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Abstract：
BACKGROUND: Current potential living kidney donor\'s assessment includes functional and anatomical evaluation. Scintigraphy is recommended in some cases and some centers include this test in the donor\'s protocol. Recent studies advocate for the avoidance of this test as CT or MRI volumetry showed to accurately assess donor\'s renal function.
OBJECTIVE: To summarize scientific evidence on image tests for pre-donation and/or post-nephrectomy renal function evaluation.
METHODS: This review followed the guidelines set by the European Association of Urology and adhered to PRISMA 2020 recommendations. The protocol was registered in PROSPERO on 10th December 2022 (ID: CRD42022379273).
RESULTS: Twenty-one studies met the inclusion criteria after thorough screening and eligibility assessment. According to QUADAS-2, patient selection and flow/timing domains showed a predominant low risk of bias. The correlation between split renal function (SRF) using CT and scintigraphy varied from weak (r = 0.21) to remarkably strong (r = 0.949). Bland-Altman agreement demonstrated moderate to excellent results, with mean differences ranging from -0.06% to 1.76%. The correlation between split renal volume (CT) and estimated glomerular filtration rate (eGFR) at 6 months or 1 year after nephrectomy showed a moderate correlation, with coefficients ranging from 0.708 to 0.83. The correlation between SRF (MRI) and renal scintigraphy reported a moderate correlation, with correlation coefficients of 0.58 and 0.84. MRI and scintigraphy displayed a good agreement, with a 66% agreement observed and mean differences of ± 0.3%.
CONCLUSIONS: Despite study heterogeneity, MRI or CT-based renal volumetry appears promising compared to scintigraphy, with favorable correlations and agreement.
OBJECTIVE: To summarize scientific evidence on image tests for pre-donation and/or post-nephrectomy renal function evaluation.
METHODS: This review followed the guidelines set by the European Association of Urology and adhered to PRISMA 2020 recommendations. The protocol was registered in PROSPERO on 10th December 2022 (ID: CRD42022379273).
RESULTS: Twenty-one studies met the inclusion criteria after thorough screening and eligibility assessment. According to QUADAS-2, patient selection and flow/timing domains showed a predominant low risk of bias. The correlation between split renal function (SRF) using CT and scintigraphy varied from weak (r = 0.21) to remarkably strong (r = 0.949). Bland-Altman agreement demonstrated moderate to excellent results, with mean differences ranging from -0.06% to 1.76%. The correlation between split renal volume (CT) and estimated glomerular filtration rate (eGFR) at 6 months or 1 year after nephrectomy showed a moderate correlation, with coefficients ranging from 0.708 to 0.83. The correlation between SRF (MRI) and renal scintigraphy reported a moderate correlation, with correlation coefficients of 0.58 and 0.84. MRI and scintigraphy displayed a good agreement, with a 66% agreement observed and mean differences of ± 0.3%.
CONCLUSIONS: Despite study heterogeneity, MRI or CT-based renal volumetry appears promising compared to scintigraphy, with favorable correlations and agreement.
摘要：
背景：当前潜在活体供肾评估包括功能和解剖学评估。在某些情况下，建议使用闪烁显像，一些中心将此测试纳入捐赠者的方案。最近的研究主张避免这种测试，因为CT或MRI容积显示可以准确评估供体的肾功能。
目的：总结捐献前和/或肾切除术后肾功能评估的影像学检查的科学依据。
方法：本综述遵循了欧洲泌尿外科协会制定的指南，并遵循了PRISMA2020的建议。该协议于2022年12月10日在PROSPERO注册（ID：CRD42022379273）。
结果：21项研究在经过全面筛选和资格评估后符合纳入标准。根据QUADAS-2，患者选择和流/定时域显示出主要的低偏倚风险。使用CT和闪烁显像术的分裂肾功能（SRF）之间的相关性从弱（r=0.21）到明显强（r=0.949）。Bland-Altman协议显示出中等到优异的结果，平均差异从-0.06%到1.76%。肾切除术后6个月或1年的分裂肾体积（CT）与估计的肾小球滤过率（eGFR）之间的相关性显示出中等相关性，系数范围从0.708到0.83。SRF（MRI）和肾闪烁显像之间的相关性报告为中度相关性，相关系数为0.58和0.84。MRI和闪烁显像显示出良好的一致性，观察到66%的一致性和±0.3%的平均差异。
结论：尽管研究存在异质性，与闪烁显像相比，基于MRI或CT的肾功能测定似乎很有希望，具有良好的相关性和一致性。
目的：总结捐献前和/或肾切除术后肾功能评估的影像学检查的科学依据。
方法：本综述遵循了欧洲泌尿外科协会制定的指南，并遵循了PRISMA2020的建议。该协议于2022年12月10日在PROSPERO注册（ID：CRD42022379273）。
结果：21项研究在经过全面筛选和资格评估后符合纳入标准。根据QUADAS-2，患者选择和流/定时域显示出主要的低偏倚风险。使用CT和闪烁显像术的分裂肾功能（SRF）之间的相关性从弱（r=0.21）到明显强（r=0.949）。Bland-Altman协议显示出中等到优异的结果，平均差异从-0.06%到1.76%。肾切除术后6个月或1年的分裂肾体积（CT）与估计的肾小球滤过率（eGFR）之间的相关性显示出中等相关性，系数范围从0.708到0.83。SRF（MRI）和肾闪烁显像之间的相关性报告为中度相关性，相关系数为0.58和0.84。MRI和闪烁显像显示出良好的一致性，观察到66%的一致性和±0.3%的平均差异。
结论：尽管研究存在异质性，与闪烁显像相比，基于MRI或CT的肾功能测定似乎很有希望，具有良好的相关性和一致性。
