CT Angiography for Evaluation of Living Renal Donors: Is Arterial Phase Only Sufficient for Preoperative Assessment?

Purpose: Multi-phase contrast enhanced CT is frequently used for reno-vascular assessment pre donation. This significantly increases radiation dose to potential renal donors. We aim to assess if arterial phase abdominal CT would provide the relevant sufficient reno-vascular information to plan renal donation.

Materials and Methods: Retrospective review of 200 living renal donors CT studies done since January 2022. Arterial phase scans were reviewed separately to evaluate the number of renal arteries & veins, renal parenchymal abnormality and extra-renal abnormality. Same data from multi-phase CT imaging review was collected. Correlation analysis, sensitivity and specificity of arterial phase only review with multi-phase review was done.

Results: Donors ranged from 19 to 59 years (M:F = 148:52). Number of renal arteries on arterial phase review correlated strongly with multiphase review (Pearson coefficient of 0.98 on the right and 0.97 on the left). Number of renal veins on arterial and multi-phase review also had a strong correlation (Pearson coefficient of 0.91 on the right and 0.92 on the left). Sensitivity of arterial phase on detection of renal scarring was 80% and specificity 99%. The sensitivity of arterial phase for renal stones was 86 and 100% specificity. Arterial phase CT did not identify 39 of the 52 extra-renal findings. None of these were clinically significant except one patient requiring MRI.

Conclusion: Arterial phase imaging findings have good correlation for reno-vascular anatomy with multi-phase CT scans. Scarring and stones have very high specificity on arterial phase CT which rarely misses clinically significant extra renal findings. Arterial phase CT may be sufficient for renal donation planning.

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Artikel online veröffentlicht:
02. April 2024