinal dysraphism. Neurourol. Urodynam.,34: 513–518.


[8] Kumar K, Ahmad A, Kumar S, Choudhry V, Kumar R, Singh T M and Muzaffar M A 2015 Evaluation of renal histopathological changes, as a predictor of recoverability of renal function following pyeloplasty for ureteropelvic junction obstruction Nephro Urol Mon. 7(4): e28051.


[9] Torimoto I, Takebayashi S, Sekikawa Z, Teranishi J, Uchida K and Inoue T 2015 Renal perfusional cortex volume for arterial input function measured by semiautomatic segmentation technique using MDCT angiographic data with 0.5-mm collimation AJR Am J Roentgenol. 204(1):98-104.