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Ng KH, Wong JHD, Leong SS. Shear wave elastography in chronic kidney disease - the physics and clinical application. Phys Eng Sci Med 2024; 47:17-29. [PMID: 38078996 DOI: 10.1007/s13246-023-01358-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 11/15/2023] [Indexed: 03/26/2024]
Abstract
Chronic kidney disease is a leading public health problem worldwide. The global prevalence of chronic kidney disease is nearly five hundred million people, with almost one million deaths worldwide. Estimated glomerular filtration rate, imaging such as conventional ultrasound, and histopathological findings are necessary as each technique provides specific information which, when taken together, may help to detect and arrest the development of chronic kidney disease, besides managing its adverse outcomes. However, estimated glomerular filtration rate measurements are hampered by substantial error margins while conventional ultrasound involves subjective assessment. Although histopathological assessment is the best tool for evaluating the severity of the renal pathology, it may lead to renal insufficiency and haemorrhage if complications occurred. Ultrasound shear wave elastography, an emerging imaging that quantifies tissue stiffness non-invasively has gained interest recently. This method applies acoustic force pulses to generate shear wave within the tissue that propagate perpendicular to the main ultrasound beam. By measuring the speed of shear wave propagation, the tissue stiffness is estimated. This paper reviews the literature and presents our combined experience and knowledge in renal shear wave elastography research. It discusses and highlights the confounding factors on shear wave elastography, current and future possibilities in ultrasound renal imaging and is not limited to new sophisticated techniques.
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Affiliation(s)
- Kwan Hoong Ng
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Sciences, UCSI University, Port Dickson, Negeri Sembilan, Malaysia
| | - Jeannie Hsiu Ding Wong
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sook Sam Leong
- Centre for Medical Imaging Studies, Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Selangor, Malaysia.
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Dabers T, Sass P, Fechner F, Weyer J, Völzke H, Mahnken AH, Lorbeer R, Mensel B, Stracke S. Age- and Sex-Specific Reference Values for Renal Volume and Association with Risk Factors for Chronic Kidney Disease in a General Population-An MRI-Based Study. J Clin Med 2024; 13:769. [PMID: 38337463 PMCID: PMC10856696 DOI: 10.3390/jcm13030769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Renal volume (RV) is associated with renal function and with a variety of cardiovascular risk factors (CVRFs). We analysed RV using magnetic resonance imaging (MRI) in a large population-based study (Study of Health in Pomerania; SHIP-TREND) to find sex- and age-specific reference values for RV and to test the influence of several markers on RV. The main objective is to describe reference values for RV in people from the general population without kidney disease. METHODS 1815 participants without kidney disease (930 women) aged 21-81 years were included in our study. Right and left RV with and without body surface area (BSA) indexation were compared among three age groups (22-39 years, 40-59 years, 60-81 years) by median and interquartile range and tested separately in women and men. RESULTS The estimated glomerular filtration rate (eGFR), serum uric acid, and right and left RV were higher in men compared to women (all p < 0.001). Left kidneys were larger than right kidneys (both sexes). With age, RV showed a continuously decreasing trend in women and an upside-down U-shaped relation in men. In multivariable linear regression models, current smoking (β = 14.96, 95% CI 12.12; 17.79), BSA (β = 97.66, 95% CI 90.4; 104.93), diastolic blood pressure (β = 0.17, 95% CI 0.01; 0.32), and eGFR (β = 0.57, 95% CI 0.50; 0.65) were positively associated with both left and right RV, whereas uric acid (β = -0.03, 95% CI -0.05; -0.01) showed an inverse association with RV. Interestingly, the same eGFR correlated with higher RV in men compared to women. CONCLUSION Reference values for RV are different for age groups and sex. For any given age, female kidneys are smaller than male kidneys. RV associates positively with eGFR, but for any chosen eGFR, renal volume in females is lower compared to males. RV decreases with age, but in men showed a U-shaped correlation. This may reflect hyperfiltration and glomerular hypertrophy associated with the presence of CVRF in middle-aged males.
