Accuracy of Ultrasound in Identifying Renal Scarring as Compared to DMSA Scan

Finkelstein, Julia B.; Rague, James T.; Chow, Jeanne S.; Venna, Alyssia; Logvinenko, Tanya; Nelson, Caleb P.; Lee, Richard S.

doi:10.1016/j.urology.2020.01.019

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…However, despite temporal advances in ultrasound technology, recent studies show poor sensitivity for renal scars compared to goldstandard dimercaptosuccinic acid scans. 16 This trend in renal scarring is consistent with identification of radioisotope imaging as a method of detecting pyelonephritic scarring in the 1980s. 17,18 Similarly, the first article in our analysis reporting CysC-based outcomes was in 2003, consistent with the identification of CysC as a valuable marker of kidney function in the late 1990s.…”

Section: Discussionsupporting

confidence: 67%

Variation in Definitions of Kidney Abnormality in Patients with Spina Bifida: A Systematic Scoping Review

et al. 2022

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Purpose:We systematically reviewed the variability in definitions of kidney abnormality (KA) outcomes in individuals with spina bifida (SB).Materials and Methods:A systematic scoping review was conducted using MEDLINE, Embase™, Cochrane Library, CINAHL, PsycInfo®, Web of Science™ and ClinicalTrials.gov for articles from time of database inception to September 2020. No language or patient age restrictions were applied. Primary research articles involving individuals with SB where KA was assessed as an outcome were included. Means of assessing KA and defining KA severity were abstracted.Results:Of 2,034 articles found, 274 were included in the review. Most articles were published after 1990 (63.5%) and included pediatric-only populations (0–18 years; 60.5%). KA outcomes were identified by imaging-based anatomical outcomes (84.7%), serum-based outcomes (44.9%), imaging-based functional outcomes (5.5%), urine-based outcomes (3.3%) and diagnoses of end-stage kidney disease (2.6%) or chronic kidney disease otherwise unspecified (1.8%). Hydronephrosis was the most commonly used specific outcome (64.6%, 177/274) with 19.8% (35/177) of articles defining hydronephrosis severity. Hydronephrosis was used more frequently in articles with pediatric-only populations. Creatinine and cystatin-C were used in 82.1% (101/123) and 17.9% (22/123) of articles reporting serum-based outcomes, respectively, with 32.7% and 50.0% of articles defining estimated glomerular filtration rate (GFR) severity. Serum-based outcomes were more common in articles including adults >18 years. Measured GFR was assessed in 9.9% (27/274) of articles, with 44.4% (12/27) of articles defining GFR severity.Conclusions:Significant variability exists in how authors define KA with few specifically defining KA severity. Consensus and consistency in defining KA outcomes are needed.

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Section: Discussionsupporting

confidence: 67%

Variation in Definitions of Kidney Abnormality in Patients with Spina Bifida: A Systematic Scoping Review

et al. 2022

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“…Renal injury has been associated with high-grade VUR ( 28 ). Finkelstein et al ( 12 ) demonstrated low accuracy in detecting renal scars by ultrasonography. Our findings showed the presence of renal scarring in 19.2% of patients submitted to renal scintigraphy (99mTc-DMSA).…”

Section: Discussionmentioning

confidence: 99%

Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder

da Silva,

de Almeida Vasconcelos,

Lima

et al. 2023

Int. braz j urol.

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Purpose: This study aimed to analyze the diagnostic accuracy of dynamic and static ultrasound (DSUS) in detecting vesicoureteral reflux (VUR) and renal scarring in a cohort of children with neurogenic bladder (NB). Materials and Methods: A retrospective, longitudinal, observational study was conducted using the Reporting Diagnostic Accuracy Studies guideline. The DSUS (index test) data were compared with voiding cystourethrography (VCUG) and renal scintigraphy 99mTc-dimercaptosuccinic (reference tests). Overall performance for predicting VUR and renal scarring was assessed using renal pelvic diameter (RPD)/distal ureteral diameter and renal parenchymal thinning on DSUS, respectively. Results: A total of 107 patients (66 girls, median age 9.6 years) participated. Seventeen patients (15.9%) presented VUR, eight bilateral. For overall reflux grade, the AUC was 0.624 for RPD and 0.630 for distal ureteral diameter. The diagnostic performance for detecting high-grade VUR was slightly better for DSUS parameters. The AUC was 0.666 for RPD and 0.691 for distal ureteral diameter. The cut-offs of 5 mm for RPD and 6.5 mm for distal ureteral diameter presented the best diagnostic odds ratio (DOR) to identify high-grade VUR. The increase of RPD during detrusor contractions showed an accuracy of 89.2%. The thinness of renal parenchyma presented an accuracy of 88% for renal scarring. Conclusion: DSUS predicts VUR and renal scarring in children with NB with fair to good accuracy, and all measurements exhibited a high negative predictive value (NPV). The increase in RPD during voiding or detrusor contractions proved to be the most accurate parameter for indicating the presence of VUR in this study.

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“…Dimercaptosuccinic acid static (DMSA) renal cortical scintigraphy is a sensitive and widely acknowledged method, particularly compared with renal ultrasonography (US), for the detection of cortical lesions, such as renal scars, without any contraindications [1,2]. In addition, the combination of DMSA scan and US contributes remarkably to the differentiation ability of lesions [1].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the combination of DMSA scan and US contributes remarkably to the differentiation ability of lesions [1]. However, this method causes exposure to low-dose radiation exposure [2]. In contrast, shear wave elastography (SWE) helps quantitatively evaluate the stiffness of renal sequelae without radiation exposure [3,4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of shear wave elastography and dimercaptosuccinic acid renal cortical scintigraphy in pediatric patients

Salan

Menzilcioğlu

Güler

et al. 2023

Nuclear Medicine Communications

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Background Although it causes low-dose radiation exposure, dimercaptosuccinic acid (DMSA) renal cortical scintigraphy is the gold standard examination method in the noninvasive diagnosis of renal scar tissue (RST). Shear wave elastography (SWE) has recently come to the fore as a technique for measuring kidney stiffness in the examination of RST. The present study aims to compare DMSA and SWE tests to evaluate whether SWE can be used instead of DMSA as a test that does not cause radiation exposure in pediatric patients. Methods In this prospective study, sonographic elastography was performed on pediatric patients with DMSA images. In the SWE examination, measurements were made from each kidney’s upper, middle and lower parts. DMSA and elastography data were compared for the diagnosis of RST. Results A total of 64 patients were included in the present study. There were 68.8% female (n = 44) and 31.2% (n = 20) male patients. There were 45 pediatric patients [Female 30 (66.7%), male 15 (33.3%)] in group 1 (pathological group) and 19 pediatric patients [Female 14 (73.7%), male 5 (26.3%)] in the control group. When DMSA data and SWE values were compared, it was found that elastography did not show a statistically significant performance in predicting renal scarring Conclusion In the existing literature, various studies reported different values for the diagnosis of renal stiffness using SWE. Similar to some previous studies, the present study observed no significant correlations between DMSA and SWE. Thus, DMSA preserves its major role and effectiveness as an important predictor of RST in pediatric patients.

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Accuracy of Ultrasound in Identifying Renal Scarring as Compared to DMSA Scan

Cited by 10 publications

References 23 publications

Variation in Definitions of Kidney Abnormality in Patients with Spina Bifida: A Systematic Scoping Review

Variation in Definitions of Kidney Abnormality in Patients with Spina Bifida: A Systematic Scoping Review

Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder

Comparison of shear wave elastography and dimercaptosuccinic acid renal cortical scintigraphy in pediatric patients

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