Multiparameter diffusion‐weighted imaging for characterizing pathological patterns in lupus nephritis patients: A preliminary study

Zhang, Shan; Lin, Yanwei; Ge, Xin; Liu, Guiqin; Zhang, Jianjian; Xu, Shuaishuai; Wu, Guangyu; Chen, Sheng; Xu, Jianrong; Suo, Shiteng

doi:10.1002/jmri.26657

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…These deposits had access to the vascular space and may activate circulating myeloid cells that express FC receptors, allowing them to infiltrate the renal tissue. By contrast, subepithelial deposits, found in Class V disease, injure podocytes but elicit a less severe inflammatory response, as they contacted only the urinary space [ 9 ]. Pairwise comparisons of the type II, III, and IV groups showed significant differences, which also conform to the most obvious characteristic of type IV LN activity.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on the use of advanced magnetic resonance imaging in lupus nephritis

Chen

Zhou

et al. 2022

BMC Med Imaging

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Objectives To investigate the correlation between the histopathology of the kidney and clinical indicators in patients with lupus nephritis (LN) using magnetic resonance imaging (MRI). Methods A total 50 female participants were enrolled in the study. Thirty patients with LN were divided into types 2, 3, 4, and 5, according to their pathological features. The control group consisted of 20 healthy female volunteers. Serum creatinine, C3, C1q, and anti-ds-DNA were measured. Conventional MRI, DTI, DWI, and BOLD scanning was performed to obtain the FA, ADC, and R2* values for the kidney. Results Compared with the control group, FA and the ADC were decreased in patients with LN, while the R2* value was increased (P < 0.05). The overall comparison of the SLEDAI (Activity index of systemic lupus erythematosus) score, total pathological score, AI, and serum creatinine C3 showed that these were significantly different between the two groups (P < 0.05). FA and the ADC were negatively correlated with urinary, blood ds-DNA, and serum creatinine and positively correlated with C1q (P < 0.05). The R2* value was positively correlated with urinary NGAL, blood ds-DNA, and serum creatinine (P < 0.05). FA and the ADC were negatively correlated with the SLEDAI score, total pathological score, AI, CI, nephridial tissue C3, and C1q. The R2* value was positively correlated with the SLEDAI score, total pathological score, AI, CI, nephridial tissue C3, and C1q (P < 0.05). Conclusions MRI examination in female patients with LN was correlated with pathologic test results, which may have clinical significance in determining the disease’s severity, treatment, and outcome.

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Section: Discussionmentioning

confidence: 99%

Clinical study on the use of advanced magnetic resonance imaging in lupus nephritis

Chen

Zhou

et al. 2022

BMC Med Imaging

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“…For instance, it is known that D is determined by higher b values (>100 s/mm 2 ), while D* is significantly influenced by lower b values. The number of b values used in the literature ranges from 1 to 16 (31), with strength generally no more than 1,500 s/mm 2 (32).…”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of renal allograft pathologic changes: comparisons of mono-exponential and bi-exponential models using diffusion-weighted imaging