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Affiliation(s)
- Thomas Dabers
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
- KfH Renal Center, 17475 Greifswald, Germany
| | - Peter Sass
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Fritz Fechner
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Julian Weyer
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Henry Völzke
- Institute for Community Medicine—SHIP Clinical-Epidemiological Research, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Andreas Horst Mahnken
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, 35037 Marburg, Germany;
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Birger Mensel
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, 35037 Marburg, Germany;
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Central Hospital Bad Berka, 99438 Bad Berka, Germany
| | - Sylvia Stracke
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
- KfH Renal Center, 17475 Greifswald, Germany
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Daniel AJ, Buchanan CE, Allcock T, Scerri D, Cox EF, Prestwich BL, Francis ST. Automated renal segmentation in healthy and chronic kidney disease subjects using a convolutional neural network. Magn Reson Med 2021; 86:1125-1136. [PMID: 33755256 DOI: 10.1002/mrm.28768] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/22/2021] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Total kidney volume (TKV) is an important measure in renal disease detection and monitoring. We developed a fully automated method to segment the kidneys from T2 -weighted MRI to calculate TKV of healthy control (HC) and chronic kidney disease (CKD) patients. METHODS This automated method uses machine learning, specifically a 2D convolutional neural network (CNN), to accurately segment the left and right kidneys from T2 -weighted MRI data. The data set consisted of 30 HC subjects and 30 CKD patients. The model was trained on 50 manually defined HC and CKD kidney segmentations. The model was subsequently evaluated on 50 test data sets, comprising data from 5 HCs and 5 CKD patients each scanned 5 times in a scan session to enable comparison of the precision of the CNN and manual segmentation of kidneys. RESULTS The unseen test data processed by the 2D CNN had a mean Dice score of 0.93 ± 0.01. The difference between manual and automatically computed TKV was 1.2 ± 16.2 mL with a mean surface distance of 0.65 ± 0.21 mm. The variance in TKV measurements from repeat acquisitions on the same subject was significantly lower using the automated method compared to manual segmentation of the kidneys. CONCLUSION The 2D CNN method provides fully automated segmentation of the left and right kidney and calculation of TKV in <10 s on a standard office computer, allowing high data throughput and is a freely available executable.
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Affiliation(s)
- Alexander J Daniel
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Thomas Allcock
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Daniel Scerri
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Benjamin L Prestwich
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom
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Kale P, Choudary GV, Sandeep P, Lakshmi A, Kumar VS, Mantri R. Correlation of three-dimensional computerized tomographic renal parenchymal volumetry with DTPA split renal function in prospective donors - A retrospective study. INDIAN JOURNAL OF TRANSPLANTATION 2021. [DOI: 10.4103/ijot.ijot_71_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Benjamin A, Chen M, Li Q, Chen L, Dong Y, Carrascal CA, Xie H, Samir AE, Anthony BW. Renal Volume Estimation Using Freehand Ultrasound Scans: An Ex Vivo Demonstration. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1769-1782. [PMID: 32376189 DOI: 10.1016/j.ultrasmedbio.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/27/2020] [Accepted: 03/10/2020] [Indexed: 06/11/2023]
Abstract
Renal volume has the potential to serve as a robust biomarker for tracking the onset and progression of renal diseases and also for quantifying renal function. We propose a method to estimate renal volumes using freehand ultrasound scans at the point of care. A conventional ultrasound probe was augmented with an Intel RealSense D435 i camera. Visual inertial simultaneous localization and mapping was used to localize the probe in free space. The acquired 2-D ultrasound images, segmented by trained clinicians, were combined with the estimated poses of the probe to yield accurate volumes. The method was tested on two ex vivo sheep kidneys embedded in gelatin phantoms. Four different scanning protocols were tested: transverse linear, transverse fan, longitudinal linear and longitudinal fan. The estimated renal volumes were compared with those obtained using the water displacement method, the ellipsoidal method and computed tomography imaging. The water displacement method yielded mean volumes of 66.00 and 66.20 mL for kidneys 1 and 2, respectively (ground truth). Freehand ultrasound scans produced mean volumes of 64.08 mL (2.90% error) and 65.25 mL (1.40% error); the ellipsoidal method yielded volumes of 57.49 mL (12.90% error) and 60.15 mL (9.13% error); and computed tomography yielded a volume of 63.00 mL (4.54% error).
