Abstract
References
- Sarier M, Sepin Ozen N, Guler H, et al. Prevalence of sexually transmitted diseases in asymptomatic renal transplant recipients. Exp Clin Transplant 2018; 1: 1-5.
- Sarier M, Callioglu M, Yuksel Y, Duman E, Emek M, Usta SS. Evaluation of the renal arteries of 2,144 living kidney donors using computed tomography angiography and comparison with ıntraoperative findings. Urologia Internationalis 2020; 104: 637–40.
- Patil UD, Ragavan A, Nadaraj, et al. Helical CT angiography in evaluation of live kidney donors. Nephrol Dial Transplant 2001; 16: 1900–4.
- Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit CareMed 2007; 176: 706-12.
- Raman SS, Pojchamarnwiputh S, Muangsomboon K, et al. Utility of 16-MDCT angiography for comprehensive preoperative vascular evaluation of laparoscopic renal donors. Am J Roentgenol 2006; 186: 1630–8.
- Carter JT, Freise CE, McTaggart RA, et al. Laparoscopic procurement of kidneys with multiple renal arteries is associated with increased ureteral complications in the recipient. Am J Transplant 2005; 5: 1312–8.
- Smith PA, Ratner LE, Lynch FC, Corl FM, Fishman EK. Role of CT angiography in the preoperative evaluation for laparoscopic nephrectomy. Radiographics 1998; 18: 589–601.
- Liefeldt L, Klüner C, Glander P, et al. Non-invasive imaging of living kidney donors: intraindividual comparison of multislice computed tomography angiography with magnetic resonance angiography. Clin Transplant 2012; 26: E412-7.
- Chai JW, Lee W, Yin YH, et al. CT angiography for living kidney donors: accuracy, cause of misinterpretation and prevalence of variation. Korean J Radiol 2008; 9: 333–9.
- Sebastia C, Peri L, Salvador R, et al. Multidetector CT of living renal donors: lessons learned from surgeons. Radiographics 2010; 30: 1875–90.
- Thomsen HS, Morcos SK, Barrett BJ. Contrast-induced nephropathy: the wheel has turned 360 degrees. Acta Radiol 2008; 49: 646-57.
- Lewington A, MacTier R, Hoefield R, Sutton A, Smith D, Downes M. Prevention of contrast induced acute kidney injury (CI-AKI) in adult patients. Royal College of Radiologist Guidelines 2013.
- Bae KT, Tao C, Gürel S, et al. Effect of patient weight and scanning duration on contrast enhancement during pulmonary multidetector CT angiography. Radiology 2007; 242: 582–9.
- Kawamoto S, Montgomery RA, Lawler LP, Horton KM, Fishman EK. Multi-detector CT angiography for preoperative evaluation of living laparoscopic kidney donors. AJR Am J Roentgenol 2003; 180: 1633-8.
- Türkvatan A, Akıncı S, Yıldız Ş, Ölçer T, Cumhur T. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors. Surg Radiol Anat 2009; 31: 227–35.
- Han WK, Na JC, Park SY. Low-dose CT angiography using ASiR-V for potential living renal donors: a prospective analysis of image quality and diagnostic accuracy. European Radiology 2019; 30: 798-805.
- Diniz G, Tugmen C, Sert İ. Türkiye ve Dünyada organ transplantasyonu. Tepecik Eğit ve Araşt Hast Dergisi 2019; 29: 1–10.
- Black CK, Termanini KM, Aguirre O, Hawksworth JS, Sosin M. Solid organ transplantation in the 21st century. Ann Transl Med 2018; 6: 409–10.
- Hainninen EL, Denecke T, Stelter L, et al. Preoperative evaluation of living kidney donors using multirow detector computed tomography: comparison with digital substraction angiography and intraoperative findings. Transpl Int 2005; 18: 1134–41.
- Ethics Committee of the Transplantation Society. The consensus statement of the Amsterdam Forum on the care of the live kidney donor. Transplantation 2004; 78: 491-2.
- Derauf B, Goldberg ME. Angiographic assessment of potential renal transplant donors. Radiol Clin North Am 1987; 25: 261–5.
- Jha RC, Korangy SJ, Ascher SM, Takahama J, Kuo PC, Johnson LB. MR angiography and preoperative evaluation for laparoscopic donor nephrectomy. AJR Am J Roentgenol 2002; 178: 1489–95.
