Pd44-01 Utilizing Computed Tomography-Based Renal Parenchymal Volumes to Estimate Split Renal Function in Patients With Ureteral Stricture Disease

You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) II (PD44)1 May 2024PD44-01 UTILIZING COMPUTED TOMOGRAPHY-BASED RENAL PARENCHYMAL VOLUMES TO ESTIMATE SPLIT RENAL FUNCTION IN PATIENTS WITH URETERAL STRICTURE DISEASE Emily Ji, Rebecca Arteaga, Aidan Raikar, Jonathan Rosenfeld, Devin Boehm, Jaewoo Kim, and Ziho Lee Emily JiEmily Ji , Rebecca ArteagaRebecca Arteaga , Aidan RaikarAidan Raikar , Jonathan RosenfeldJonathan Rosenfeld , Devin BoehmDevin Boehm , Jaewoo KimJaewoo Kim , and Ziho LeeZiho Lee View All Author Informationhttps://doi.org/10.1097/01.JU.0001008800.83683.92.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evaluation of split renal function (SRF) is critical for guiding surgical treatment decisions for patients with ureteral stricture disease (USD). Typically, nuclear medicine renal scans (NRS) are obtained to estimate SRF. However, evidence from the oncology, transplant, and trauma literature suggests that computed tomography (CT) based renal parenchymal volumes may be used to calculate SRF. There are currently no data regarding the applicability of this method to patients with USD and patients with hydronephrosis. The purpose of our study was to determine whether CT-based renal parenchymal volumes may be used to predict SRF in patients with ureteral stricture disease. METHODS: We retrospectively reviewed all patients undergoing surgery for USD at a single institution from October 2021 to October 2023. Patients who had preoperative NRS and CT scan with intravenous contrast within three months of each other were included. Patients with a solitary kidney or transplant kidney were excluded. Volume measurements were independently obtained by two investigators using the 3D Region of Interest Tool on Visage®7 Enterprise Imaging Platform (Visage Imaging, Inc., San Diego, USA). Authors were blinded to the NRS derived SRF during volume measurements. Intraclass correlation coefficient (ICC) was used to assess consistency between investigators. Estimated CT SRF was calculated as follows: REstimatedSRF=RCTVolume/(RCTVolume+LCTVolume). Predictive accuracy was assessed using Pearson correlation coefficient (r) and linear regression. RESULTS: 40 of 142 patients met inclusion criteria. There was excellent reliability in parenchymal volume calculations between raters (ICC=0.997). There was a strong linear correlation between estimated CT SRF and NRS SRF (r=0.897). Figure 1 shows the relationship between CT estimated right kidney SRF and observed right kidney SRF on NRS. A linear regression model found RObservedSRF=-0.064+1.135 (REstimatedSRF), with r2=0.800. CONCLUSIONS: CT derived parenchymal volume analysis may be used to estimate SRF in patients with USD. This may obviate the need to routinely obtain preoperative renal scans when assessing surgical management options. Further validation is necessary to assess the durability and robustness of our model. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e904 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Emily Ji More articles by this author Rebecca Arteaga More articles by this author Aidan Raikar More articles by this author Jonathan Rosenfeld More articles by this author Devin Boehm More articles by this author Jaewoo Kim More articles by this author Ziho Lee More articles by this author Expand All Advertisement PDF downloadLoading ...