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Affiliation(s)
- Alex Benjamin
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Melinda Chen
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Qian Li
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lei Chen
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yi Dong
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Hua Xie
- Philips Research North America, Cambridge, Massachusetts, USA
| | - Anthony E Samir
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian W Anthony
- Device Realization and Computational Instrumentation Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
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Lin P, Min Z, Wei G, Lei H, Feifei Z, Yunfei Z. Volumetric evaluation of renal sinus adipose tissue on computed tomography images in bilateral nephrolithiasis patients. Int Urol Nephrol 2020; 52:1027-1034. [PMID: 32006179 PMCID: PMC7270052 DOI: 10.1007/s11255-020-02395-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/20/2020] [Indexed: 12/29/2022]
Abstract
Purpose To compare renal sinus fat volume (RSFV) separately within the right and left kidneys between bilateral nephrolithiasis patients and healthy controls. Methods This cross-sectional study analyzed patients who underwent unenhanced abdominal computed tomography (CT) divided into nephrolithiasis (n = 102) and healthy control (n = 130) groups. Age, sex, blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP)], estimated glomerular filtration rate (eGFR), body weight, and height of each participant were extracted. Volumetric renal sinus adipose tissue was measured separately for both kidneys on CT images. Urea, serum creatinine (Scr), uric acid (UA), total serum cholesterol (TCH), serum triglyceride (TG), and serum high- and low-density lipoprotein (HDL and LDL, respectively) cholesterol levels were obtained. Results Overall, 232 participants (mean age 47 years, 50% women) were enrolled. There were no differences in sex, DBP, urea, and LDL-cholesterol between the two groups (all p > 0.05). However, nephrolithiasis patients had higher age, BMI, SBP, and RSFV; higher Scr, UA, TCH, and TG serum levels; and lower HDL-cholesterol level and eGFR. Average left RSFV was significantly higher than right RSFV in healthy controls (4.56 ± 2.29 versus 3.34 ± 1.90 cm3, p < 0.001). A significant relationship between bilateral RSFV, age, BMI, SBP, and eGFR was noted in bilateral nephrolithiasis patients. Multivariate linear regression analysis showed age, BMI, and LDL-cholesterol to be independent predictors of left RSFV, and only BMI was an independent predictor of right RSFV. Conclusions Our data showed renal sinus adipose tissue accumulation and the relationship among RSFV, age, BMI, and LDL-cholesterol in bilateral nephrolithiasis patients.
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Affiliation(s)
- Peng Lin
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zeng Min
- Department of Nephrology, The Central Hospital of Wuhan, Wuhan, China
| | - Gong Wei
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hu Lei
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zeng Feifei
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zha Yunfei
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Abstract
BACKGROUND The kidneys are the dose-limiting organ in lutetium-177 DOTATATE therapy. Therefore, it is advisable to perform critical organ dosimetry focussed on renal dose in treated patients. A key uncertainty in such dose estimates is the use of standard phantoms to represent the individual patient. The primary aim of this study was to investigate the accuracy of methods for estimating kidney size, and hence absorbed kidney dose, by comparison with individual measurements from computed tomography (CT) imaging. MATERIALS AND METHODS Kidney volume was measured using diagnostic CT images for 57 patients who underwent lutetium-177 DOTATATE therapy. Kidney mass was also estimated in two ways: using the standard adult phantoms, as well as through the application of a weight scaling factor to these phantoms and their organs. Dose calculations were performed for each of the three methods using OLINDA/EXM software. RESULTS Scaling of the phantom by patient weight gave a more accurate result when compared with the CT gold standard than the standard phantom. The dose difference from the CT method had mean values of 1.4% (SD=22.6%) and 8.4% (SD=21.5%) for scaled and unscaled, respectively. Patient weight was not found to be a good predictor of kidney mass in these patients (r of 0.12 from linear regression analysis). CONCLUSION The most accurate method of organ volume estimation would be individual measurements from CT imaging; however, where this is not possible, scaling of organ masses by weight ratio is more accurate than the use of the standard phantom.
