A simple method for determining split renal function from dynamic (99m)Tc-MAG3 scintigraphic data.
PURPOSE
Commonly used methods for determining split renal function (SRF) from dynamic scintigraphic data require extrarenal background subtraction and additional correction for intrarenal vascular activity. The use of these additional regions of interest (ROIs) can produce inaccurate results and be challenging, e.g. if the heart is out of the camera field of view. The purpose of this study was to evaluate a new method for determining SRF called the blood pool compensation (BPC) technique, which is simple to implement, does not require extrarenal background correction and intrinsically corrects for intrarenal vascular activity.


METHODS
In the BPC method SRF is derived from a parametric plot of the curves generated by one blood-pool and two renal ROIs. Data from 107 patients who underwent (99m)Tc-MAG3 scintigraphy were used to determine SRF values. Values calculated using the BPC method were compared to those obtained with the integral (IN) and Patlak-Rutland (PR) techniques using Bland-Altman plotting and Passing-Bablok regression. The interobserver variability of the BPC technique was also assessed for two observers.


RESULTS
The SRF values obtained with the BPC method did not differ significantly from those obtained with the PR method and showed no consistent bias, while SRF values obtained with the IN method showed significant differences with some bias in comparison to those obtained with either the PR or BPC method. No significant interobserver variability was found between two observers calculating SRF using the BPC method.


CONCLUSION
The BPC method requires only three ROIs to produce reliable estimates of SRF, was simple to implement, and in this study yielded statistically equivalent results to the PR method with appreciable interobserver agreement. As such, it adds a new reliable method for quality control of monitoring relative kidney function.
['Wesolowski|Michal J|MJ|', 'Conrad|Gary R|GR|', 'Šámal|Martin|M|', 'Watson|Gage|G|', 'Wanasundara|Surajith N|SN|', 'Babyn|Paul|P|', 'Wesolowski|Carl A|CA|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D007668:Kidney D008099:Liver D008297:Male D008875:Middle Aged D015588:Observer Variation D011786:Quality Control D011866:Radioisotope Renography D011877:Radionuclide Imaging D019275:Radiopharmaceuticals D012044:Regression Analysis D015203:Reproducibility of Results D017263:Technetium Tc 99m Mertiatide D055815:Young Adult
Split renal function Blood pool compensation Kidney function 99mTc-MAG3 scintigraphy Radionuclide renography