Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease

Hassan, Kamal; Loberant, Norman; Abbas, Nur; Hassan, Fadi; Saad, Hassan; Khazim, Khaled

doi:10.2147/tcrm.s118465

Cited by 42 publications

(53 citation statements)

References 44 publications

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“…The utility of elastography in the assessment of renal parenchyma had been previously reported, but the results are contradictory [11][12][13]. Syversveen et al [14,15] reported no differences in shear-wave elastography (SWE) values between different grades of kidney allograft fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study

Bolboacă

Elec

Elec³

et al. 2020

Diagnostics

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Shear-wave elastography (SWE) showed the absence or presence of significant differences among stable kidney allograft function and allograft dysfunction. We evaluated the variability of kidney allograft stiffness in relation to allograft dysfunction, respectively, in terms of a correlation of stiffness with patients' characteristics. A single-center prospective study on patients who had undergone renal transplantation was conducted between October 2017 and November 2018. Patients were clinically classified as having a stable allograft function or allograft dysfunction. SWE examinations performed by the same radiologist with a LOGIQ E9 were evaluated. Ten measurements were done for Young's modulus (kPa) at the level of allograft cortex and another ten at the level of medulla. Eighty-three SWE examinations from 63 patients, 69 stable allografts, and 14 allografts with dysfunction were included in the analysis. The intra-examinations stiffness showed high variability, with the quantile covariation coefficient ranging from 2.21% to 45.04%. The inter-examinations stiffness showed heterogeneity (from 28.66% to 42.38%). The kidney allograft cortex stiffness showed significantly higher values in cases with dysfunction (median = 28.70 kPa, interquartile range (IQR) = (25.68-31.98) kPa) as compared to those with stable function (median = 20.99 kPa, interquartile range = (16.08-27.68) kPa; p-value = 0.0142). Allograft tissue stiffness (both cortex and medulla) was significantly negatively correlated with body mass index (−0.44, p-value < 0.0001 for allograft cortex and −0.42, p-value = 0.0001 for allograft medulla), and positively correlated with Proteinuria/Creatinuria ratio (0.33, p-value = 0.0021 for allograft cortex and 0.28, p-value = 0.0105 for allograft medulla) but remained statistically significant only in cases with stable function. The cortical tissue stiffness proved significantly higher values for patients with allograft dysfunction as compared to patients with stable function, but to evolve as an additional tool for the evaluation of patients with a kidney transplant and to change the clinical practice, more extensive studies are needed.

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Section: Introductionmentioning

confidence: 99%

Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study

Bolboacă

Elec

Elec³

et al. 2020

Diagnostics

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“…CS values obtained in SWE tests have been more popular recently. (21) SWE is a cost-effective, reliable and noninvasive US test that can be used to determine tissue elasticity. (34) Renal parenchymal fibrosis is the most important sign of kidney disease, causing changes in mechanical features of kidneys that can be measured objectively with SWE.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that patients with Type II DM have an increase in renal cortical stiffness (CS) that is observed on SWE. (20)(21)(22) However, to our knowledge, there is no information in the literature regarding changes in CS in patients with pre-DM and newly diagnosed Type II DM. We hypothesise that CS, as determined by SWE, may indicate early changes at the cellular level prior to the onset of nephropathy in patients with pre-DM and newly diagnosed Type II DM.…”

Section: Introductionmentioning

confidence: 99%

Renal cortical stiffness is markedly increased in pre-diabetes mellitus and associated with albuminuria

Sümbül¹,

Koç²,

Gulumsek³

2020

smedj

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Introduction:We aimed to investigate changes in renal cortical stiffness (CS) in Type II diabetes mellitus (DM) and pre-DM patients compared to subjects with normal glucose metabolism (NGM), as well as the usefulness of renal CS to determine the presence of nephropathy.Methods: This study included 125 individuals with NGM, pre-DM and Type II DM. Routine laboratory data was obtained, and micro-and macrovascular involvement were investigated.Urinary albumin-creatinine ratio (ACR) was measured for urinary albuminuria detection. In addition to routine renal ultrasonography, CS was measured using renal elastography. Results:Among the included patients, 42, 40 and 43 patients had NGM, pre-DM and Type II DM, respectively, with prevalence of nephropathy of 5%, 15% and 33%, respectively. Carotid and aortic intima-media thickness (IMT), renal width, and CS were found to be higher in the pre-DM and Type II DM groups than the NGM group. Aortic-IMT, renal width and urinary ACR levels were independently associated with CS. Patients with nephropathy were found to have a higher CS value than those without nephropathy (8.72 ± 1.67 kPa vs. 10.60 ± 1.74 kPa, p = 0.001). In ROC analysis, when the cutoff value for CS was taken as 9.2 kPa, renal CS predicted the possibility of nephropathy with 78.9% sensitivity and 71.4% specificity.Conclusion: CS values are significantly higher in patients with impaired glucose metabolism.We recommend CS measurement as part of routine screening of nephropathy in patients with pre-DM and newly diagnosed Type II DM.

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“…There have been several reports of using SWE to evaluate both normal and abnormal kidneys. Inconsistent results have been obtained, irrespective of the ultrasound vendor . The kidney is a complex organ with a cortex, medulla, central fat, vasculature, collecting system, and capsule.…”

mentioning

confidence: 99%

“…It is used to determine liver and splenic stiffness in patients with chronic liver disease . Stiffness values of the kidney have also been evaluated in the kidney to assess chronic renal disease, hydronephrosis, and renal masses …”

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confidence: 99%

Can Accurate Shear Wave Velocities Be Obtained in Kidneys?

Barr

2019

J of Ultrasound Medicine

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Objectives There are conflicting results in the literature on the use of shear wave elastography of the kidney parenchyma to determine whether renal stiffness values are related to a disease process. This study was conducted to evaluate the raw data from 3 ultrasound systems and determine whether adequate displacement curves are obtained to accurately estimate shear wave speeds. Methods Shear wave elastography was performed on 5 healthy volunteers with 3 ultrasound systems. The raw data were collected and evaluated for the shear wave propagation quality to determine whether accurate estimates of renal shear wave speeds could be determined. Results Results from the 3 machines demonstrate that accurate shear wave displacement curves are not obtained with renal elastography on existing systems (as of June 2018). One vendor has recently released software that appears to acquire accurate shear wave displacements. Conclusions Elastographic studies performed on the kidney to date are likely to be inaccurate. A new algorithm that appears to acquire accurate shear wave displacements in the kidney has been developed. Additional studies are needed to confirm that the new algorithm provides accurate clinical results. This study demonstrates that although the system provides a shear wave speed, it is important to confirm the accuracy of that number by evaluating the raw data.

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Shear wave elastography imaging for assessing the chronic pathologic changes in advanced diabetic kidney disease

Cited by 42 publications

References 44 publications

Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study

Shear-Wave Elastography Variability Analysis and Relation with Kidney Allograft Dysfunction: A Single-Center Study

Renal cortical stiffness is markedly increased in pre-diabetes mellitus and associated with albuminuria

Can Accurate Shear Wave Velocities Be Obtained in Kidneys?

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