Assessment of kidney volume in polycystic kidney disease using MRI without contrast medium.

Background/Aims: Total renal volume (TRV) is an important index to evaluate the progression of autosomal-dominant polycystic kidney disease (ADPKD). TRV has been assessed by manually tracing renal contours from CT or MR scans, often employing contrast medium (CM). We developed a fast and nearly automated technique based on the analysis of MR images acquired without CM injection for TRV quantification. Methods: 30 ADPKD patients underwent MRI. After the selection of one point inside each kidney for the entire volume, the automatic extraction of kidney contours was performed on each acquired slice; the segmentation procedure was based on region growing and on the application of morphological operators and curvature-based motion. The area inside each contour was calculated and TRV was derived. Volume measurements were validated by comparison with measurements obtained by stereology. Results: TRV estimated in patients was 768 ± 545 ml (range 161–3,111 ml). The automatic measurements were in excellent correlation with the manual ones (r = 0.99, y = x – 0.7), with a small bias and narrow limits of agreement in both absolute (–5 ± 37 ml) and percentage (–0.6 ± 9.6%) terms. Conclusion: This preliminary study showed the feasibility of a fast and nearly automated method for determining TRV; importantly it does not require the use of potentially nephrotoxic CM.