Two-Dimensional Shear-Wave Elastography for Kidney Stiffness Assessment

Abstract

This study aimed to analyze the utility of bidimensional shear-wave elastography for renal assessment and in the prediction of chronic kidney disease (CKD). The study included 92 subjects: 50 healthy volunteers and 42 patients with different degrees of CKD (mean age, 57.5 ± 13.4; 50% were female), excluding those undergoing renal replacement therapies, obstructive pathology, or renal lithiasis. We performed kidney shear-wave velocity (KSWV) determinations in the midportion of the parenchyma of each kidney. The median values were expressed in meters per second. We obtained successful assessments in 94% of the cases for the right kidney (RK) and 90.2% for the left kidney (LK), with an intraclass correlation coefficient of 0.96 (RK) and 0.91 (LK). We obtained significantly lower KSWV values in the CKD lot as opposed to the healthy volunteers: RK: 1.38 ± 0.1 versus 1.78 ± 0.1 m/s, P = 0.05; LK: 1.37 ± 0.1 m/s versus 1.72 ± 0.1 m/s. We could predict the presence of CKD with a sensitivity of 89.2% and a specificity of 76.9% for a KSWV of less than 1.47 m/s, with a tendency of KSWV to decrease with CKD progression.Our study shows that KSWV measured using bidimensional shearwave elastography decreases in patients with CKD compared with normal subjects, and that for a cutoff value of below 1.47 m/s we could predict, with a good sensitivity and specificity, the presence of CKD.

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

“…a study about 2D SWE of normal kidney and various degree of chronic kidney diseases, there was no statistical difference between both kidney (Grosu et al, 2019). However, another study about SWE in the renal allograft presented urinary pressure, hydronephrosis vascular perfusion, body score index, and probe pressure as factors affecting SWE measurements (Early et al, 2017).…”

“…Two-dimensional shear wave elastography has been used mainly in diffuse liver disease for staging liver fibrosis in human medicine. Moreover, there are many studies about the 2D SWE application for differentiating between benign and malignant breast masses, differentiate between benign and malignant thyroid nodules, identification of the parathyroid adenoma and hyperplasia, and estimation of the kidney stiffness in chronic renal diseases (Barr et al, 2015b;Cosgrove et al, 2017;Golu et al, 2017;Lee et al, 2017;Bob et al, 2018;Kyriakidou et al, 2018;Liu et al, 2018;Cotoi et al, 2019;Grosu et al, 2019;Sãftoiu et al, 2019;Cotoi et al, 2020). In veterinary literature, 2D SWE was applied to distinguish malignant from benign conditions of mammary tumors and lymph nodes and to evaluate the margination and acute changes in stiffness of the ablated liver tissue after radiofrequency ablation in dogs (Glińska-Suchocka et al, 2013;Feliciano et al, 2017;Lee et al, 2018;Silva et al, 2018).…”

Technical Performance of Acoustic Radiation Force Impulse Imaging for Measuring Renal Parenchymal Stiffness: A Systematic Review and Meta‐Analysis

“…The intraobserver agreement of KS measurement was obtained in seven studies. 1,4,18,23,24,28,30 The pooled ICC was 0.77 (95% CI 0.49-0.91) by random-effects model, indicating good agreement (Figure 4). Significant heterogeneity was noted in Cochran's Q test (P < .001) and Higgins I 2 (94%).…”

“…The demographic and technical characteristics of the 24 studies (2993 patients) 1,[3][4][5][6][7]11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] are presented in Tables 1-3, respectively. Study populations ranged from healthy subjects to patients with chronic kidney disease, renal allografts, diabetic kidney disease, vesicoureteral reflux, and ureteropelvic junction obstruction.…”

“…Seventeen studies were performed in native kidneys. 1,[3][4][5][6]11,[16][17][18]21,[23][24][25]27,28,30,32 The proportion of technical failure was acquired in seven studies 1,3,6,11,17,23,27 and the pooled proportion of a For laterality of kidney, studies having measured kidney stiffness in either right or left affected kidneys according to the conditions (ureteropelvic junction obstruction 25 and vesicoureteral reflux 18,21 ) and transplanted kidney 7,19,20,22,26,29,31 were excluded in subgroup analyses.…”