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Roseman DA, Hwang SJ, Oyama-Manabe N, Chuang ML, O'Donnell CJ, Manning WJ, Fox CS. Clinical associations of total kidney volume: the Framingham Heart Study. Nephrol Dial Transplant 2018; 32:1344-1350. [PMID: 27325252 DOI: 10.1093/ndt/gfw237] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 05/18/2016] [Indexed: 01/01/2023] Open
Abstract
Background Total kidney volume (TKV) is an imaging biomarker that may have diagnostic and prognostic utility. The relationships between kidney volume, renal function and cardiovascular disease (CVD) have not been characterized in a large community-dwelling population. This information is needed to advance the clinical application of TKV. Methods We measured TKV in 1852 Framingham Heart Study participants (mean age 64.1 ± 9.2 years, 53% women) using magnetic resonance imaging. A healthy sample was used to define reference values. The associations between TKV, renal function and CVD risk factors were determined using multivariable logistic regression analysis. Results Overall, mean TKV was 278 ± 54 cm3 for women and 365 ± 66 cm3 for men. Risk factors for high TKV (>90% healthy referent size) were body surface area (BSA), diabetes, smoking and albuminuria, while age, female and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 were protective. Participants with high TKV had higher odds of diabetes [odds ratio (OR) 2.15, P < 0.001] and lower odds of eGFR <60 mL/min/1.73 m2 (OR 0.32, P = 0.007). Risk factors for low TKV (<10% healthy referent size) were age, female and eGFR <60 mL/min/1.73 m2, while BSA and diabetes were protective. Participants with low TKV had higher odds of eGFR <60 mL/min/1.73 m2 (OR 6.12, P < 0.001) and albuminuria (OR 1.56, P = 0.03). Conclusions Low TKV is associated with markers of kidney damage including albuminuria and eGFR <60 mL/min/1.73 m2, while high TKV is associated with diabetes and decreased odds of eGFR <60 mL/min/1.73 m2. Prospective studies are needed to characterize the natural progression and clinical consequences of TKV.
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Affiliation(s)
- Daniel A Roseman
- National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA
| | - Shih-Jen Hwang
- National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.,Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Michael L Chuang
- National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.,Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Christopher J O'Donnell
- National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.,Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.,Cardiology Section, Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Warren J Manning
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Caroline S Fox
- National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.,Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.,Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Cox EF, Buchanan CE, Bradley CR, Prestwich B, Mahmoud H, Taal M, Selby NM, Francis ST. Multiparametric Renal Magnetic Resonance Imaging: Validation, Interventions, and Alterations in Chronic Kidney Disease. Front Physiol 2017; 8:696. [PMID: 28959212 PMCID: PMC5603702 DOI: 10.3389/fphys.2017.00696] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 08/30/2017] [Indexed: 12/15/2022] Open
Abstract
Background: This paper outlines a multiparametric renal MRI acquisition and analysis protocol to allow non-invasive assessment of hemodynamics (renal artery blood flow and perfusion), oxygenation (BOLD T2*), and microstructure (diffusion, T1 mapping). Methods: We use our multiparametric renal MRI protocol to provide (1) a comprehensive set of MRI parameters [renal artery and vein blood flow, perfusion, T1, T2*, diffusion (ADC, D, D*, fp), and total kidney volume] in a large cohort of healthy participants (127 participants with mean age of 41 ± 19 years) and show the MR field strength (1.5 T vs. 3 T) dependence of T1 and T2* relaxation times; (2) the repeatability of multiparametric MRI measures in 11 healthy participants; (3) changes in MRI measures in response to hypercapnic and hyperoxic modulations in six healthy participants; and (4) pilot data showing the application of the multiparametric protocol in 11 patients with Chronic Kidney Disease (CKD). Results: Baseline measures were in-line with literature values, and as expected, T1-values were longer at 3 T compared with 1.5 T, with increased T1 corticomedullary differentiation at 3 T. Conversely, T2* was longer at 1.5 T. Inter-scan coefficients of variation (CoVs) of T1 mapping and ADC were very good at <2.9%. Intra class correlations (ICCs) were high for cortex perfusion (0.801), cortex and medulla T1 (0.848 and 0.997 using SE-EPI), and renal artery flow (0.844). In response to hypercapnia, a decrease in cortex T2* was observed, whilst no significant effect of hyperoxia on T2* was found. In CKD patients, renal artery and vein blood flow, and renal perfusion was lower than for healthy participants. Renal cortex and medulla T1 was significantly higher in CKD patients compared to healthy participants, with corticomedullary T1 differentiation reduced in CKD patients compared to healthy participants. No significant difference was found in renal T2*. Conclusions: Multiparametric MRI is a powerful technique for the assessment of changes in structure, hemodynamics, and oxygenation in a single scan session. This protocol provides the potential to assess the pathophysiological mechanisms in various etiologies of renal disease, and to assess the efficacy of drug treatments.
