Assessment of renal quality with quantitative contrast-enhanced ultrasound (CEUS) for differentiating kidney histopathology before procurement

Abstract

Purpose: This study aimed to investigate the use of contrast-enhanced ultrasonography (CEUS) to assess the kidneys' quality before procurement. Methods: This prospective study included 74 donors and 148 recipients of kidneys. 119 kidneys underwent quantitative analysis. Before organ procurement, potential kidney donors underwent CEUS, though organ procurement involved a zero-point puncture biopsy. CEUS parameters of the renal cortex and medulla were evaluated, including rise time (RT), time to peak (TTP), the area under the curve (AUC), wash-in slope (WIS), peak intensity (PI), and mean transit time (MTT). Donors' kidneys were classified based on their pathological. Additionally, short-term clinical indicators of renal recipients were collected and analyzed to determine whether the patients had delayed recovery of renal allograft function. Results: This experiment included 148 cases of kidney information, divided into two groups based on the Remuzzi score of the kidneys. However, 29 kidneys were excluded from the quantitative analysis due to loss or low quality of CEUS images. Comparing the time-intensity curve (TIC) of renal cortical region of interest (ROI), we found that the group with lower pathological scores exhibited higher PI (P=0.002), AUC(P=0.003), and WIS (P=0.009). TIC comparison results for renal medulla ROI revealed that the group with lower pathological scores had higher PI (P=0.010), AUC (P=0.023), and WIS (P=0.024). Conclusions: This study highlighted the potential of CEUS as a non-invasive, safe, and real-time examination method that correlates with the Remuzzi score and renal pathology. Therefore, it can be used as a prospective preoperative non-invasive evaluation method for the donor's kidney.

Contrast-Enhanced Ultrasound in the Diagnosis of Solid Renal Lesions

“…Among others, we can distinguish Optison, Definity/Luminity, Sonazoid and SonoVue; however, the last one is mostly used [9]. UCAs are not nephrotoxic and cannot be excreted by the kidney; therefore, they can be safely administered to patients with renal failure without the risk of contrast-related nephropathy or nephrogenic systemic fibrosis [10,11]. Multiple injections of contrast agent are permitted, due to its short half-life (about 5 min) [12].…”

“…Multiple injections of contrast agent are permitted, due to its short half-life (about 5 min) [12]. CEUS shows real-time blood flow using microbubble contrast agents and complementary harmonic pulse sequences [11].…”