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Rigamonti E, Caruzzo CA, Valotta A, Caretta A, Scopigni FR. Autosomal dominant polycystic kidney disease and pericardial effusion: coincidence? I think not! Case report and review of the literature. Eur Heart J Case Rep 2024; 8:ytae144. [PMID: 38576468 PMCID: PMC10993018 DOI: 10.1093/ehjcr/ytae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary disease causing chronic renal failure, with a high incidence of extra-renal manifestations including pericardial effusion. Case summary We present the case of a 41-year-old female, known for ADPKD, who presented to our emergency department with epigastric pain radiating to the interscapular area. Blood exams showed moderate increase in inflammatory markers. Echocardiography revealed a circumferential pericardial effusion of 10 mm. She was put under treatment with colchicine therapy (1 mg b.i.d.) based on a presumptive diagnosis of acute pericarditis with pericardial effusion. She was hospitalized due to increase in pericardial effusion, underwent pericardial drainage, and started prednisone therapy with rapid recovery. We started a close follow-up on a monthly basis, with progressive decrease in pericardial effusion and progressive amelioration in symptoms, although the patient continued to report mild asthenia. Discussion Pericardial effusion and ADPKD are conditions that both require an interdisciplinary discussion for optimal patient care that avoids neglecting pivotal symptoms and avoidable invasive examinations.
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Affiliation(s)
- Elia Rigamonti
- Department of Cardiology, Institute Cardio-Centro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Carlo Alberto Caruzzo
- Department of Cardiology, Institute Cardio-Centro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Amabile Valotta
- Department of Cardiology, Institute Cardio-Centro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Alessandro Caretta
- Department of Cardiology, Institute Cardio-Centro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Francesca Romana Scopigni
- Department of Cardiology, Institute Cardio-Centro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
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Petrone M, Catania M, De Rosa LI, Degliuomini RS, Kola K, Lupi C, Brambilla Pisoni M, Salvatore S, Candiani M, Vezzoli G, Sciarrone Alibrandi MT. Role of Female Sex Hormones in ADPKD Progression and a Personalized Approach to Contraception and Hormonal Therapy. J Clin Med 2024; 13:1257. [PMID: 38592079 PMCID: PMC10932431 DOI: 10.3390/jcm13051257] [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: 12/19/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
This review navigates the intricate relationship between gender, hormonal influences, and the progression of autosomal dominant polycystic kidney disease (ADPKD), highlighting the limited literature on this crucial topic. The study explores the impact of female sex hormones on liver and renal manifestations, uncovering gender-specific differences in disease progression. Actually, hormonal therapy in women with ADPKD remains a challenging issue and is a source of concern regarding its potential impact on disease outcomes, particularly at the hepatic level. Notably, women with ADPKD exhibit a slower renal disease progression compared to men, attributed to hormonal dynamics. This review sheds light on the role of estrogen in regulating pathways of the renin-angiotensin-aldosterone system, revealing its complex interplay and implications for cardiovascular and renal health. Therapeutic considerations for fertile women with ADPKD, including contraception options, are discussed, emphasizing the necessity for personalized approaches. In the postmenopausal phase, the review evaluates the role of hormonal replacement therapy, considering its potential benefits and risks in the context of ADPKD. The review concludes by underscoring the imperative need for tailored treatment approaches for ADPKD patients, considering individual risks and benefits. The scarcity of literature underlines the call for further research to enhance our understanding of optimal hormonal therapies in the context of ADPKD, ultimately paving the way for innovative and personalized therapeutic interventions.
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Affiliation(s)
- Micaela Petrone
- O.U. Obstetric and Gynecology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (M.P.); (R.S.D.); (C.L.); (S.S.); (M.C.)
| | - Martina Catania
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Liliana Italia De Rosa
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Rebecca S. Degliuomini
- O.U. Obstetric and Gynecology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (M.P.); (R.S.D.); (C.L.); (S.S.); (M.C.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Kristiana Kola
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Chiara Lupi
- O.U. Obstetric and Gynecology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (M.P.); (R.S.D.); (C.L.); (S.S.); (M.C.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Brambilla Pisoni
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
| | - Stefano Salvatore
- O.U. Obstetric and Gynecology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (M.P.); (R.S.D.); (C.L.); (S.S.); (M.C.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Massimo Candiani
- O.U. Obstetric and Gynecology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (M.P.); (R.S.D.); (C.L.); (S.S.); (M.C.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Giuseppe Vezzoli
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
- Vita Salute San Raffaele University, 20132 Milan, Italy
| | - Maria Teresa Sciarrone Alibrandi
- O.U. Nephrology and Dialysis, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (L.I.D.R.); (K.K.); (M.B.P.); (G.V.); (M.T.S.A.)
