Cortical perfusion index: A predictor of acute rejection in transplanted kidneys
Abstract
The presently available non-invasive methods for the diagnosis of acute rejection crisis (ARC) of renal transplants are not satisfactory. However, the need for such a test is of paramount clinical importance. A prospective study of 74 post-transplantation events in renal allograft recipients was performed. Clinical, surgical exploration and biopsy data were correlated with TC-99m DTPA scintigraphy using the following indices: Global perfusion index (GPI), cortical perfusion index (CPI), medullary perfusion index (MPI), the peak-to-plateau ratio (P/P), iliac artery peak to renal peak time (delta-P) and washout half-time (T1/2). Of the 74 events, 24 were proven to be due to acute rejection crisis (ARC), 13 were of ureteral obstruction, 18 various nephropathies and 19 in stable renal transplant function. The P/P, delta-P and T1/2 were not good predictors of ARC; the sensitivity was 79%, 79% and 80% respectively. The sensitivity of the GPI was 58% and the specificity was 87%. The cortical perfusion index rated better: specificity=84% and sensitivity=87%. However, the best indicator of ARC seemed to be the percent increase in cortical perfusion index over previous values obtained during stable graft function. Thus the sensitivity was found to be 91% and specificity was 96%. The difference between global and corticalmore »
- Authors:
- Publication Date:
- Research Org.:
- State Univ. of New York at Stony Brook, Univ. Hospital, Stony Brook, NY
- OSTI Identifier:
- 6854879
- Report Number(s):
- CONF-850611-
Journal ID: CODEN: JNMEA; TRN: 87-010762
- Resource Type:
- Conference
- Journal Name:
- J. Nucl. Med.; (United States)
- Additional Journal Information:
- Journal Volume: 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 62 RADIOLOGY AND NUCLEAR MEDICINE; KIDNEYS; PERFUSED TISSUES; RENOGRAPHY; SCINTISCANNING; TRANSPLANTS; TECHNETIUM 99; DIAGNOSTIC USES; BLOOD VESSELS; COMPARATIVE EVALUATIONS; DIAGNOSIS; PERFORMANCE; TRACER TECHNIQUES; ANIMAL TISSUES; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BIOMEDICAL RADIOGRAPHY; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPE APPLICATIONS; ISOTOPES; MEDICINE; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; TECHNETIUM ISOTOPES; TISSUES; USES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics; 550602 - Medicine- External Radiation in Diagnostics- (1980-)
Citation Formats
Atkins, H L, Oster, Z H, Anaise, D, Wein, S, Waltzer, W, Gonder, A, Cooch, E, and Rapaport, F T. Cortical perfusion index: A predictor of acute rejection in transplanted kidneys. United States: N. p., 1985.
Web.
Atkins, H L, Oster, Z H, Anaise, D, Wein, S, Waltzer, W, Gonder, A, Cooch, E, & Rapaport, F T. Cortical perfusion index: A predictor of acute rejection in transplanted kidneys. United States.
Atkins, H L, Oster, Z H, Anaise, D, Wein, S, Waltzer, W, Gonder, A, Cooch, E, and Rapaport, F T. 1985.
"Cortical perfusion index: A predictor of acute rejection in transplanted kidneys". United States.
@article{osti_6854879,
title = {Cortical perfusion index: A predictor of acute rejection in transplanted kidneys},
author = {Atkins, H L and Oster, Z H and Anaise, D and Wein, S and Waltzer, W and Gonder, A and Cooch, E and Rapaport, F T},
abstractNote = {The presently available non-invasive methods for the diagnosis of acute rejection crisis (ARC) of renal transplants are not satisfactory. However, the need for such a test is of paramount clinical importance. A prospective study of 74 post-transplantation events in renal allograft recipients was performed. Clinical, surgical exploration and biopsy data were correlated with TC-99m DTPA scintigraphy using the following indices: Global perfusion index (GPI), cortical perfusion index (CPI), medullary perfusion index (MPI), the peak-to-plateau ratio (P/P), iliac artery peak to renal peak time (delta-P) and washout half-time (T1/2). Of the 74 events, 24 were proven to be due to acute rejection crisis (ARC), 13 were of ureteral obstruction, 18 various nephropathies and 19 in stable renal transplant function. The P/P, delta-P and T1/2 were not good predictors of ARC; the sensitivity was 79%, 79% and 80% respectively. The sensitivity of the GPI was 58% and the specificity was 87%. The cortical perfusion index rated better: specificity=84% and sensitivity=87%. However, the best indicator of ARC seemed to be the percent increase in cortical perfusion index over previous values obtained during stable graft function. Thus the sensitivity was found to be 91% and specificity was 96%. The difference between global and cortical perfusion indices reflects shunting of blood for cortex to medulla. This study suggest that the cortical perfusion index (CPI) and the percent increase in CPI can be used to non-invasively diagnose acute renal allograft rejection.},
doi = {},
url = {https://www.osti.gov/biblio/6854879},
journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 26:5,
place = {United States},
year = {Wed May 01 00:00:00 EDT 1985},
month = {Wed May 01 00:00:00 EDT 1985}
}