- Halpern EJ, Mitchell DG, Wechsler RJ, Outwater EK, Moritz MJ, Wilson GA. Preoperative evaluation of living renal donors: comparison of CT angiography and MR angiography. Radiology 2000; 216: 434–9.
- Fleischmann D. How to design injection protocols for multiple detector-row CT angiography (MDCTA) Eur Radiol 2005;15 Suppl 5: e60–5.
- Rankin SC, Jan W, Koffman CG. Noninvasive Imaging of Living Related Kidney Donors. Am J Roentgenol 2001; 177: 349–55.
- Ghonge N, Gadanayak S, Rajakumari V. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know? Indian J Radiol Imaging 2014; 24: 367.
- Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagnostic and Interventional Imaging 2016; 97: 891–7.
- Holden A, Smith A, Dukes P, Pilmore H, Yasutomi M. Assessment of 100 live potential renal donors for laparoscopic nephrectomy with multi–detector row helical CT. Radiology 2005; 237: 973–80.
- Kim JK, Park SY, Kim H, et al. Living donor kidneys: usefulness of multi–detector row CT for comprehensive evaluation. Radiology 2003; 229: 869–76.
- Caoili EM, Cohan RH, Korobkin M, et al. Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 2002; 222: 353–60.
Comparison of low-dose contrast computed tomography angiography findings with surgical results in living kidney donors
Abstract
Aim: To analyze the image quality and diagnostic performance of CT angiography using low dose (60 ml) contrast medium for living kidney donors and compare with surgical results.
Material and Method: Angiographic findings of 81 renal donor candidates in 128-slice MDCT were evaluated by two independent radiologists in terms of renal artery number, early bifurcation, renal vein variations, pelvicalyceal system and ureter variations. Results were compared with intraoperative findings. The image quality, diagnostic performance and interobserver agreement of MDCT obtained with low dose contrast material were analyzed.
Results: The mean age of the 81 living kidney donors included in the study was 49±12 (24-68) years. Left nephrectomy was performed in 71% (n=64) and right nephrectomy in 29% (n=17) of the donors. Intraoperative accessory arteries were detected in 22.2% (n:18) of the donors. The specificity, sensitivity, and accuracy for detecting accessory artery variation in MDCT were 100%, 88.9%, and 97.5%, respectively. Early bifurcation was observed in 21% (n=17) of the donors. Specificity, sensitivity and accuracy for early bifurcation detection were 98.4%, 94.1% and 97.5%, respectively. Renal vein variation was detected in 12.3% (n=10) of the donors. Specificity, sensitivity, and accuracy for renal vein variation detection were 100%. Variations of the pelvicalyceal system and ureter were observed in 3.7% (n=3) of the donors. The specificity, sensitivity, and accuracy for detecting pelvicalyceal system and ureteral variations were 100%. Interobserver agreement was excellent in detecting variations of accessory arteries, renal venous anomalies, pelvicalyceal system and ureters by MDCT (kappa: 1,000; p< 0.001). It was higher in early bifurcation detection (kappa: 0.853; p< 0.001).
Conclusion: MDCT angiography with a lower dose of iodine contrast at 60 mL in kidney donors is sufficient to detect vascular anomalies and provide anatomical information. It is possible to reduce the contrast agent dose in CTA without affecting the preoperative evaluation.
Keywords
Multidetector computed tomography Kidney Transplantation Contrast dose Contrast dose reduction
References
- Sarier M, Sepin Ozen N, Guler H, et al. Prevalence of sexually transmitted diseases in asymptomatic renal transplant recipients. Exp Clin Transplant 2018; 1: 1-5.
- Sarier M, Callioglu M, Yuksel Y, Duman E, Emek M, Usta SS. Evaluation of the renal arteries of 2,144 living kidney donors using computed tomography angiography and comparison with ıntraoperative findings. Urologia Internationalis 2020; 104: 637–40.
- Patil UD, Ragavan A, Nadaraj, et al. Helical CT angiography in evaluation of live kidney donors. Nephrol Dial Transplant 2001; 16: 1900–4.
- Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi GF. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit CareMed 2007; 176: 706-12.
- Raman SS, Pojchamarnwiputh S, Muangsomboon K, et al. Utility of 16-MDCT angiography for comprehensive preoperative vascular evaluation of laparoscopic renal donors. Am J Roentgenol 2006; 186: 1630–8.
- Carter JT, Freise CE, McTaggart RA, et al. Laparoscopic procurement of kidneys with multiple renal arteries is associated with increased ureteral complications in the recipient. Am J Transplant 2005; 5: 1312–8.
