Rapid MR Imaging Detection of Renal Cysts: Age-based Standards

Nascimento, Alessandra B.; Mitchell, Donald G.; Zhang, Xiaoming; Kamishima, Tamotsu; Parker, Laurence; Holland, George A.

doi:10.1148/radiol.2213010178

Cited by 90 publications

(37 citation statements)

References 15 publications

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“…28,29 Magnetic resonance imaging (MRI), with its enhanced sensitivity for detecting small renal cysts, is also a promising modality 30 ; however, MRI may also detect a greater number of simple cysts as well as small cysts arising from ADPKD. Until the diagnostic utility of MRI in ADPKD is formally evaluated, the high diagnostic accuracy of ultrasonography, as well as its safety, accessibility, and comparatively low cost, will ensure its ongoing widespread use in ADPKD.…”

Section: Discussionmentioning

confidence: 99%

Unified Criteria for Ultrasonographic Diagnosis of ADPKD

Pei

Obaji

Dupuis

et al. 2009

Journal of the American Society of Nephrology

616

448

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Individuals who are at risk for autosomal dominant polycystic kidney disease are often screened by ultrasound using diagnostic criteria derived from individuals with mutations in PKD1. Families with mutations in PKD2 typically have less severe disease, suggesting a potential need for different diagnostic criteria. In this study, 577 and 371 at-risk individuals from 58 PKD1 and 39 PKD2 families, respectively, were assessed by renal ultrasound and molecular genotyping. Using sensitivity data derived from genetically affected individuals and specificity data derived from genetically unaffected individuals, various diagnostic criteria were compared. In addition, data sets were created to simulate the PKD1 and PKD2 case mix expected in practice to evaluate the performance of diagnostic criteria for families of unknown genotype. The diagnostic criteria currently in use performed suboptimally for individuals with mutations in PKD2 as a result of reduced test sensitivity. In families of unknown genotype, the presence of three or more (unilateral or bilateral) renal cysts is sufficient for establishing the diagnosis in individuals aged 15 to 39 y, two or more cysts in each kidney is sufficient for individuals aged 40 to 59 y, and four or more cysts in each kidney is required for individuals Ն60 yr. Conversely, fewer than two renal cysts in at-risk individuals aged Ն40 yr is sufficient to exclude the disease. These unified diagnostic criteria will be useful for testing individuals who are at risk for autosomal dominant polycystic kidney disease in the usual clinical setting in which molecular genotyping is seldom performed.

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Section: Discussionmentioning

confidence: 99%

Unified Criteria for Ultrasonographic Diagnosis of ADPKD

Pei

Obaji

Dupuis

et al. 2009

Journal of the American Society of Nephrology

616

448

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show abstract

“…However, similar to CT, current diagnostic criteria for ADPKD are applicable to MRI if cysts larger than 1 cm are included (13). A prospective cohort of 115 at-risk patients formally compared the two modalities, indicating a higher sensitivity for MRI (98% versus 95%) and equal specificity (98%) based on the presence of five or more bilateral cysts on MRI compared with only three or more bilateral cysts on US when diagnosing ADPKD (oral presentation by York Pei at the Renal Week of the American Society of Nephrology, October 30-November 4, 2012, in San Diego, CA).…”

Section: Mrimentioning

confidence: 99%

Renal Relevant Radiology

Rahbari-Oskoui¹,

Mittal²,

Mittal³

et al. 2014

Clinical Journal of the American Society of Nephrology

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SummaryAutosomal-dominant polycystic kidney disease is a systemic disorder and the most common hereditary renal disease, which is characterized by cyst growth, progressive renal enlargement, and development of renal failure. The cystic nature of autosomal dominant polycystic kidney disease and its renal and extrarenal complications (kidney stones, cyst hemorrhage, intracerebral aneurysm, liver cysts, cardiac valve abnormalities, etc.) give radiologic imaging studies a central role in the management of these patients. This article reviews the indications, comparative use, and limitation of various imaging modalities (ultrasonography, magnetic resonance imaging, computerized tomography scan, Positron emission tomography scan, and renal scintigraphy) for the diagnosis and management of complications in autosomal dominant polycystic kidney disease. Finally, this work provides evidence for the value of total kidney volume to predict disease progression in autosomal dominant polycystic kidney disease.

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“…Both computed tomography (CT) scan and magnetic resonance imaging (MRI), with and without contrast enhancement, have been used for diagnosis of ADPKD, generally in cases in which ultrasonography is equivocal (2,37). Both of these techniques, with improved resolution, can detect cysts of smaller size than ultrasonography.…”

Section: Renal Imaging In Adpkdmentioning

confidence: 99%

“…Heavy-weighted T2 images also permit the detection of cysts of only 2 to 3 mm in diameter with great certainty (2). Its safety and enhanced sensitivity thus make it a very promising imaging modality for ADPKD (37). However, MRI likely will detect both small, simple cysts and small cysts that arise from ADPKD.…”

Section: Renal Imaging In Adpkdmentioning

confidence: 99%

Diagnostic Approach in Autosomal Dominant Polycystic Kidney Disease

Pei

2006

Clinical Journal of the American Society of Nephrology

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Autosomal dominant polycystic kidney disease (ADPKD) is the most common Mendelian disorder of the kidney and affects all racial groups worldwide. It is characterized by focal development of renal and extrarenal cysts in an age-dependent manner. Typically, only a few renal cysts are detected in most affected individuals before 30 yr of age. However, by the fifth decade of life, hundreds to thousands of renal cysts will be found in the majority of patients. ADPKD is genetically heterogeneous. Mutations of two genes, PKD1 and PKD2, account for approximately 85 and 15% of cases, respectively. Although the clinical manifestations of these two genotypes overlap completely, patients with PKD1 have much more severe renal disease compared with those with PKD2, as evidenced by their ESRD occurring approximately 15 yr earlier. Renal ultrasonography commonly is used for the assessment of ADPKD, and age-dependent ultrasound diagnostic criteria with high sensitivity and specificity have been established for individuals who are born with 50% risk for PKD1. Although these diagnostic criteria are used widely for genetic counseling and for the evaluation of at-risk individuals as living-related kidney donors to their affected relatives, their application to individuals who are at risk for PKD2 or have undefined genotype needs to be refined further. Molecular genetic testing is available for ADPKD and may be useful for evaluation of at-risk individuals with equivocal imaging results, younger at-risk individuals as a living-related kidney donor, and individuals with atypical or de novo renal cystic disease.

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Rapid MR Imaging Detection of Renal Cysts: Age-based Standards

Cited by 90 publications

References 15 publications

Unified Criteria for Ultrasonographic Diagnosis of ADPKD

Unified Criteria for Ultrasonographic Diagnosis of ADPKD

Renal Relevant Radiology

Diagnostic Approach in Autosomal Dominant Polycystic Kidney Disease

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