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Affiliation(s)
- Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Christopher R Bradley
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Benjamin Prestwich
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Huda Mahmoud
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Maarten Taal
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
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Comparison of the planimetry and point-counting methods for estimating kidney volume using magnetic resonance imaging. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2017.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Cansu A, Kupeli A, Kul S, Eyuboglu I, Oguz S, Ozturk MH, Dinc H. Evaluation of the relationship between renal function and renal volume-vascular indices using 3D power Doppler ultrasound. Eur J Radiol 2014; 83:1080-1085. [DOI: 10.1016/j.ejrad.2014.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 11/27/2022]
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Tyson R, Logsdon SA, Werre SR, Daniel GB. Estimation of feline renal volume using computed tomography and ultrasound. Vet Radiol Ultrasound 2012; 54:127-32. [PMID: 23278991 DOI: 10.1111/vru.12007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/14/2012] [Indexed: 11/27/2022] Open
Abstract
Renal volume estimation is an important parameter for clinical evaluation of kidneys and research applications. A time efficient, repeatable, and accurate method for volume estimation is required. The purpose of this study was to describe the accuracy of ultrasound and computed tomography (CT) for estimating feline renal volume. Standardized ultrasound and CT scans were acquired for kidneys of 12 cadaver cats, in situ. Ultrasound and CT multiplanar reconstructions were used to record renal length measurements that were then used to calculate volume using the prolate ellipsoid formula for volume estimation. In addition, CT studies were reconstructed at 1 mm, 5 mm, and 1 cm, and transferred to a workstation where the renal volume was calculated using the voxel count method (hand drawn regions of interest). The reference standard kidney volume was then determined ex vivo using water displacement with the Archimedes' principle. Ultrasound measurement of renal length accounted for approximately 87% of the variability in renal volume for the study population. The prolate ellipsoid formula exhibited proportional bias and underestimated renal volume by a median of 18.9%. Computed tomography volume estimates using the voxel count method with hand-traced regions of interest provided the most accurate results, with increasing accuracy for smaller voxel sizes in grossly normal kidneys (-10.1 to 0.6%). Findings from this study supported the use of CT and the voxel count method for estimating feline renal volume in future clinical and research studies.
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Affiliation(s)
- Reid Tyson
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061, USA.