- Smith PA, Ratner LE, Lynch FC, Corl FM, Fishman EK. Role of CT angiography in the preoperative evaluation for laparoscopic nephrectomy. Radiographics 1998; 18: 589–601.
- Liefeldt L, Klüner C, Glander P, et al. Non-invasive imaging of living kidney donors: intraindividual comparison of multislice computed tomography angiography with magnetic resonance angiography. Clin Transplant 2012; 26: E412-7.
- Chai JW, Lee W, Yin YH, et al. CT angiography for living kidney donors: accuracy, cause of misinterpretation and prevalence of variation. Korean J Radiol 2008; 9: 333–9.
- Sebastia C, Peri L, Salvador R, et al. Multidetector CT of living renal donors: lessons learned from surgeons. Radiographics 2010; 30: 1875–90.
- Thomsen HS, Morcos SK, Barrett BJ. Contrast-induced nephropathy: the wheel has turned 360 degrees. Acta Radiol 2008; 49: 646-57.
- Lewington A, MacTier R, Hoefield R, Sutton A, Smith D, Downes M. Prevention of contrast induced acute kidney injury (CI-AKI) in adult patients. Royal College of Radiologist Guidelines 2013.
- Bae KT, Tao C, Gürel S, et al. Effect of patient weight and scanning duration on contrast enhancement during pulmonary multidetector CT angiography. Radiology 2007; 242: 582–9.
- Kawamoto S, Montgomery RA, Lawler LP, Horton KM, Fishman EK. Multi-detector CT angiography for preoperative evaluation of living laparoscopic kidney donors. AJR Am J Roentgenol 2003; 180: 1633-8.
- Türkvatan A, Akıncı S, Yıldız Ş, Ölçer T, Cumhur T. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors. Surg Radiol Anat 2009; 31: 227–35.
- Han WK, Na JC, Park SY. Low-dose CT angiography using ASiR-V for potential living renal donors: a prospective analysis of image quality and diagnostic accuracy. European Radiology 2019; 30: 798-805.
- Diniz G, Tugmen C, Sert İ. Türkiye ve Dünyada organ transplantasyonu. Tepecik Eğit ve Araşt Hast Dergisi 2019; 29: 1–10.
- Black CK, Termanini KM, Aguirre O, Hawksworth JS, Sosin M. Solid organ transplantation in the 21st century. Ann Transl Med 2018; 6: 409–10.
- Hainninen EL, Denecke T, Stelter L, et al. Preoperative evaluation of living kidney donors using multirow detector computed tomography: comparison with digital substraction angiography and intraoperative findings. Transpl Int 2005; 18: 1134–41.
- Ethics Committee of the Transplantation Society. The consensus statement of the Amsterdam Forum on the care of the live kidney donor. Transplantation 2004; 78: 491-2.
- Derauf B, Goldberg ME. Angiographic assessment of potential renal transplant donors. Radiol Clin North Am 1987; 25: 261–5.
- Jha RC, Korangy SJ, Ascher SM, Takahama J, Kuo PC, Johnson LB. MR angiography and preoperative evaluation for laparoscopic donor nephrectomy. AJR Am J Roentgenol 2002; 178: 1489–95.
- Halpern EJ, Mitchell DG, Wechsler RJ, Outwater EK, Moritz MJ, Wilson GA. Preoperative evaluation of living renal donors: comparison of CT angiography and MR angiography. Radiology 2000; 216: 434–9.
- Fleischmann D. How to design injection protocols for multiple detector-row CT angiography (MDCTA) Eur Radiol 2005;15 Suppl 5: e60–5.
- Rankin SC, Jan W, Koffman CG. Noninvasive Imaging of Living Related Kidney Donors. Am J Roentgenol 2001; 177: 349–55.
- Ghonge N, Gadanayak S, Rajakumari V. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know? Indian J Radiol Imaging 2014; 24: 367.
- Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagnostic and Interventional Imaging 2016; 97: 891–7.
- Holden A, Smith A, Dukes P, Pilmore H, Yasutomi M. Assessment of 100 live potential renal donors for laparoscopic nephrectomy with multi–detector row helical CT. Radiology 2005; 237: 973–80.
- Kim JK, Park SY, Kim H, et al. Living donor kidneys: usefulness of multi–detector row CT for comprehensive evaluation. Radiology 2003; 229: 869–76.
- Caoili EM, Cohan RH, Korobkin M, et al. Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 2002; 222: 353–60.
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| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Publication Date | January 17, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 1 |
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