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  • Title: Feasibility of triphasic CT with a modified two-point Patlak plot to determine spit kidney glomerular filtration rate in clinical practice.
    Author: Zhang YD, Xue CQ, Wu CJ, Tao J, Zhou WL, Shi HB.
    Journal: Abdom Radiol (NY); 2017 Jan; 42(1):226-235. PubMed ID: 27503300.
    Abstract:
    PURPOSE: To investigate whether triphasic CT with a simplified Patlak plot can be used in clinical practice for the estimate of split kidney glomerular filtration rate (SKGFR). MATERIALS AND METHODS: The animal experiment included 15 rabbits that underwent 40 dynamic contrast-enhanced CT scans of the kidneys with 1.5 s time interval. Patlak-derived SKGFR was obtained using standard forty-point, two-point (unenhanced phase, arterial phase t α, and portovenous phase t β), and a modified two-point (MTP) (unenhanced, t α, t β, and a virtual t τ [t τ = (t α + t β)/2]) image data, respectively. The MTP-Patlak plot approach was then validated in 13 patients who underwent a triphasic renal contrast-enhanced CT examination. SKGFR measured by 99mTc-DTPA clearance was as a standard reference. RESULTS: MTP-Patlak significantly reduced input function errors than two-point Patlak (21.1 ± 16.2 % vs 30.8 ± 15.2 %, p < 0.01) and showed good concordance with standard Patlak for measurement of SKGFR in animal experiment (1.20 ± 0.38 mL/g/min vs 1.51 ± 0.43 mL/g/min; linear correlation coefficient r = 0.87, p < 0.001). Human study showed that mean SKGFR was 45.7 mL/min (range, 26.5-86.2 mL/min) obtained from 99mTc-DTPA, and 38.2 mL/min (range, 18.6-79.3 mL/min) obtained from triphasic CT using MTP-Patlak plot. Linear correlation between the two methods was r = 0.75 (p < 0.01). The mean difference between SKGFRs as determined with the two methods was 7.4 ± 9.0 mL/min. CONCLUSION: The MTP-Patlak approach, featured with simplicity, is feasible in a clinically indicated CT examination for the evaluation of split renal function.
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