Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients

Soudmand, Arash; Ozturk, Funda Ulu; Uslu, Nihal; Haberal, Nihan; Boyvat, Fatih; Moray, Gökhan; Haberal, Mehmet

doi:10.6002/ect.2017.0238

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Very few studies are available in the literature on the detection of early fibrosing changes in transplanted kidneys using sonoelastography, which assesses stiffness as a measure of fibrosis[ 34 - 36 , 45 - 50 ]. A large number of studies are available for superficial organs like the breast and thyroid gland[ 15 - 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Exploiting the superficial location of the kidney allograft, several studies have been conducted to determine the diagnostic utility of SWE in the evaluation of kidney allograft dysfunction and compared it with various clinical, laboratory, or imaging parameters[ 34 - 36 , 48 - 55 ]. The mean parenchymal stiffness on SWE was 24.5 + 7.34 kPa (range: 17-32 kPa) in patients with allograft dysfunction in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have suggested that quantitative elastography is a reliable non-invasive tool to assess chronic fibrosing changes in organs like the liver[ 22 - 26 ] and kidney[ 27 - 32 ] at early stages. A few studies have investigated the usefulness of sonoelastography in the assessment of chronic fibrosing changes in the kidney allograft[ 33 - 36 ]. In the first clinical pilot study by Arndt et al [ 33 ], parenchymal stiffness measured by sonoelastography was found to be suitable for assessing the progression of kidney allograft fibrosis.…”

Section: Introductionmentioning

confidence: 99%

“…They concluded that a longitudinal assessment of parenchymal stiffness might be a powerful tool to identify patients with chronic allograft damage who benefit from biopsy and consequent adaptation of the immunosuppressive treatment[ 33 ]. Subsequently, many more studies have reported the diagnostic utility of sonoelastography in the assessment of chronic kidney allograft dysfunction[ 34 - 36 ]. However, only a few studies have compared the diagnostic performance of RI vs shear-wave elastography (SWE) in the assessment of chronic sclerosing changes in the kidney allograft.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Jesrani,

Faiq,

Rashid

et al. 2024

World J Transplant

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BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results. AIM To compare the diagnostic performance of resistive index (RI) and shear wave elastography (SWE) in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results. METHODS This is a cross-sectional and comparative study. A total of 154 kidney transplant recipients were included in this study, which was conducted at the Departments of Transplantation and Radiology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from August 2022 to February 2023. All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate (GFR) after three months of transplantation were enrolled in this study. SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility. RESULTS The mean age of all patients was 35.32 ± 11.08 years. Among these, 126 (81.8%) were males and 28 (18.2%) were females. The mean serum creatinine in all patients was 2.86 ± 1.68 mg/dL and the mean estimated GFR was 35.38 ± 17.27 mL/min/1.73 m2. Kidney allograft biopsy results showed chronic changes in 55 (37.66%) biopsies. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE for the detection of chronic allograft damage were 93.10%, 96.87%%, 94.73%, and 95.87%, respectively, and the diagnostic accuracy was 95.45%. For RI, the sensitivity, specificity, PPV, and NPV were 76.92%, 83.33%, 70.17%, and 87.62%, respectively, and the diagnostic accuracy was 81.16%. CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage. It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Jesrani,

Faiq,

Rashid

et al. 2024

World J Transplant

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Effectiveness of two-dimensional shear-wave sonoelastography in the diagnosis and follow-up of infantile hypertrophic pyloric stenosis

