Is Computed Tomography an Alternative to Scintigraphy for Preoperative Evaluation of Living Kidney Donor Split Renal Function?

Objective: This study aimed to evaluate whether computed tomography (CT) can replace scintigraphy for the preoperative evaluation of split renal function (SRF) and to determine the agreement between different CT volumetric measurement methods used so as to demonstrate this function. Materials and Methods: The split renal function (SRF) percentage of living kidney donor candidates was determined by diethylenetriamine pentaacetic acid (DTPA) perfusion scintigraphy. The modified ellipsoid volume (MELV), semi-automatic total kidney volume (STKV) and semi-automatic renal cortex volume (SRCV) of the candidates who underwent contrast-enhanced CT were measured and the percentages of both kidney volumes were calculated. The inter-method agreement was evaluated using Pearson's correlation test and the Bland-Altman plot test. Results: There was no correlation between the right and left kidney SRF and MELV (r=-0.033 and r=-0.092), MELV% (r=0.076 and r=0.076), STKV (r=-0.005 and r=-0.120), STKV% (r=0.175 and r=0.172), SRCV (r=-0.001 and r=0.130) and SRCV% (r=0.205 and r=0.183). There were significant correlations between the right MELV and STKV (r=0.855) and SRCV (r=0.813), and between the left MELV and STKV (r=0.787) and SRCV (r=0.770). Conclusion: Although CT provided detailed preoperative anatomical information, volumetric measurements did not show agreement with SRF. The agreement of each 3 volumetric examinations within themselves made us think that disagreement with SRF was independent of the volumetric method chosen.