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MRI-based Kidney Volume Measurements in ADPKD: Reliability and Effect of Gadolinium Enhancement

Kyongtae T. Bae^*, Cheng Tao^*, Fang Zhu^*, James E. Bost, Arlene B. Chapman, Jared J. Grantham, Vicente E. Torres^||, Lisa M. Guay-Woodford^¶, Catherine M. Meyers^**, William M. Bennett; and Consortium for Radiologic Imaging Studies Polycystic Kidney Disease (CRISP)

^* Department of Radiology and Department of General Internal Medicine, University of Pittsburgh, Pennsylvania; Medicine (Renal Division), Emory University School of Medicine, DeKalb County, Georgia; University of Kansas Medical Center, Kansas City; ^|| Mayo Foundation, Rochester, Minnesota; ^¶ University of Alabama at Birmingham; the ^** National Institutes of Health, NIDDK, Bethesda, Maryland; and Northwest Renal Clinic, Portland, Oregon

Correspondence: Dr. Kyongtae T. Bae, Department of Radiology, University of Pittsburgh School of Medicine, 3362 Fifth Avenue, Pittsburgh, PA 15213. Phone: 412-641-2657; Fax: 412-641-2582; E-mail: baek{at}upmc.edu

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.