Paul Kennedy1, Octavia Bane1, Stefanie J Hectors2, Sonja Gordic3, Mark Berger4, Veronica Delaney5, Fadi Salem6, Sara Lewis7, Madhav Menon5, Bachir Taouli8. 1. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, United States. 2. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, United States; Department of Radiology, Weill Cornell Medicine, United States. 3. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, United States; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland. 4. Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, United States. 5. Division of Renal Medicine, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, United States. 6. Department of Pathology, Icahn School of Medicine at Mount Sinai, United States. 7. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, United States; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, United States. 8. BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, United States; Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, United States. Electronic address: bachir.taouli@mountsinai.org.
Abstract
PURPOSE: To investigate the utility of magnetic resonance elastography (MRE) vs. ultrasound (US) point shear wave elastography (pSWE) for the assessment of chronic renal allograft dysfunction, prediction of outcome and determine the correlation with Banff pathology scores. METHODS: In this IRB approved prospective study, 27 enrolled patients with functional (n = 15) and chronic dysfunctional (n = 12) renal allografts underwent same day 2D MRE and pSWE. Histogram parameters [including mean, median, standard deviation, kurtosis and skewness] of the magnitude of the complex shear modulus (MRE) and median Young's modulus (pSWE) were measured in the cortex (MRE and pSWE) and combined corticomedullary regions (MRE). Histopathology was available for 16 patients (4 functional, 12 dysfunctional). RESULTS: MRE and pSWE stiffness were not significantly different between functional and dysfunctional groups (p range 0.139-0.347). The skewness of MRE corticomedullary stiffness was significantly lower (p = 0.04) in patients with chronic dysfunction and correlated significantly with Banff histopathologic scores (range r=-0.518-0.567, p = 0.035-0.040). MRE cortical and corticomedullary mean stiffness showed strong performance in predicting graft loss/relist (AUC 0.958, p = 0.011 for both). Reliable pSWE measurements were obtained in 13 patients (48 %). pSWE stiffness did not correlate with Banff scores and did not predict outcome. CONCLUSIONS: The skewness of MRE corticomedullary stiffness is sensitive to changes in chronic allograft dysfunction, while mean/median MRE renal stiffness and median US stiffness did not differentiate patients with stable function vs those with chronic renal allograft dysfunction. MRE corticomedullary mean stiffness appears to be a predictor of graft loss/relist. pSWE was not found to be a useful method for assessing renal allografts.
PURPOSE: To investigate the utility of magnetic resonance elastography (MRE) vs. ultrasound (US) point shear wave elastography (pSWE) for the assessment of chronic renal allograft dysfunction, prediction of outcome and determine the correlation with Banff pathology scores. METHODS: In this IRB approved prospective study, 27 enrolled patients with functional (n = 15) and chronic dysfunctional (n = 12) renal allografts underwent same day 2D MRE and pSWE. Histogram parameters [including mean, median, standard deviation, kurtosis and skewness] of the magnitude of the complex shear modulus (MRE) and median Young's modulus (pSWE) were measured in the cortex (MRE and pSWE) and combined corticomedullary regions (MRE). Histopathology was available for 16 patients (4 functional, 12 dysfunctional). RESULTS: MRE and pSWE stiffness were not significantly different between functional and dysfunctional groups (p range 0.139-0.347). The skewness of MRE corticomedullary stiffness was significantly lower (p = 0.04) in patients with chronic dysfunction and correlated significantly with Banff histopathologic scores (range r=-0.518-0.567, p = 0.035-0.040). MRE cortical and corticomedullary mean stiffness showed strong performance in predicting graft loss/relist (AUC 0.958, p = 0.011 for both). Reliable pSWE measurements were obtained in 13 patients (48 %). pSWE stiffness did not correlate with Banff scores and did not predict outcome. CONCLUSIONS: The skewness of MRE corticomedullary stiffness is sensitive to changes in chronic allograft dysfunction, while mean/median MRE renal stiffness and median US stiffness did not differentiate patients with stable function vs those with chronic renal allograft dysfunction. MRE corticomedullary mean stiffness appears to be a predictor of graft loss/relist. pSWE was not found to be a useful method for assessing renal allografts.
Authors: A L Croci Chiocchini; C Sportoletti; G Comai; S Brocchi; I Capelli; O Baraldi; P Bruno; F Conti; C Serra; M Meola; M Zompatori; G La Manna Journal: Prog Transplant Date: 2017-12 Impact factor: 1.187
Authors: T Nakao; H Ushigome; T Nakamura; S Harada; K Koshino; T Suzuki; T Ito; S Nobori; N Yoshimura Journal: Transplant Proc Date: 2015-04 Impact factor: 1.066
Authors: Fernando G Cosio; Joseph P Grande; Hani Wadei; Timothy S Larson; Matthew D Griffin; Mark D Stegall Journal: Am J Transplant Date: 2005-10 Impact factor: 8.086
Authors: Lizette Warner; Meng Yin; Kevin J Glaser; John A Woollard; Carolina A Carrascal; Michael J Korsmo; John A Crane; Richard L Ehman; Lilach O Lerman Journal: Invest Radiol Date: 2011-08 Impact factor: 6.016