Prospective comparison between DCE-MRR and 99mTc-DTPA-based SPECT for determination of allograft renal function

Abstract

Background: Glomerular filtration rate (GFR) is a preferred indicator of allograft renal function, but direct measurement of GFR remains complicated. Purpose: To prospectively compare dynamic contrast-enhanced MR renography (DCE-MRR) with 99mTc-DTPA-based single-photon emission computed tomography (SPECT) for determination of allograft renal function. Study Type: Prospective. Population: Seventy kidney-transplant recipients. Field Strength: A low-dose DCE-MRR with a 3.0T scanner and a 99mTc-DTPA-based SPECT after renal transplantation were performed. Assessment: 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. Statistical Tests: Pearson correlation test and Bland–Altman agreement analysis. Results: 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. Data Conclusion: DCE-MRR using JZ2C is superior to 99mTc-DTPA-based SPECT to determine allograft renal function. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2019;49:262–269.