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Gupta S, Singh AH, Shabbir A, Hahn PF, Harris G, Sahani D. Assessing renal parenchymal volume on unenhanced CT as a marker for predicting renal function in patients with chronic kidney disease. Acad Radiol 2012; 19:654-60. [PMID: 22578224 DOI: 10.1016/j.acra.2012.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 02/10/2012] [Accepted: 02/13/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To estimate renal volume in chronic kidney disease (CKD) patients using a semiautomated software and compare them with split renal function estimates from radionuclide renogram (RR). We proposed that renal volume from unenhanced computed tomography (CT) scans may serve as surrogate marker for assessing renal function in CKD patients. MATERIALS AND METHODS Unenhanced multidetector CT scans of 26 patients with CKD (estimated glomerular filtration rate [eGFR] <60 mL/kg/body surface area [BSA]) and 10 controls (eGFR >60 mL/kg/BSA) were analyzed to calculate renal volumes using a semiautomated software (AMIRAV5.2.0). Volumes obtained were then correlated with corresponding eGFR and split renal function estimates from RR. Volumes were also compared with those obtained on enhanced scans in 10 cases (five disease group, five controls). Bland-Altman analysis was used to assess agreement between methods. RESULTS A moderately positive correlation was found between renal volume obtained on unenhanced CT and eGFR (r = 0.65, P < .0001), whereas a significantly high correlation with split function estimates from RR (r = 0.95, P < .001) was found. Bland-Altman analysis revealed a good agreement between renal volume from CT and renal function from RR (34/36 observations were within 95% CI and there were two outliers). Correlation between volumes obtained from unenhanced and enhanced CT scans was also significant (r = 0.96). CONCLUSION In patients with CKD, renal volume derived from unenhanced CT can possibly serve as a surrogate marker for assessing and monitoring renal function reserves to plan further management.
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Affiliation(s)
- Supriya Gupta
- Department of Abdominal and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
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Gong IH, Hwang J, Choi DK, Lee SR, Hong YK, Hong JY, Park DS, Jeon HG. Relationship among total kidney volume, renal function and age. J Urol 2011; 187:344-9. [PMID: 22099987 DOI: 10.1016/j.juro.2011.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Indexed: 01/22/2023]
Abstract
PURPOSE We measured kidney volume using software and investigated the relationship between kidney volume and renal function. MATERIALS AND METHODS Age, gender, height, body weight, body mass index, body surface area and serum creatinine were recorded for 539 normal individuals. A tissue segmentation tool program was used to measure kidney volume from computerized tomography images. The glomerular filtration rate was calculated using the Cockcroft-Gault equation and an abbreviated modification of diet in renal disease equation. We looked for correlations of renal parenchymal volume with age and anthropometric measurements. We also tested for a correlation between kidney volume and renal function using the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations. RESULTS Mean kidney volume in all participants was 261.3 ± 58.1 ml. Mean volume in men was approximately 14 ml greater than in women (266.1 vs 251.8 ml, p = 0.004). Kidney volume correlated significantly with height (r = 0.344, p <0.001), body weight (r = 0.343, p <0.001), body mass index (r = 0.177, p <0.001), body surface area (r = 0.371, p <0.001) and age (r = -0.418, p <0.001). Kidney volume also correlated with the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations (p <0.001, r = 0.615 and p <0.001, r = 0.432, respectively). Kidney volume and the glomerular filtration rate decreased in parallel with increasing age. CONCLUSIONS Kidney volume correlates well with renal function and anthropometric measurements. Knowledge of these relationships will be valuable in clinical urology and nephrology.
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Affiliation(s)
- In Hyuck Gong
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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15
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Kalisvaart J, Bootwala Y, Poonawala H, Elmore J, Kirsch A, Scherz H, Jones R, Grattan-Smith JD, Smith E. Comparison of Ultrasound and Magnetic Resonance Urography for Evaluation of Contralateral Kidney in Patients With Multicystic Dysplastic Kidney Disease. J Urol 2011; 186:1059-64. [DOI: 10.1016/j.juro.2011.04.105] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Indexed: 11/26/2022]
Affiliation(s)
- Jonathan Kalisvaart
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Yasmin Bootwala
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Husain Poonawala
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - James Elmore
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Andrew Kirsch
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Hal Scherz
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Richard Jones
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - J. Damien Grattan-Smith
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
