ABSTRACT
PURPOSE: whilst renal scintigraphy (RS) can be associated with interobserver variability, it remains the standard method of evaluating split renal function. AIM: to compare the efficacy of the novel technique of kidney function assessment and renal scintigraphy. METHOD: for this prospective single-arm study we recruited patients who were recommended dynamic renal scintigraphy with 99mTc-DTPA (diethylenetriaminepentacetate). After scintigraphy, mathematical analysis of computed tomography (MACT) was done in all patients, by a single person (SK) blinded to RS results. RESULTS: the study included a total of 97 patients with mean age of 50.9 (range, 23-78) years. From this sample, 65 were females and 32 males. All patients underwent both RS and contrast-enhanced computed tomography for further MACT in 2016-2018. CT results were found to be similar to renal scintigraphy results with Pearson correlation coefficient of 0.945 (Ñ < 0.001). Substantial similarities in renal plasma flow for both kidneys were also observed (0.815, Ñ < 0.001). CONCLUSION: MACT proved feasible, effective and safe in estimating renal function. Its results are closely correlated with RS findings and could be easily integrated into surgical practice.
Subject(s)
Contrast Media , Kidney/diagnostic imaging , Kidney/physiopathology , Radiographic Image Enhancement/methods , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical data , Adult , Aged , Female , Glomerular Filtration Rate , Humans , Kidney Function Tests/methods , Kidney Function Tests/statistics & numerical data , Male , Middle Aged , Models, Biological , Models, Theoretical , Observer Variation , Prospective Studies , Radionuclide Imaging/methods , Radionuclide Imaging/statistics & numerical data , Reproducibility of Results , Young AdultABSTRACT
Contrast-enhanced multi-slice computed tomography (MSCT) is commonly used in the diagnosis of complex malignant tumours. This technology provides comprehensive and accurate information about tumour size and shape in relation to solid tumours and the affected adjacent organs and tissues. This case report demonstrates the benefit of using MSCT 3D imaging for preoperative planning in a patient with late-stage (T4) sarcomatoid renal cell carcinoma, a rare renal malignant tumour. The surgical margin on the liver was negative, and no metastases to veins, lungs or other organs were detected by abdominal and chest contrast-enhanced CT. Although sarcomatoid histology is considered to be a poor prognostic factor, the patient is alive and well 17 months after surgery. The MSCT imaging modality enables 3D rendering of an area of interest, which assists surgical decision-making in cases of advanced renal tumours. In this case, as a result of MSCT 3D reconstruction, the patient received justified surgical treatment without compromising oncological principles.
