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

BackgroundGlomerular filtration rate (GFR) is a preferred indicator of allograft renal function, but direct measurement of GFR remains complicated.PurposeTo 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 TypeProspective.PopulationSeventy kidney‐transplant recipientsField StrengthA low‐dose DCE‐MRR with a 3.0T scanner and a 99mTc‐DTPA‐based SPECT after renal transplantation were performed.AssessmentA 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 TestsPearson correlation test and Bland–Altman agreement analysis.ResultsThe 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 ConclusionDCE‐MRR using JZ2C is superior to 99mTc‐DTPA‐based SPECT to determine allograft renal function.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2019;49:262–269.