Demir,

Unlu,

Kiris Uzun

et al. 2024

Pediatr Surg Int

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Introduction We sought to determine the effectiveness and utility of two-dimensional shear-wave sonoelastography (2D-SW-SE) in the diagnosis and postoperative follow-up of infantile hypertrophic pyloric stenosis (IHPS). Materials and Methods Twenty-three infants were included in the study, 13 in the IHPS group and 10 in the control group (CG). Preoperative B-mode ultrasonography measurements (longitudinal length and single-wall thickness of the pylorus) and 2D-SW-SE measurements (pylorus tissue stiffness and shear-wave propagation speed) were compared between the groups. The infants with IHPS then underwent Ramstedt pyloromyotomy and were invited for follow-ups on the tenth day and the first, third, and sixth months postoperatively. Measurements taken at the follow-ups were compared with the preoperative values. Results No differences were found between the groups regarding age, gender, body weight, or week of birth. The pyloric lengths in the IHPS group were longer than in the CG (p < 0.001), and the single-wall thicknesses were thicker (p < 0.001). The pylorus in the IHPS group was four times stiffer than in the CG (27.4 kPa versus 7.66 kPa), and the shear-wave propagation speed in the tissue was higher (1.34 m/s versus 2.69 m/s; p < 0.001). Both values decreased over time in the IHPS group and were normal by the third postoperative month. Conclusions 2D-SW-SE can be used as an assistive imaging tool alongside B-mode ultrasound for diagnosing IHPS. It can also be used to identify inadequate surgery by detecting whether the pyloric tissue has softened at follow-up.

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Investigating the role of ultrasound-based shear wave elastography in kidney transplanted patients: correlation between non-invasive fibrosis detection, kidney dysfunction and biopsy results—a systematic review and meta-analysis

Filipov,

Teutsch,

Szabó

et al. 2024

J Nephrol

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Introduction Interstitial fibrosis and tubular atrophy are leading causes of renal allograft failure. Shear wave elastography could be a promising noninvasive method for providing information on the state of the kidney, with specific regard to fibrosis but currently available data in the literature are controversial. Our study aimed to analyze the correlation between shear wave elastography and various kidney dysfunction measures. Methods This review was registered on PROSPERO (CRD42021283152). We systematically searched three major databases (MEDLINE, Embase, and CENTRAL) for articles concerning renal transplant recipients, shear wave elastography, fibrosis, and kidney dysfunction. Meta-analytical calculations for pooled Pearson and Spearman correlation coefficients (r) were interpreted with 95% confidence intervals (CIs). Heterogeneity was tested with Cochran’s Q test. I2 statistic and 95% CI were reported as a measurement of between-study heterogeneity. Study quality was assessed with the QUADAS2 tool. Results In total, 16 studies were included in our meta-analysis. Results showed a moderate correlation between kidney stiffness and interstitial fibrosis and tubular atrophy, graded according to BANFF classification, on biopsy findings for pooled Pearson (r = 0.48; CI: 0.20, 0.69; I2 = 84%) and Spearman correlations (r = 0.57; CI: 0.35, 0.72; I2 = 74%). When compared to kidney dysfunction parameters, we found a moderate correlation between shear wave elastography and resistive index (r = 0.34 CI: 0.13, 0.51; I2 = 67%) and between shear wave elastography and estimated Glomerular Filtration Rate (eGFR) (r = -0.65; CI: − 0.81, − 0.40; I2 = 73%). All our outcomes had marked heterogeneity. Conclusion Our results showed a moderate correlation between kidney stiffness measured by shear wave elastography and biopsy results. While noninvasive assessment of kidney fibrosis after transplantation is an important clinical goal, there is insufficient evidence to support the use of elastography over the performance of a kidney biopsy. Graphical abstract

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Efficacy of the Sonoelastography Method for Diagnosis of Fibrosis in Renal Transplant Patients

Abstract: Our study showed a significant correlation between Banff degree and the acoustic radiation force impulse values of renal transplant patients. In addition to biopsy, sonoelastography can be beneficial for the diagnosis of fibrosis in renal transplant patients.

Cited by 5 publications

References 23 publications

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Effectiveness of two-dimensional shear-wave sonoelastography in the diagnosis and follow-up of infantile hypertrophic pyloric stenosis

Investigating the role of ultrasound-based shear wave elastography in kidney transplanted patients: correlation between non-invasive fibrosis detection, kidney dysfunction and biopsy results—a systematic review and meta-analysis

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