Value of multiparametric magnetic resonance imaging for evaluating chronic kidney disease and renal fibrosis

© 2023. The Author(s), under exclusive licence to European Society of Radiology..

OBJECTIVES: To identify optimized MRI markers for evaluating chronic kidney disease (CKD) and renal interstitial fibrosis (IF).

MATERIALS AND METHODS: This prospective study included 43 patients with CKD and 20 controls. The CKD group was divided into mild and moderate-to-severe subgroups based on pathological results. Scanned sequences included T1 mapping, R2* mapping, intravoxel incoherent motion imaging, and diffusion-weighted imaging. One-way analyses of variance were used to compare MRI parameters among groups. Correlations of MRI parameters with estimated glomerular filtration rate (eGFR) and renal IF were analyzed using age as covariates. The support vector machine (SVM) model was used to evaluate the diagnostic efficacy of multiparametric MRI.

RESULTS: Compared to control values, renal cortical apparent diffusion coefficient (cADC), medullary ADC (mADC), cortical pure diffusion coefficient (cDt), medullary Dt (mDt), cortical shifted apparent diffusion coefficient (csADC), and medullary sADC (msADC) values gradually decreased in the mild and moderate-to-severe groups, while cortical T1 (cT1) and medullary T1 (mT1) values gradually increased. Values of cADC, mADC, cDt, mDt, cT1, mT1, csADC, and msADC were significantly associated with eGFR and IF (p < 0.001). The SVM model indicated that multiparametric MRI combining cT1 and csADC can distinguish patients with CKD from controls with high accuracy (0.84), sensitivity (0.70), and specificity (0.92) (AUC: 0.96). Multiparametric MRI combining cT1 and cADC exhibited high accuracy (0.91), sensitivity (0.95), and specificity (0.81) for evaluating IF severity (AUC: 0.96).

CONCLUSION: Multiparametric MRI combining T1 mapping and diffusion imaging may be of clinical utility in non-invasive assessment of CKD and IF.

CLINICAL RELEVANCE STATEMENT: This study shows that multiparametric MRI combining T1 mapping and diffusion imaging may be clinically useful in the non-invasive assessment of chronic kidney disease (CKD) and interstitial fibrosis; this could provide information for risk stratification, diagnosis, treatment, and prognosis.

KEY POINTS: • Optimized MRI markers for evaluating chronic kidney disease and renal interstitial fibrosis were investigated. • Renal cortex/medullary T1 values increased as interstitial fibrosis increased; cortical shifted apparent diffusion coefficient (csADC) correlated significantly with eGFR and interstitial fibrosis. • Support vector machine (SVM) combining cortical T1 (cT1) and csADC/cADC effectively identifies chronic kidney disease and accurately predicts renal interstitial fibrosis.

Errataetall:	CommentIn: Eur Radiol. 2023 May 25;:. - PMID 37231072
Medienart:	E-Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:33
Enthalten in:	European radiology - 33(2023), 8 vom: 17. Aug., Seite 5211-5221

Sprache:	Englisch

Beteiligte Personen:	Hua, Chenchen [VerfasserIn] Qiu, Lu [VerfasserIn] Zhou, Leting [VerfasserIn] Zhuang, Yi [VerfasserIn] Cai, Ting [VerfasserIn] Xu, Bin [VerfasserIn] Hao, Shaowei [VerfasserIn] Fang, Xiangming [VerfasserIn] Wang, Liang [VerfasserIn] Jiang, Haoxiang [VerfasserIn]

Links:	Volltext

Themen:	Fibrosis Journal Article Kidney Multiparametric magnetic resonance imaging Support vector machine

Anmerkungen:	Date Completed 10.07.2023 Date Revised 13.10.2023 published: Print-Electronic CommentIn: Eur Radiol. 2023 May 25;:. - PMID 37231072 Citation Status MEDLINE

doi:	10.1007/s00330-023-09674-1

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM356515117