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Hogan MC, Simmons K, Ullman L, Gondal M, Dahl NK. Beyond Loss of Kidney Function: Patient Care in Autosomal Dominant Polycystic Kidney Disease. KIDNEY360 2023; 4:1806-1815. [PMID: 38010035 PMCID: PMC10758524 DOI: 10.34067/kid.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
Patients with autosomal dominant polycystic kidney disease benefit from specialized care over their lifetimes, starting with diagnosis of the condition with ongoing discussion of both the renal course and extra-renal issues. Both renal and extra-renal issues may continue to cause major morbidity even after successful kidney transplant or initiation of RRT, and extra-renal disease aspects should always be considered as part of routine management. In this review, we will focus on updates in pain/depression screening, cardiac manifestations, liver and pancreatic cysts, kidney stone management, and genetic counseling. In some instances, we have shared our current clinical practice rather than an evidence-based guideline. We anticipate more standardization of care after the release of the Kidney Disease Improving Global Outcomes guidelines for management in autosomal dominant polycystic kidney disease later this year.
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Affiliation(s)
- Marie C. Hogan
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Kathryn Simmons
- Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Lawrence Ullman
- Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Maryam Gondal
- Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Neera K. Dahl
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
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Zhu J, Liu F, Mao J. Clinical findings, underlying pathogenetic processes and treatment of vascular dysfunction in autosomal dominant polycystic kidney disease. Ren Fail 2023; 45:2282027. [PMID: 37970664 PMCID: PMC11001366 DOI: 10.1080/0886022x.2023.2282027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by the development of fluid-filled cysts in the kidneys. The primary cause of ADPKD is mutations in the PKD1 (polycystic kidney disease 1) or PKD2 (polycystic kidney disease 2) gene. Patients with ADPKD often develop a variety of vascular abnormalities, which have a major impact on the structure and function of the blood vessels and can lead to complications such as hypertension, intracranial aneurysm (ICAN), and atherosclerosis. The progression of ADPKD involves intricate molecular and cellular processes that lead to the development of these vascular abnormalities. Our understanding of these processes remains incomplete, and available treatment options are limited. The aim of this review is to delve into the underlying mechanisms of these vascular abnormalities and to explore potential interventions.
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Affiliation(s)
- Jinjun Zhu
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Fei Liu
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianhua Mao
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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5
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Jost JS, Kaireit TF, Auber B, Beller J, Schmidt-Ott KM, Schmitt R, Wulfmeyer VC. Prevalence of pericardial effusion in autosomal dominant polycystic kidney disease. Clin Kidney J 2023; 16:2041-2047. [PMID: 37915895 PMCID: PMC10616529 DOI: 10.1093/ckj/sfad181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Indexed: 11/03/2023] Open
Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) has numerous extrarenal manifestations. Pericardial effusion (PE) may be an underrecognized complication with a reported prevalence of up to 35%. Our study is the first to systematically evaluate the prevalence of PE and associated risk factors in an ADPKD cohort outside the USA. Methods Clinically stable ADPKD patients from a specialized outpatient clinic were evaluated retrospectively. Magnetic resonance tomography and computed tomography scans were analysed regarding the presence of PE (≥4 mm). Imaging results were linked to clinical characteristics. Results Of 286 ADPKD patients, 208 had computed tomography or magnetic resonance imaging suitable for evaluation of PE. In this group we detected PE in 17 patients (8.2%). The overall prevalence of PE was 6.3%, with more females being affected (prevalence of PE was 7.8% in females and 3.8% in males). The PE mean size was 6.8 ± 3.3 mm. The prevalence of autoimmune diseases was higher in the patients with PE (11.8% versus 2.1%, P = .022), while the presence and size of PE was not associated with signs of rapid progressive disease, ADPKD genotype, patient age, body mass index and other clinical parameters. Exploratory investigation of individual characteristics of PE patients by regression tree analysis suggested renal functional impairment, sex and proteinuria as candidate variables. Conclusions PE prevalence in our cohort was lower than previously reported and showed a clear female preponderance. Our data suggest that patients with PEs >10 mm deserve further attention, as they may have additional non-ADPKD-related pathologies.
