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Research ArticleImaging

Comparison of Performance of Improved Serum Estimators of Glomerular Filtration Rate (GFR) to 99mTc-DTPA GFR Methods in Patients with Hepatic Cirrhosis

Zaid Haddadin, Vivian Lee, Christopher Conlin, Lei Zhang, Kristi Carlston, Glen Morrell, Daniel Kim, John M. Hoffman and Kathryn Morton
Journal of Nuclear Medicine Technology March 2017, 45 (1) 42-49; DOI: https://doi.org/10.2967/jnmt.116.180851
Zaid Haddadin
1University of Utah School of Medicine, Salt Lake City, Utah
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Vivian Lee
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Christopher Conlin
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Lei Zhang
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Kristi Carlston
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Glen Morrell
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Daniel Kim
3Department of Radiology, Northwestern University, Chicago, Illinois
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John M. Hoffman
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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Kathryn Morton
2Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; and
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  • FIGURE 1.
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    FIGURE 1.

    Scatterplots of mGFR vs. eGFR values for MDRD and CKD-EPI (SCr), CKD-EPI (CysC), and CKD-EPI (CysC+SCr). Graphs in left-hand column use UV/P 99mTc-DTPA method for mGFR as reference. Corresponding graphs in right-hand column use plasma 99mTc-DTPA method. Line of identity (dashed line), linear line fit (solid line), and 95% confidence intervals (thin dotted lines) are shown for each set of comparisons.

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    FIGURE 2.

    Scatterplots of mGFR vs. eGFR values for CKD-EPI (CysC) and CKD-EPI (CysC+SCr). Graphs in left-hand column use UV/P 99mTc-DTPA method for mGFR as reference. Corresponding graphs in right-hand column use plasma 99mTc-DTPA method. Line of identity (dashed line), linear line fit (solid line), and 95% confidence intervals (thin dotted lines) are shown for each set of comparisons.

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    TABLE 1

    Descriptive Statistics for 2 99mTc-DTPA Methods for mGFR and 4 Equations for eGFR in 54 Patients with Hepatic Cirrhosis

    GFR methodMean (mL/min)SDRange
    Plasma DTPA mGFR96.4031.8952.45–189.78
    UV/P DTPA mGFR88.6343.3334.95–262.60
    MDRD94.8623.9547.42–169.56
    CKD-EPI (SCr)99.0920.8651.35–138.38
    CKD-EPI (CysC)95.2427.4942.97–165.04
    CKD-EPI (CysC+SCr)97.2522.8245.96–154.79
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    TABLE 2

    Comparison of Performance of Equations for eGFR to 2 99mTc-DTPA Reference Methods for mGFR in Patients with Hepatic Cirrhosis

    Reference GFR method
    Estimating equationParameterUV/P DTPA mGFRPlasma DTPA mGFR
    MDRDAccuracy p1029.63%35.19%
    Accuracy p2048.15%68.52%
    Accuracy p3057.41%88.89%
    Precision16.4517.50
    Mean bias−6.23 (−14.70 to 2.23)1.54 (−4.73 to 7.86)
    Mean percentage bias19.32%2.53%
    Correlation0.72 (0.56–0.83)0.69 (0.52–0.81)
    CKD-EPI (SCr)Accuracy p1020.37%35.19%
    Accuracy p2038.89%64.81%
    Accuracy p3055.56%83.33%
    Precision17.2815.06
    Mean bias−10.46 (−20.22 to −0.70)−2.69 (−8.93 to 3.55)
    Mean percentage bias26.03%17.90%
    Correlation0.57 (0.36–0.73)0.70 (0.53–0.81)
    CKD-EPI (CysC)Accuracy p1022.22%31.48%
    Accuracy p2044.44%61.11%
    Accuracy p3059.26%77.78%
    Precision25.5519.59
    Mean bias−6.61 (−16.73 to 3.50)1.16 (−5.13 to 7.44)
    Mean percentage bias34.84%19.51%
    Correlation0.53 (0.30–0.70)0.71 (0.54–0.82)
    CKD-EPI (CysC+SCr)Accuracy p1016.67%42.59%
    Accuracy p2050.00%75.93%
    Accuracy p3061.11%85.19%
    Precision18.1314.18
    Mean bias−8.63 (−17.99 to 0.74)−0.85 (−6.25 to 4.54)
    Mean percentage bias23.21%15.04%
    Correlation0.62 (0.42–0.76)0.79 (0.66–0.87)
    • Data in parentheses are 95% confidence intervals.

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Journal of Nuclear Medicine Technology: 45 (1)
Journal of Nuclear Medicine Technology
Vol. 45, Issue 1
March 1, 2017
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Comparison of Performance of Improved Serum Estimators of Glomerular Filtration Rate (GFR) to 99mTc-DTPA GFR Methods in Patients with Hepatic Cirrhosis
Zaid Haddadin, Vivian Lee, Christopher Conlin, Lei Zhang, Kristi Carlston, Glen Morrell, Daniel Kim, John M. Hoffman, Kathryn Morton
Journal of Nuclear Medicine Technology Mar 2017, 45 (1) 42-49; DOI: 10.2967/jnmt.116.180851

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Comparison of Performance of Improved Serum Estimators of Glomerular Filtration Rate (GFR) to 99mTc-DTPA GFR Methods in Patients with Hepatic Cirrhosis
Zaid Haddadin, Vivian Lee, Christopher Conlin, Lei Zhang, Kristi Carlston, Glen Morrell, Daniel Kim, John M. Hoffman, Kathryn Morton
Journal of Nuclear Medicine Technology Mar 2017, 45 (1) 42-49; DOI: 10.2967/jnmt.116.180851
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Keywords

  • 99mTc-DTPA
  • Glomerular Filtration Rate
  • MDRD
  • CKD-EPI
  • cirrhosis
  • creatinine
  • Cr
  • GFR
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