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Mp19-08 Magnetic Resonance (mr) Renography: a More Reliable Measure of Change in Single Kidney Function After Partial Nephrectomy

Year: 2016
Type: article
Abstract: You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2016MP19-08 MAGNETIC RESONANCE (MR) RENOGRAPHY: A MORE RELIABLE MEASURE OF CHANGE IN SINGLE KIDNEY FUNCTION AFTER PARTIAL NEPHRECTOMY Dmitry Volkin, Stella Kang, and William C Huang Dmitry VolkinDmitry Volkin More articles by this author , Stella KangStella Kang More articles by this author , and William C HuangWilliam C Huang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2756AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Single kidney GFR (skGFR) changes after partial nephrectomy are the most sensitive indicator of operative effects on renal function, but conventional techniques for measurement are impractical and invasive. As a proxy, kidney volume has been used to estimate post-operative kidney function, using cylindrical formulas to estimate the proportion of preserved function. MR renography is a previously validated, accurate technique for measurement of skGFR and can be performed as a 10 minute adjunct to pre- and post-operative clinical MRI. We hypothesized that MR renography captures post-operative changes in skGFR more reliably than estimation based on changes in cylindrical volume. METHODS Patients enrolled in this IRB approved prospective study underwent MRI of the abdomen/pelvis with MR renography to determine skGFR. Scans were obtained preoperatively, and at 2 days and 6 months after partial nephrectomy. We also approximated kidney volume at each time point using the cylindrical formula as previously described in the literature. In each kidney, the volume-estimated GFR (veGFR) was the proportion of the baseline skGFR preserved at both postoperative timepoints. We then compared veGFR to the actual postoperative skGFR measured using MR renography. RESULTS Seventeen patients had pre- and early post-operative imaging; 10 completed the protocol at 6 months. Early post-operatively, operated kidney veGFR overestimated directly measured skGFR by 6% to 552%. In the non-operated kidney the discrepancy between the two ranged from -29% to 65%. By 6 months, veGFR was still unreliable when compared to the MR-based skGFR in either kidney. Differences in the operated kidney ranged from -47% to 64% and -17% to 128% in the non-operated unit. At 6 months, only 40% of patients had a veGFR in the operative kidney that came within 25% of directly measured skGFR; this was the case in 70% of patients in the non-operated kidney. CONCLUSIONS MR renography is a more reliable method of measuring changes in skGFR than the commonly used technique tested in our study, especially in the operated kidney. MR renography can easily be incorporated into the management algorithm for kidney surgery as part of MRI staging and follow up. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e206-e207 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Dmitry Volkin More articles by this author Stella Kang More articles by this author William C Huang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
DOI: 10.1016/j.juro.2016.02.2756
Language: English
Field: Medicine
Open Access status: bronze
OpenAlex ID: W2326897375
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