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Evaluating Renal Transplant Status Using Viscoelastic Response (VisR) Ultrasound
- Source :
- Ultrasound in Medicine & Biology. 44:1573-1584
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Chronic kidney disease is most desirably and cost-effectively treated by renal transplantation, but graft survival is a major challenge. Although irreversible graft damage can be averted by timely treatment, intervention is delayed when early graft dysfunction goes undetected by standard clinical metrics. A more sensitive and specific parameter for delineating graft health could be the viscoelastic properties of the renal parenchyma, which are interrogated non-invasively by Viscoelastic Response (VisR) ultrasound, a new acoustic radiation force (ARF)-based imaging method. Assessing the performance of VisR imaging in delineating histologically confirmed renal transplant pathologies in vivo is the purpose of the study described here. VisR imaging was performed in patients with (n = 19) and without (n = 25) clinical indication for renal allograft biopsy. The median values of VisR outcome metrics (τ, relative elasticity [RE] and relative viscosity [RV]) were calculated in five regions of interest that were manually delineated in the parenchyma (outer, center and inner) and in the pelvis (outer and inner). The ratios of a given VisR metric for all possible region-of-interest combinations were calculated, and the corresponding ratios were statistically compared between biopsied patients subdivided by diagnostic categories versus non-biopsied, control allografts using the two-sample Wilcoxon test (p 0.05). Although τ ratios non-specifically differentiated allografts with vascular disease, tubular/interstitial scarring, chronic allograft nephropathy and glomerulonephritis from non-biopsied control allografts, RE distinguished only allografts with vascular disease and tubular/interstitial scarring, and RV distinguished only vascular disease. These results suggest that allografts with scarring and vascular disease can be identified using non-invasive VisR RE and RV metrics.
- Subjects :
- Adult
Male
medicine.medical_specialty
Acoustics and Ultrasonics
Biophysics
030230 surgery
Kidney
01 natural sciences
Article
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
0103 physical sciences
Biopsy
Parenchyma
Image Processing, Computer-Assisted
Humans
Medicine
Radiology, Nuclear Medicine and imaging
In patient
Prospective Studies
010301 acoustics
Pelvis
Radiological and Ultrasound Technology
medicine.diagnostic_test
Viscosity
business.industry
Ultrasound
Middle Aged
medicine.disease
Kidney Transplantation
Elasticity
Transplantation
surgical procedures, operative
medicine.anatomical_structure
Renal transplant
Elasticity Imaging Techniques
Female
Radiology
business
Kidney disease
Subjects
Details
- ISSN :
- 03015629
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Ultrasound in Medicine & Biology
- Accession number :
- edsair.doi.dedup.....7dd58a95da0d0066c6df78f54dde375c