Ultrasound-Based Shear Wave Elastography in the Assessment of Patients with Diabetic Kidney Disease

Bob, Flaviu; Grosu, Iulia; Sporea, Ioan; Bota, Simona; Popescu, Alina; Sima, Alexandra; Şirli, Roxana; Petrică, Ligia; Timar, Romulus; Schiller, Adalbert

doi:10.1016/j.ultrasmedbio.2017.04.019

Cited by 38 publications

(39 citation statements)

References 29 publications

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“…The best cut-off point for predicting diabetic nephropathy in their study was 2.43 m/second with sensitivity of 84.1% and specificity of 67.3%. 31 Similar findings were also seen in a study by Bob et al 32 In our study, we found maximum diagnostic accuracy at 5.31 kPa.…”

Section: Discussionsupporting

confidence: 92%

Role of intrarenal resistive index and ElastPQ® renal shear modulus in early diagnosis and follow-up of diabetic nephropathy: A prospective study

Krishnan

Malik

2020

Ultrasound

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Introduction We aimed to establish baseline normal values of ElastPQ® (Philips Healthcare, Bothell, Washington, USA) renal shear modulus, evaluate changes in intrarenal resistive index and renal shear modulus in various stages of diabetic nephropathy, their diagnostic potential and role in follow-up. Methods Our prospective observational study was performed over two years. In total, 130 adult cases with diabetic nephropathy and 130 normal adult controls were selected. Diabetic nephropathy was confirmed by persistent albuminuria on 24-hour urinary albumin testing at three month intervals and staged by albuminuria quantification. Measurement of intrarenal resistive index and renal shear modulus in all subjects was performed and their variation with stage of nephropathy was statistically analyzed using Pearson’s correlation. Receiver operating characteristic curves were plotted and their individual and combined diagnostic potentials were assessed. Statistical significance was tested using t tests and analysis of variance. Interrater agreement was tested using Cohen’s kappa coefficient. Results Mean intrarenal resistive index was significantly higher for cases (mean 0.72 ± 0.05) than controls (mean 0.62 ± 0.04) and showed significant age variation (p < 0.05). Normal values of ElastPQ® renal shear modulus ranged from 3.87 to 4.72 kPa and was significantly higher for cases (mean 8.59 ± 1.77 kPa) than controls (mean 4.32 ± 0.45 kPa) and showed significant differences between each stage of nephropathy, being highest in stage 2. Maximum diagnostic accuracy was at 0.65 (sensitivity 90%, specificity 76.2%, area under curve 0.916) for intrarenal resistive index and at 5.31 kPa (sensitivity 90.8%, specificity 84.6%, area under curve 0.923) for renal shear modulus. Combination of the two further improved diagnostic performance (highest accuracy of 89%, sensitivity 81.7%, specificity 96.3%). Conclusions Normal range of ElastPQ® renal shear modulus values could be established. Intrarenal resistive index and renal shear modulus can be used as imaging parameters for early diagnosis and follow-up of diabetic nephropathy.

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Section: Discussionsupporting

confidence: 92%

Role of intrarenal resistive index and ElastPQ® renal shear modulus in early diagnosis and follow-up of diabetic nephropathy: A prospective study

Krishnan

Malik

2020

Ultrasound

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“…In other studies, the correlation between CKD stages and kidney stiffness was negative, as shear wave velocity was found to decrease with increasing stages of CKD [270,286] or decreasing eGFR [287,288]. The cut-off values of renal stiffness proposed by different studies could only predict advanced stages of CKD.…”

Section: Kidney Stiffness For the Assessment Of Renal Pathologymentioning

confidence: 93%

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

et al. 2019

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“…Unlike SE, SWE does not require external compression and can therefore be used in both allografts and native kidneys. In CKD, most studies have reported decreased SWV [163][164][165] , associated with impaired renal function. 163,165 One study also demonstrated a good correlation between SWE-measured SWV and renal fibrosis.…”

Section: Ultrasound Elastographymentioning

confidence: 99%

“…In CKD, most studies have reported decreased SWV [163][164][165] , associated with impaired renal function. 163,165 One study also demonstrated a good correlation between SWE-measured SWV and renal fibrosis. 164 On the other hand, Samir et al found increased renal stiffness in CKD patients , 166 and Wang et al showed that SWE-estimated stiffness did not predict CKD stage or correlate with renal fibrosis.…”

Section: Ultrasound Elastographymentioning

confidence: 99%

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

Jiang

Ferguson

Lerman

2019

Translational Research

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Renal fibrosis is a useful biomarker for diagnosis and guidance of therapeutic interventions of chronic kidney disease (CKD), a worldwide disease that affects more than 10% of the population and is one of the major causes of death. Currently, tissue biopsy is the gold standard for assessment of renal fibrosis. However, it is invasive, and prone to sampling error and observer variability, and may also result in complications. Recent advances in diagnostic imaging techniques, including magnetic resonance imaging (MRI) and ultrasonography, have shown promise for noninvasive assessment of renal fibrosis. These imaging techniques measure renal fibrosis by evaluating its impacts on the functional, mechanical, and molecular properties of the kidney, such as water mobility by diffusion MRI, tissue hypoxia by blood oxygenation level dependent MRI, renal stiffness by MR and ultrasound elastography, and macromolecule content by magnetization transfer imaging. Other MR techniques, such as T 1 /T 2 mapping and susceptibility-weighted imaging have also been explored for measuring renal fibrosis. Promising findings have been reported in both preclinical and clinical studies using these techniques. Nevertheless, limited specificity, sensitivity, and practicality in these techniques may hinder their immediate application in clinical routine. In this review, we will introduce methodologies of these techniques, outline their applications in fibrosis imaging, and discuss their limitations and pitfalls.

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Ultrasound-Based Shear Wave Elastography in the Assessment of Patients with Diabetic Kidney Disease

Cited by 38 publications

References 29 publications

Role of intrarenal resistive index and ElastPQ® renal shear modulus in early diagnosis and follow-up of diabetic nephropathy: A prospective study

Role of intrarenal resistive index and ElastPQ® renal shear modulus in early diagnosis and follow-up of diabetic nephropathy: A prospective study

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

Noninvasive assessment of renal fibrosis by magnetic resonance imaging and ultrasound techniques

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