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Affiliation(s)
- Johanna Sophia Jost
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Till Frederik Kaireit
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Bernd Auber
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | | | - Roland Schmitt
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
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Rahbari-Oskoui FF. Management of Hypertension and Associated Cardiovascular Disease in Autosomal Dominant Polycystic Kidney Disease. ADVANCES IN KIDNEY DISEASE AND HEALTH 2023; 30:417-428. [PMID: 38097332 DOI: 10.1053/j.akdh.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 12/18/2023]
Abstract
Autosomal dominant polycystic kidney disease is the most commonly inherited disease of the kidneys affecting an estimated 12,000,000 people in the world. Autosomal dominant polycystic kidney disease is a systemic disease, with a wide range of associated features that includes hypertension, valvular heart diseases, cerebral aneurysms, aortic aneurysms, liver cysts, abdominal hernias, diverticulosis, gross hematuria, urinary tract infections, nephrolithiasis, pancreatic cysts, and seminal vesicle cysts. The cardiovascular anomalies are somewhat different than in the general population and also chronic kidney disease population, with higher morbidity and mortality rates. This review will focus on cardiovascular diseases associated with autosomal dominant polycystic kidney disease and their management.
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Affiliation(s)
- Frederic F Rahbari-Oskoui
- Director of the PKD Center of Excellence, Department of Medicine-Renal Division, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, GA.
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Caroli A, Kline TL. Abdominal Imaging in ADPKD: Beyond Total Kidney Volume. J Clin Med 2023; 12:5133. [PMID: 37568535 PMCID: PMC10420262 DOI: 10.3390/jcm12155133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
In the context of autosomal dominant polycystic kidney disease (ADPKD), measurement of the total kidney volume (TKV) is crucial. It acts as a marker for tracking disease progression, and evaluating the effectiveness of treatment strategies. The TKV has also been recognized as an enrichment biomarker and a possible surrogate endpoint in clinical trials. Several imaging modalities and methods are available to calculate the TKV, and the choice depends on the purpose of use. Technological advancements have made it possible to accurately assess the cyst burden, which can be crucial to assessing the disease state and helping to identify rapid progressors. Moreover, the development of automated algorithms has increased the efficiency of total kidney and cyst volume measurements. Beyond these measurements, the quantification and characterization of non-cystic kidney tissue shows potential for stratifying ADPKD patients early on, monitoring disease progression, and possibly predicting renal function loss. A broad spectrum of radiological imaging techniques are available to characterize the kidney tissue, showing promise when it comes to non-invasively picking up the early signs of ADPKD progression. Radiomics have been used to extract textural features from ADPKD images, providing valuable information about the heterogeneity of the cystic and non-cystic components. This review provides an overview of ADPKD imaging biomarkers, focusing on the quantification methods, potential, and necessary steps toward a successful translation to clinical practice.
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Affiliation(s)
- Anna Caroli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
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8
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Liu J, Yin X, Dev H, Luo X, Blumenfeld JD, Rennert H, Prince MR. Pleural Effusions on MRI in Autosomal Dominant Polycystic Kidney Disease. J Clin Med 2023; 12:386. [PMID: 36615184 PMCID: PMC9820892 DOI: 10.3390/jcm12010386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) has cystic fluid accumulations in the kidneys, liver, pancreas, arachnoid spaces as well as non-cystic fluid accumulations including pericardial effusions, dural ectasia and free fluid in the male pelvis. Here, we investigate the possible association of ADPKD with pleural effusion. ADPKD subjects (n = 268) and age-gender matched controls without ADPKD (n = 268) undergoing body magnetic resonance imaging from mid-thorax down into the pelvis were independently evaluated for pleural effusion by 3 blinded expert observers. Subjects with conditions associated with pleural effusion were excluded from both populations. Clinical and laboratory data as well as kidney, liver and spleen volume, pleural fluid volume, free pelvic fluid and polycystic kidney disease genotype were evaluated. Pleural effusions were observed in 56 of 268 (21%) ADPKD subjects compared with 21 of 268 (8%) in controls (p < 0.0001). In a subpopulation controlling for renal function by matching estimated glomerular filtration rate (eGFR), 28 of 110 (25%) ADPKD subjects had pleural effusions compared to 5 of 110 (5%) controls (p < 0.001). Pleural effusions in ADPKD subjects were more prevalent in females (37/141; 26%) than males (19/127,15%; p = 0.02) and in males were weakly correlated with the presence of free pelvic fluid (r = 0.24, p = 0.02). ADPKD subjects with pleural effusions were younger (48 ± 14 years old vs. 43 ± 14 years old) and weighed less (77 vs. 70 kg; p ≤ 0.02) than those without pleural effusions. For ADPKD subjects with pleural effusions, the mean volume of fluid layering dependently in the posterior−inferior thorax was 19 mL and was not considered to be clinically significant. Pleural effusion is associated with ADPKD, but its role in the pathogenesis of ADPKD requires further evaluation.
