Determination of glomerular filtration rate per unit renal volume using computerized tomography: Correlation with conventional measures of total and divided renal function
Y. Tsushima et al., Determination of glomerular filtration rate per unit renal volume using computerized tomography: Correlation with conventional measures of total and divided renal function, J UROL, 165(2), 2001, pp. 382-385
Purpose: Previous studies suggest that functional computerized tomography (
CT) can measure glomerular filtration rate (GFR) per unit renal volume. We
compared this index with conventionally determined GFR measurements.
Materials and Methods: A total of 16 men and 8 women 63.3 +/- 14.9 years ol
d (range 31 to 88) were studied using with contrast enhanced CT. A single s
lice of kidney was scanned sequentially after bolus injection (0.5 to 1.0 m
l. per second(-1)) of 20 ml. iopamidol (300 mg. iodine per ml.-l). GFR per
volume of kidney was calculated using a Patlak graphical analysis and this
index was multiplied by renal volume on CT to yield global GFR (ml. per min
ute(-1)). Divided function was also calculated. GFR and divided renal funct
ion were calculated in all cases from radioisotope renography with (99m) di
ethylenetetraminepentaacetic acid. In 12 subjects in whom 24-hour urine col
lection was possible GFR was also calculated from creatinine clearance.
Results: A strong correlation was observed between divided renal function,
expressed with respect to the right kidney calculated from CT (52.7 +/- 14.
8%, range 19.9% to 97.4%) and by radioisotope renography (51.7 +/- 14.6%, r
ange 18.9% to 92.6%, r = 0.97, p <0.0001). A strong correlation (r = 0.92,
p <0.0001) was also seen between global GFR determined by CT (80.1 +/- 43.9
ml. per minute(-1), range 38.2 to 197.9) and creatinine clearance (72.4 +/
- 47.5, range 14.6 to 168.5), and was stronger than the correlation between
the radioisotope and creatinine clearance method (r = 0.67, p = 0.02) in t
he same patients.
Conclusion: Functional CT using nonionic contrast material can measure GFR
normalized to renal volume and is an accurate alternative to conventional m
ethods of renal function evaluation.