Fan

Zhou

et al. 2020

Quant Imaging Med Surg

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Background: Diffusion-weighted imaging (DWI) can noninvasively assess renal allograft pathologic changes that provide useful information for clinical management and prognostication. However, it is still unknown whether the bi-exponential model analysis of DWI signals is superior to that of the monoexponential model.Methods: Pathologic and DWI data from a total of 47 allografts were prospectively collected and analyzed. Kidney transplant interstitial fibrosis was quantified digitally. The severity of acute and chronic pathologic changes was semi-quantified by calculating the acute composite scores (ACS) and chronic composite score (CCS). Mono-exponential total apparent diffusion coefficient (ADCT), and the bi-exponential parameters of true diffusion (D) and perfusion fraction (fp) were acquired. The diagnostic performances of both monoexponential and bi-exponential parameters were assessed and compared by calculating the area under the curve (AUC) from receiver-operating characteristic (ROC) curve analysis.Results: ADCT, D, and fp were all significantly correlated with interstitial fibrosis, ACS, and CCS.Cortical fp discriminated mild from moderate and severe ACS with the largest AUC of 0.89 [95% confidence interval (CI), 0.77-0.96]. Noticeably, only cortical fp could differentiate severe ACS from mild-to-moderate ACS (P<0.001) with an AUC of 0.80 (95% CI, 0.65-0.90) and a sensitivity of 100% (95% CI, 66.4-100%).Strikingly, the joint use of D and fp in either the cortex or the medulla could achieve a sensitivity of 100% for identifying either mild or severe interstitial fibrosis. Meanwhile, the serial use of cortical D and cortical fp showed the largest specificity for identifying both mild [88.9% (95% CI, 70.8-97.6%)] and severe [84.4% (95% CI, 67.2-94.7%)] interstitial fibrosis. For identifying mild CCS, the AUC of medullary ADCT (0.90, 95% CI, 0.78-0.97) was similar to that of cortical D (0.81, 95% CI, 0.67-0.91) and fp (0.86, 95% CI, 0.73-0.94), but statistically larger than that of medullary D (P=0.005) and fp (P=0.01). Furthermore, the parallel use of cortical D and cortical fp could increase the sensitivity to 95.0% (95% CI, 75.1-99.9%), whereas serial use of medullary D and medullary fp could increase the specificity to 100% (95% CI, 87.2-100%).The AUCs for differentiating severe from mild and moderate CCS were statistically insignificant among all parameters in the cortex and medulla (P≥0.15).Conclusions: Cortical fp was superior to the ADCT for identifying both mild and severe acute pathologic changes. Nevertheless, ADCT was equal to or better than single D or fp for evaluating chronic pathologic changes. Thus, both monoexponential and bi-exponential analysis of DWI images are complementary for evaluating kidney allograft pathologic changes, and the combined use of D and fp can increase the sensitivity and specificity for discriminating allograft pathologic changes severity. MRI acquisitionAll patients underwent MRI imaging using a 3.0 Tesla clinical MRI imaging unit (Discovery MR 750; General

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“…In 2014, a study first reported the feasibility of DKI in the kidneys of healthy volunteers [ 18 ]. Over the past decade, numerous studies have investigated the application of DKI in kidney diseases to assess renal injury, such as renal tumors [ 19 – 21 ], acute kidney injury from various causes [ 12 , 22 , 23 ], chronic kidney disease [ 13 , 24 , 25 ], diabetic nephropathy [ 12 , 26 , 27 ], IgA nephropathy [ 28 , 29 ], and lupus nephritis [ 30 ]. However, few studies have applied DKI to assess renal injury in patients with PA.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of stretched-exponential and kurtosis models of diffusion-weighted imaging in renal assessment to distinguish patients with primary aldosteronism from healthy controls

Wen,

Peng,

Yue

et al. 2024

PLoS ONE

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Purpose To compare the ability of diffusion parameters obtained by stretched-exponential and kurtosis models of diffusion-weighted imaging (DWI) to distinguish between patients with primary aldosteronism (PA) and healthy controls (HCs) in renal assessment. Materials and methods A total of 44 participants (22 patients and 22 HCs) underwent renal MRI with an 11 b-value DWI sequence and a 3 b-value diffusion kurtosis imaging (DKI) sequence from June 2021 to April 2022. Binary logistic regression was used to construct regression models combining different diffusion parameters. Receiver-operating characteristic (ROC) curve analysis and comparisons were used to evaluate the ability of single diffusion parameters and combined diffusion models to distinguish between the two groups. Results A total of six diffusion parameters (including the cortical anomalous exponent term [α_Cortex], medullary fractional anisotropy [FA_Medulla], cortical FA [FA_Cortex], cortical axial diffusivity [Da_Cortex], medullary mean diffusivity [MD_Medulla] and medullary radial diffusivity [Dr_Medulla]) were included, and 10 regression models were studied. The area under the curve (AUC) of Dr_Medulla was 0.855, comparable to that of FA_Cortex and FA_Medulla and significantly higher than that of α_Cortex, Da_Cortex and MD_Medulla. The AUC of the Model_all parameters was 0.967, comparable to that of Model_FA (0.946) and Model_DKI (0.966) and significantly higher than that of the other models. The sensitivity and specificity of Model_all parameters were 87.2% and 95%, respectively. Conclusion The Model_all parameters, Model_FA and Model_DKI were valid for differentiating between PA patients and HCs with similar differentiation efficacy and were superior to single diffusion parameters and other models.

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Multiparameter diffusion‐weighted imaging for characterizing pathological patterns in lupus nephritis patients: A preliminary study

Cited by 8 publications

References 34 publications

Clinical study on the use of advanced magnetic resonance imaging in lupus nephritis

Clinical study on the use of advanced magnetic resonance imaging in lupus nephritis

Quantitative assessment of renal allograft pathologic changes: comparisons of mono-exponential and bi-exponential models using diffusion-weighted imaging

Comparative study of stretched-exponential and kurtosis models of diffusion-weighted imaging in renal assessment to distinguish patients with primary aldosteronism from healthy controls

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