Lena Berchtold1, Iris Friedli2, Lindsey A Crowe2, Chantal Martinez1, Solange Moll3, Karine Hadaya1, Thomas de Perrot2, Christophe Combescure4, Pierre-Yves Martin1, Jean-Paul Vallée2, Sophie de Seigneux1. 1. Service and Laboratory of Nephrology, Department for Statistics, Department of Internal Medicine Specialties and of Physiology and Metabolism, University Hospital and University of Geneva, Geneva, Switzerland. 2. Service of Radiology, Department for Statistics, Department of Radiology and Medical Informatics, University Hospital and University of Geneva, Geneva, Switzerland. 3. Department of Clinical Pathology, Institute of Clinical Pathology, University Hospital of Geneva, Geneva, Switzerland. 4. CRC & Division of Clinical-Epidemiology, Department of Health and Community Medicine, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
Abstract
BACKGROUND: Kidney cortical interstitial fibrosis (IF) is highly predictive of renal prognosis and is currently assessed by the evaluation of a biopsy. Diffusion magnetic resonance imaging (MRI) is a promising tool to evaluate kidney fibrosis via the apparent diffusion coefficient (ADC), but suffers from inter-individual variability. We recently applied a novel MRI protocol to allow calculation of the corticomedullary ADC difference (ΔADC). We here present the validation of ΔADC for fibrosis assessment in a cohort of 164 patients undergoing biopsy and compare it with estimated glomerular filtration rate (eGFR) and other plasmatic parameters for the detection of fibrosis. METHODS: This monocentric cross-sectional study included 164 patients undergoing renal biopsy at the Nephrology Department of the University Hospital of Geneva between October 2014 and May 2018. Patients underwent diffusion-weighted imaging, and T1 and T2 mappings, within 1 week after biopsy. MRI results were compared with gold standard histology for fibrosis assessment. RESULTS: Absolute cortical ADC or cortical T1 values correlated poorly to IF assessed by the biopsy, whereas ΔADC was highly correlated to IF (r=-0.52, P < 0.001) and eGFR (r = 0.37, P < 0.01), in both native and allograft patients. ΔT1 displayed a lower, but significant, correlation to IF and eGFR, whereas T2 did not correlate to IF nor to eGFR. ΔADC, ΔT1 and eGFR were independently associated with kidney fibrosis, and their combination allowed detection of extensive fibrosis with good specificity. CONCLUSION: ΔADC is better correlated to IF than absolute cortical or medullary ADC values. ΔADC, ΔT1 and eGFR are independently associated to IF and allow the identification of patients with extensive IF.
BACKGROUND:Kidney cortical interstitial fibrosis (IF) is highly predictive of renal prognosis and is currently assessed by the evaluation of a biopsy. Diffusion magnetic resonance imaging (MRI) is a promising tool to evaluate kidney fibrosis via the apparent diffusion coefficient (ADC), but suffers from inter-individual variability. We recently applied a novel MRI protocol to allow calculation of the corticomedullary ADC difference (ΔADC). We here present the validation of ΔADC for fibrosis assessment in a cohort of 164 patients undergoing biopsy and compare it with estimated glomerular filtration rate (eGFR) and other plasmatic parameters for the detection of fibrosis. METHODS: This monocentric cross-sectional study included 164 patients undergoing renal biopsy at the Nephrology Department of the University Hospital of Geneva between October 2014 and May 2018. Patients underwent diffusion-weighted imaging, and T1 and T2 mappings, within 1 week after biopsy. MRI results were compared with gold standard histology for fibrosis assessment. RESULTS: Absolute cortical ADC or cortical T1 values correlated poorly to IF assessed by the biopsy, whereas ΔADC was highly correlated to IF (r=-0.52, P < 0.001) and eGFR (r = 0.37, P < 0.01), in both native and allograft patients. ΔT1 displayed a lower, but significant, correlation to IF and eGFR, whereas T2 did not correlate to IF nor to eGFR. ΔADC, ΔT1 and eGFR were independently associated with kidney fibrosis, and their combination allowed detection of extensive fibrosis with good specificity. CONCLUSION: ΔADC is better correlated to IF than absolute cortical or medullary ADC values. ΔADC, ΔT1 and eGFR are independently associated to IF and allow the identification of patients with extensive IF.
Authors: Andrea Beck-Tölly; Michael Eder; Dietrich Beitzke; Farsad Eskandary; Asan Agibetov; Katharina Lampichler; Martina Hamböck; Heinz Regele; Johannes Kläger; Maja Nackenhorst; Georg A Böhmig Journal: Transplant Direct Date: 2020-07-15
Authors: Thomas De Perrot; Christine Sadjo Zoua; Carl G Glessgen; Diomidis Botsikas; Lena Berchtold; Rares Salomir; Sophie De Seigneux; Harriet C Thoeny; Jean-Paul Vallée Journal: J Clin Med Date: 2022-03-30 Impact factor: 4.241
Authors: Charlotte Buchanan; Huda Mahmoud; Eleanor Cox; Rebecca Noble; Benjamin Prestwich; Isma Kasmi; Maarten W Taal; Susan Francis; Nicholas M Selby Journal: Clin Kidney J Date: 2021-02-10