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Affiliation(s)
- Jin Liu
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Xiaorui Yin
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Hreedi Dev
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Xianfu Luo
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Jon D. Blumenfeld
- Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA
- The Rogosin Institute, New York, NY 10065, USA
| | - Hanna Rennert
- Department of Pathology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Martin R. Prince
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
- Columbia College of Physicians and Surgeons, New York, NY 10027, USA
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The Changing Complementary Role of Multimodality Imaging in Clinical Cardiology. J Clin Med 2022; 11:jcm11237095. [PMID: 36498670 PMCID: PMC9736251 DOI: 10.3390/jcm11237095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022] Open
Abstract
Over the past two decades, major technological developments and progress have been reached for all imaging modalities applied to clinical cardiology, from echocardiography to magnetic resonance, computed tomography, nuclear imaging, etc [...].
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10
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Sharbatdaran A, Romano D, Teichman K, Dev H, Raza SI, Goel A, Moghadam MC, Blumenfeld JD, Chevalier JM, Shimonov D, Shih G, Wang Y, Prince MR. Deep Learning Automation of Kidney, Liver, and Spleen Segmentation for Organ Volume Measurements in Autosomal Dominant Polycystic Kidney Disease. Tomography 2022; 8:1804-1819. [PMID: 35894017 PMCID: PMC9326744 DOI: 10.3390/tomography8040152] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/01/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
Organ volume measurements are a key metric for managing ADPKD (the most common inherited renal disease). However, measuring organ volumes is tedious and involves manually contouring organ outlines on multiple cross-sectional MRI or CT images. The automation of kidney contouring using deep learning has been proposed, as it has small errors compared to manual contouring. Here, a deployed open-source deep learning ADPKD kidney segmentation pipeline is extended to also measure liver and spleen volumes, which are also important. This 2D U-net deep learning approach was developed with radiologist labeled T2-weighted images from 215 ADPKD subjects (70% training = 151, 30% validation = 64). Additional ADPKD subjects were utilized for prospective (n = 30) and external (n = 30) validations for a total of 275 subjects. Image cropping previously optimized for kidneys was included in training but removed for the validation and inference to accommodate the liver which is closer to the image border. An effective algorithm was developed to adjudicate overlap voxels that are labeled as more than one organ. Left kidney, right kidney, liver and spleen labels had average errors of 3%, 7%, 3%, and 1%, respectively, on external validation and 5%, 6%, 5%, and 1% on prospective validation. Dice scores also showed that the deep learning model was close to the radiologist contouring, measuring 0.98, 0.96, 0.97 and 0.96 on external validation and 0.96, 0.96, 0.96 and 0.95 on prospective validation for left kidney, right kidney, liver and spleen, respectively. The time required for manual correction of deep learning segmentation errors was only 19:17 min compared to 33:04 min for manual segmentations, a 42% time saving (p = 0.004). Standard deviation of model assisted segmentations was reduced to 7, 5, 11, 5 mL for right kidney, left kidney, liver and spleen respectively from 14, 10, 55 and 14 mL for manual segmentations. Thus, deep learning reduces the radiologist time required to perform multiorgan segmentations in ADPKD and reduces measurement variability.
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Affiliation(s)
- Arman Sharbatdaran
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Dominick Romano
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Kurt Teichman
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Hreedi Dev
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Syed I. Raza
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Akshay Goel
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Mina C. Moghadam
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Jon D. Blumenfeld
- The Rogosin Institute and Department of Medicine Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (J.D.B.); (J.M.C.); (D.S.)
| | - James M. Chevalier
- The Rogosin Institute and Department of Medicine Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (J.D.B.); (J.M.C.); (D.S.)
| | - Daniil Shimonov
- The Rogosin Institute and Department of Medicine Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (J.D.B.); (J.M.C.); (D.S.)
| | - George Shih
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
| | - Yi Wang
- Departments of Radiology at Weill Cornell Medicine and Biomedical Engineering, Cornell University, New York, NY 10065, USA;
| | - Martin R. Prince
- Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA; (A.S.); (D.R.); (K.T.); (H.D.); (S.I.R.); (A.G.); (M.C.M.); (G.S.)
- Columbia College of Physicians and Surgeons, Cornell University, New York, NY 10027, USA
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