Nicholas Walle MD, Presenter: Nothing to Disclose

Michael David Beland MD, Abstract Co-Author: Speakers Bureau, General Electric Company

William W. Mayo-Smith MD, Abstract Co-Author: Nothing to Disclose

John J. Cronan MD, Abstract Co-Author: Nothing to Disclose

Susie Hu MD, Abstract Co-Author: Nothing to Disclose

Scott Collins RT, Abstract Co-Author: Nothing to Disclose

Evaluation of a potential renal donor often includes renal CT angiography (CTA) and direct measurements of renal function. The purpose of this study is to determine if measurements of segmented renal cortical volumes versus total renal volumes calculated from renal donor CTAs correlate with available renal function data, thus providing additional data to estimate renal function prior to renal transplantation.

An IRB approved, HIPAA compliant retrospective search of the renal donor database identified 25 patients (8 M, 17 F, mean age 44 years) who underwent renal CTA and 24 hour creatinine clearance prior to donor nephrectomy at our institution from October 2007- May 2009. All renal donor CTAs were performed on a 64-detector row scanner in the corticomedullary phase. Total renal volumes and total renal cortical volumes were then calculated using volume rendering software at the CT workstation and then manual thresholding (using 118HU for the low value) to select renal cortical volumes. Bilateral cortical and total renal volumes were added in each patient. Statistical analysis was done using the Pearson correlation coefficient and Fisher Z transformation.

Mean (range) total renal volume was 363 mL (246-507 mL) and mean segmented cortical volume was 208 mL (148-274 mL). Mean 24 hour creatinine clearance was 134 mL/min (48-220 mL/min). The correlation between total renal volumes and twenty-four hour creatinine clearance was +0.68 and the correlation between segmented cortical renal volumes and 24 hour creatinine clearance was +0.50. This difference was not significantly different (p=0.17).

Manually segmented renal cortical volumes were not better correlated with 24 hour creatinine clearance than total renal volume. Total renal volumes derived from CTA may serve as a surrogate estimation of renal function in patients being evaluated as potential renal donors.

The labor intensive manual segmentation of cortical volume does not correlate better with renal function than total renal volume and is unlikely to provide added benefit in renal transplant donors.

Walle, N, Beland, M, Mayo-Smith, W, Cronan, J, Hu, S, Collins, S, Do Segmented Cortical Volumes Calculated on Renal Donor CT Angiograms Correlate with Renal Function?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009284.html