Prospective Comparison Between Dce-Mrr And Tc-99m-Dtpa-Based Spect For Determination Of Allograft Renal Function

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 Tc-99m-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 Tc-99m-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 m(2). 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 m(2), 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 m(2), and a precision of 14.61 mL/min/1.73 m(2), as well as high accuracy (30-50% intervals: 74.3-90.0%). Although SPECT had a small bias (7.74 mL/min/1.73 m(2)), it had a poor correlation coefficient (0.38), poor precision (23.93 mL/min/1.73 m(2)), and low accuracy (64.3-72.3%) as compared with DCE-MRR using JZ2C. Data Conclusion DCE-MRR using JZ2C is superior to Tc-99m-DTPA-based SPECT to determine allograft renal function. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:262-269.