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Evaluation of Renal Function with ^99mTc-MAG3 Using Semiautomated Regions of Interest

Department of Radiology, Institute of Medical Science, University of Tokyo, Tokyo; Department of Radiology, Nishi-Niigata Central National Hospital, Niigata; and Department of Radiology and Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan

View larger version (84K): [in this window] [in a new window]   FIGURE 1. Process of defining semiautomated ROIs in patient with CL of 231.5 mL/min/1.73 m2. (A) Preliminary ROIs for kidneys, liver, and background area between kidneys. (B) Intermediary binary image generated with image subtraction. (C) Final binary image. Intersections of diagonals of preliminary kidney ROIs are superimposed. (D) Renal and subrenal background ROIs as final products.

View larger version (126K): [in this window] [in a new window]   FIGURE 2. Examples of ROIs defined by semiautomated method and simple threshold method with 30% threshold. Qualities of semiautomated (A) and threshold (B) ROIs in patient with CL of 17.5 mL/min/1.73 m2 were graded as fair and poor, respectively. Semiautomated (C) and threshold (D) methods provided good and poor results, respectively, in patient with CL of 79.9 mL/min/1.73 m2 and relative hypofunction of left kidney. Use of simple threshold overestimates renal area, especially for left side.

View larger version (22K): [in this window] [in a new window]   FIGURE 3. Visual grading and CL measured by single-sample method. (A) Semiautomated method. (B) Simple threshold method with 30% threshold.

View larger version (25K): [in this window] [in a new window]   FIGURE 4. CL measured by single-sample method and predicted with semiautomated ROIs. SI at 0.5–2 min was used in predicting CL by slope method (A), and RU at 1–2.5 min was used for area method (B). Solid and broken lines represent identical line and regression line, respectively.

View larger version (20K): [in this window] [in a new window]   FIGURE 5. %RK obtained with manual ROIs and semiautomated ROIs. %RK was calculated by slope method (A) or area method (B). Solid and broken lines represent identical line and regression line, respectively.

View larger version (24K): [in this window] [in a new window]   FIGURE 6. CL predicted with semiautomated ROIs defined by 2 operators. CL was calculated by slope method (A) or area method (B). Solid line represents regression line.

View larger version (20K): [in this window] [in a new window]   FIGURE 7. %RK predicted with semiautomated ROIs defined by 2 operators. %RK was calculated by slope method (A) or area method (B). Solid line represents regression line.