MRI-based kidney volume measurements in ADPKD: reliability and effect of gadolinium enhancement

Clin J Am Soc Nephrol. 2009 Apr;4(4):719-25. doi: 10.2215/CJN.03750708. Epub 2009 Apr 1.

Abstract

Background and objectives: To evaluate the inter- and intrareader reliability and the effect of gadolinium enhancement on kidney volume measurements obtained from pre- and postgadolinium T1 MR images in patients with autosomal dominant polycystic kidney disease (ADPKD).

Design, setting, participants, & measurements: Twenty subjects were randomly selected with approximately equal frequency from three kidney-size groups. Pre- and postgadolinium 3D T1 (pre-T1, post-T1) MR images were obtained. The stereology method was applied to segment and measure kidney volumes. The measurement process was repeated at two-wk intervals by two radiologists. Reliability was assessed with correlation coefficients. Intra- and inter-reader bias and measure differences were assessed with paired T-tests. The size effect on the pre- and post-T1 measurements was evaluated with one-way ANOVA.

Results: The intra- and inter-reader reliability was extremely high in all measurements. No systematic intrareader bias but a small inter-reader bias for the post-T1 measurements was observed. All kidney volumes measured on the pre- and post-T1 images were highly correlated with each other for both readers. The post-T1 volumes were significantly higher than pre-T1 volumes. While the post-pre volume differences were relatively constant across the three kidney-size groups, the post-pre percent volume differences were significantly smaller as the size of the kidney increased.

Conclusions: Kidney volume measurements can be made with minimum intra- and inter-reader variability on both pre- and post-T1 MR images. Kidney volumes measured on the pre-T1 were smaller than those on post-T1, and percent differences between pre-T1 and post-T1 kidney volumes decreased with increasing kidney size.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Contrast Media*
  • Databases as Topic
  • Female
  • Gadolinium*
  • Humans
  • Image Enhancement
  • Imaging, Three-Dimensional
  • Kidney / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Observer Variation
  • Organ Size
  • Polycystic Kidney, Autosomal Dominant / pathology*
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Young Adult

Substances

  • Contrast Media
  • Gadolinium