Juan J Cerrolaza1, Craig A Peters2, Aaron D Martin3, Emmarie Myers4, Nabile Safdar5, Marius George Linguraru6. 1. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C.. Electronic address: jcerrola@childrensnational.org. 2. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C.; Division of Urology and Pediatrics, Children's National Health System, Washington, D.C.. Electronic address: crpeters@childrensnational.org. 3. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C.; Division of Urology and Pediatrics, Children's National Health System, Washington, D.C. 4. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C. 5. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. 6. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, D.C.; Departments of Radiology and Pediatrics, School of Medicine and Health Science, George Washington University, Washington, D.C.
Abstract
PURPOSE: We define sonographic biomarkers for hydronephrotic renal units that can predict the necessity of diuretic nuclear renography. MATERIALS AND METHODS: We selected a cohort of 50 consecutive patients with hydronephrosis of varying severity in whom 2-dimensional sonography and diuretic mercaptoacetyltriglycine renography had been performed. A total of 131 morphological parameters were computed using quantitative image analysis algorithms. Machine learning techniques were then applied to identify ultrasound based safety thresholds that agreed with the t½ for washout. A best fit model was then derived for each threshold level of t½ that would be clinically relevant at 20, 30 and 40 minutes. Receiver operating characteristic curve analysis was performed. Sensitivity, specificity and area under the receiver operating characteristic curve were determined. Improvement obtained by the quantitative imaging method compared to the Society for Fetal Urology grading system and the hydronephrosis index was statistically verified. RESULTS: For the 3 thresholds considered and at 100% sensitivity the specificities of the quantitative imaging method were 94%, 70% and 74%, respectively. Corresponding area under the receiver operating characteristic curve values were 0.98, 0.94 and 0.94, respectively. Improvement obtained by the quantitative imaging method over the Society for Fetal Urology grade and hydronephrosis index was statistically significant (p <0.05 in all cases). CONCLUSIONS: Quantitative imaging analysis of renal sonograms in children with hydronephrosis can identify thresholds of clinically significant washout times with 100% sensitivity to decrease the number of diuretic renograms in up to 62% of children.
PURPOSE: We define sonographic biomarkers for hydronephrotic renal units that can predict the necessity of diuretic nuclear renography. MATERIALS AND METHODS: We selected a cohort of 50 consecutive patients with hydronephrosis of varying severity in whom 2-dimensional sonography and diuretic mercaptoacetyltriglycine renography had been performed. A total of 131 morphological parameters were computed using quantitative image analysis algorithms. Machine learning techniques were then applied to identify ultrasound based safety thresholds that agreed with the t½ for washout. A best fit model was then derived for each threshold level of t½ that would be clinically relevant at 20, 30 and 40 minutes. Receiver operating characteristic curve analysis was performed. Sensitivity, specificity and area under the receiver operating characteristic curve were determined. Improvement obtained by the quantitative imaging method compared to the Society for Fetal Urology grading system and the hydronephrosis index was statistically verified. RESULTS: For the 3 thresholds considered and at 100% sensitivity the specificities of the quantitative imaging method were 94%, 70% and 74%, respectively. Corresponding area under the receiver operating characteristic curve values were 0.98, 0.94 and 0.94, respectively. Improvement obtained by the quantitative imaging method over the Society for Fetal Urology grade and hydronephrosis index was statistically significant (p <0.05 in all cases). CONCLUSIONS: Quantitative imaging analysis of renal sonograms in children with hydronephrosis can identify thresholds of clinically significant washout times with 100% sensitivity to decrease the number of diuretic renograms in up to 62% of children.
Authors: B M Zeeshan Hameed; Aiswarya V L S Dhavileswarapu; Syed Zahid Raza; Hadis Karimi; Harneet Singh Khanuja; Dasharathraj K Shetty; Sufyan Ibrahim; Milap J Shah; Nithesh Naik; Rahul Paul; Bhavan Prasad Rai; Bhaskar K Somani Journal: J Clin Med Date: 2021-04-26 Impact factor: 4.241
Authors: Jose de Bessa; Cicilia M Rodrigues; Maria Cristina Chammas; Eduardo P Miranda; Cristiano M Gomes; Paulo R Moscardi; Marcia C Bessa; Carlos A Molina; Ricardo B Tiraboschi; Jose M Netto; Francisco T Denes Journal: PeerJ Date: 2018-05-18 Impact factor: 2.984