| | - Edwin Smith
- Emory University School of Medicine (JK, YB, JE, AK, HS, ES) and Children's Healthcare of Atlanta (JE, AK, HS, RJ, JDG-S, ES), Atlanta, Georgia
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Muto NS, Kamishima T, Harris AA, Kato F, Onodera Y, Terae S, Shirato H. Renal cortical volume measured using automatic contouring software for computed tomography and its relationship with BMI, age and renal function. Eur J Radiol 2011; 78:151-6. [PMID: 19914788 DOI: 10.1016/j.ejrad.2009.10.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 09/28/2009] [Accepted: 10/01/2009] [Indexed: 10/20/2022]
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17
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Gronwald W, Klein MS, Zeltner R, Schulze BD, Reinhold SW, Deutschmann M, Immervoll AK, Böger CA, Banas B, Eckardt KU, Oefner PJ. Detection of autosomal dominant polycystic kidney disease by NMR spectroscopic fingerprinting of urine. Kidney Int 2011; 79:1244-53. [PMID: 21389975 DOI: 10.1038/ki.2011.30] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is a frequent cause of kidney failure; however, urinary biomarkers for the disease are lacking. In a step towards identifying such markers, we used multidimensional-multinuclear nuclear magnetic resonance (NMR) spectroscopy with support vector machine-based classification and analyzed urine specimens of 54 patients with ADPKD and slightly reduced estimated glomerular filtration rates. Within this cohort, 35 received medication for arterial hypertension and 19 did not. The results were compared with NMR profiles of 46 healthy volunteers, 10 ADPKD patients on hemodialysis with residual renal function, 16 kidney transplant patients, and 52 type 2 diabetic patients with chronic kidney disease. Based on the average of 51 out of 701 NMR features, we could reliably discriminate ADPKD patients with moderately advanced disease from ADPKD patients with end-stage renal disease, patients with chronic kidney disease of other etiologies, and healthy probands with an accuracy of >80%. Of the 35 patients with ADPKD receiving medication for hypertension, most showed increased excretion of proteins and also methanol. In contrast, elevated urinary methanol was not found in any of the control and other patient groups. Thus, we found that NMR fingerprinting of urine differentiates ADPKD from several other kidney diseases and individuals with normal kidney function. The diagnostic and prognostic potential of these profiles requires further evaluation.
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Affiliation(s)
- Wolfram Gronwald
- Institute of Functional Genomics, University of Regensburg, Germany.
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18
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Meijer E, Rook M, Tent H, Navis G, van der Jagt EJ, de Jong PE, Gansevoort RT. Early renal abnormalities in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2010; 5:1091-8. [PMID: 20413443 PMCID: PMC2879311 DOI: 10.2215/cjn.00360110] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 03/10/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Potential therapeutic interventions are being developed for autosomal dominant polycystic kidney disease (ADPKD). A pivotal question will be when to initiate such treatment, and monitoring disease progression will thus become more important. Therefore, the prevalence of renal abnormalities in ADPKD at different ages was evaluated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Included were 103 prevalent ADPKD patients (Ravine criteria). Measured were mean arterial pressure (MAP), total renal volume (TRV), GFR, effective renal plasma flow (ERPF), renal vascular resistance (RVR), and filtration fraction (FF). Twenty-four-hour urine was collected. ADPKD patients were compared with age- and gender-matched healthy controls. RESULTS Patients and controls were subdivided into quartiles of age (median ages 28, 37, 42, and 52 years). Patients in the first quartile of age had almost the same GFR when compared with controls, but already a markedly decreased ERPF and an increased FF (GFR 117 +/- 32 versus 129 +/- 17 ml/min, ERPF 374 +/- 119 versus 527 +/- 83 ml/min, FF 32% +/- 4% versus 25% +/- 2%, and RVR 12 (10 to 16) versus 8 (7 to 8) dynes/cm(2), respectively). Young adult ADPKD patients also had higher 24-hour urinary volumes, lower 24-hour urinary osmolarity, and higher urinary albumin excretion (UAE) than healthy controls, although TRV in these young adult patients was modestly enlarged (median 1.0 L). CONCLUSIONS Already at young adult age, ADPKD patients have marked renal abnormalities, including a decreased ERPF and increased FF and UAE, despite modestly enlarged TRV and near-normal GFR. ERPF, FF, and UAE may thus be better markers for disease severity than GFR.
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Affiliation(s)
- Esther Meijer
- Division of Nephrology, Department of Internal Medicine and
| | - Mieneke Rook
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hilde Tent
- Division of Nephrology, Department of Internal Medicine and
| | - Gerjan Navis
- Division of Nephrology, Department of Internal Medicine and
| | - Eric J. van der Jagt
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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