Role of preoperative MR volumetry in patients with renal cell carcinoma for prediction of postoperative renal function after radical nephrectomy and nephron sparing surgery

ABSTRACT Purpose Preoperative computed tomography or magnetic resonance (MR) imaging are commonly used for radiological evaluation of renal cell carcinoma (RCC) before radical nephrectomy or nephron sparing surgery(NSS). This study aimed to assess the role of MRI for predicting postoperative renal function by preoperative estimation of renal parenchymal volume and correlation with glomerular filtration rate (GFR). Materials and Methods A prospective observational study was conducted from February 2015 to October 2016 at a tertiary care hospital in northern India. MR imaging was done on 3 Tesla MR scanner (Signa Hdxt General Electrics, Milwaukee, USA). MR volumetry was used to estimate the renal parenchymal volume. GFR was measured in all patients using Tc99m Diethyl-triamine-penta-acetic acid using Russell's algorithm. Such measurement was done preoperatively, and postoperatively 3 months after surgery. Results 30 patients with suspected RCC underwent NSS (n=10) and radical nephrectomy (n=20). Median tumour volume was 175.7cc (range: 4.8 to 631.8cc). The median volume of the residual parenchyma on the affected side was 84.25±41.97cc while that on the unaffected side was 112.25±26.35cc. There was good correlation among the unaffected kidney volume and postoperative GFR for the radical nephrectomy group (r=0.83) as well as unaffected kidney volume, total residual kidney volume and residual volume of affected kidney with postoperative GFR for the NSS group (r=0.71, r=0.73, r=0.79 respectively; P <0.05). Conclusion Preoperative residual parenchymal volume on MR renal volumetry correlates well with postoperative GFR in patients with RCC undergoing radical nephrectomy or NSS.

Pattern of injuries due to electric current.

A one year study, from October 2007 to September 2008, was under taken in an attempt to study the pattern of electrical injury, the cause of death, manner of death, and diagnosis by histopathological examination. The study was compromised of 62 cases brought with history of electrical shock. Of the total 62 cases, males were 57(91.93%) and females were 5(8.06%) the mean age is 26 .27 year. The peak age of victims are 21-30 years age group 24 cases (38.71%].In the age group of 1n 0-10 years age group victims 3. Most of cases were due to low tension and domestic circuit. The patterns of electrical injuries are noted, such as entry, exit and both entry, exit wounds, flash burns and no electrical signs. The maximum victims showed dermo-epidermal degree of electrical burns .The histopathological examination is an important aid in diagnosis of electrical injuries and recommendations about preventive safety measures to reduce the mortality.