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Renal Volume Measurements: Accuracy and Repeatability of US Compared with That of MR Imaging¹

¹ From the Departments of Radiology (J.B., M.O., R.K., F.J.A.B.) and Nephrology (J.J.B.), University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; the Department of Radiology, University of Virginia Health Sciences Center, Charlottesville (E.E.d.L.); and the Julius Centre for Patient Oriented Research, University Utrecht, the Netherlands (K.G.M.M.). Received March 31, 1998; revision requested June 16; revision received August 27; accepted January 20, 1999. Address reprint requests to J.B.

PURPOSE: To determine the accuracy and repeatability of ultrasonography (US) with the ellipsoid formula in calculating the renal volume.

MATERIALS AND METHODS: The renal volumes in 20 volunteers aged 19–51 years were determined by using US with the ellipsoid formula and magnetic resonance (MR) imaging with the voxel-count method by two independent observers for each modality. The observers performed all measurements twice, with an interval between the first and second examinations. The voxel-count method was the reference standard. Repeatability was evaluated by calculating the SD of the difference (method of Bland and Altman).

RESULTS: Renal volume was underestimated with US by 45 mL (25%) on average. A comparable underestimation was found when the ellipsoid formula was applied to MR images. This indicates that the inaccuracy of US renal volume measurements (a) occured because the kidney does not resemble an ellipsoid and (b) was not primarily related to the imaging modality. Intra- and interobserver variations in US volume measurements were poor; the SD of the difference was 21–32 mL. For comparison, the SD of the difference in reference-standard measurements was 5–10 mL.

CONCLUSION: Use of US with the ellipsoid formula is not appropriate for accurate and reproducible calculation of renal volume.

Index terms: Kidney, MR, 81.121416 • Kidney, US, 81.12989, 81.92 • Magnetic resonance (MR), volume measurement, 81.121416 • Ultrasound (US), comparative studies, 81.12989

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