Prospective comparison between DCE-MRR and ^99m Tc-DTPA-based SPECT for determination of allograft renal function.

Wan‐Li, Zhou; Jun, Tao; Yu‐Dong, Zhang; Fei, Shuang; Zhijian, Han; Chen‐Jiang, Wu; Zijie, Wang; Yongjun, Li; Hongliang, Que; Zhengkai, Huang; Zengjun, Wang; Ruoyun, Tan; Min, Gu; Wan-Li, Zhou; Yu-Dong, Zhang; Chen-Jiang, Wu

<bold>Background: </bold>Glomerular filtration rate (GFR) is a preferred indicator of allograft renal function, but direct measurement of GFR remains complicated.<bold>Purpose: </bold>To prospectively compare dynamic contrast-enhanced MR renography (DCE-MRR) with 99m Tc-DTPA-based single-photon emission computed tomography (SPECT) for determination of allograft renal function.<bold>Study Type: </bold>Prospective.<bold>Population: </bold>Seventy kidney-transplant recipients FIELD STRENGTH: A low-dose DCE-MRR with a 3.0T scanner and a 99m Tc-DTPA-based SPECT after renal transplantation were performed.<bold>Assessment: </bold>A Baumann-Rudin (BR) and a modified two-compartment model (JZ2C) were used for DCE-MRR analysis. Standard Gate's method was used for SPECT analysis. An endogenous creatinine clearance rate (CCr) constituted the reference standard.<bold>Statistical Tests: </bold>Pearson correlation test and Bland-Altman agreement analysis.<bold>Results: </bold>The reference CCr-GFR was 59.58 ± 23.72 mL/min/1.73 m2 . GFR determined by eGFR, BR, JZ2C, and SPECT was 90.22 ± 34.38, 36.78 ± 14.46, 48.99 ± 23.88, and 67.32 ± 18.44 mL/min/1.73 m2 , respectively. DCE-MRR using JZ2C had the best overall performance, with a Pearson correlation coefficient of 0.81, a bias of -10.58 mL/min/1.73 m2 , and a precision of 14.61 mL/min/1.73 m2 , as well as high accuracy (30-50% intervals: 74.3-90.0%). Although SPECT had a small bias (7.74 mL/min/1.73 m2 ), it had a poor correlation coefficient (0.38), poor precision (23.93 mL/min/1.73 m2 ), and low accuracy (64.3-72.3%) as compared with DCE-MRR using JZ2C.<bold>Data Conclusion: </bold>DCE-MRR using JZ2C is superior to 99m Tc-DTPA-based SPECT to determine allograft renal function.<bold>Level Of Evidence: </bold>2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:262-269.

Journal of Magnetic Resonance Imaging, 2019, Vol 49, Issue 1, p262

1053-1807

Academic Journal

10.1002/jmri.26188