Semiautomated Segmentation of Polycystic Kidneys in T2-Weighted MR Images

Kline, Timothy L.; Edwards, Marie E.; Korfiatis, Panagiotis; Akkus, Zeynettin; Torres, Vicente E.; Erickson, Bradley J.

doi:10.2214/ajr.15.15875

Cited by 37 publications

(52 citation statements)

References 37 publications

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“…Figure shows the organ segmentation from the 3D image shown in Figure : the zebrafish brain has a volume of 4.5 ± 0.2 mm 3 , the heart 0.82 ± 0.04 mm 3 , and the kidney 4.9 ± 0.2 mm 3 . (We report here only geometrical errors (less than 0.5%), which are much smaller than the variability introduced by different operators (~5%) …”

Section: Resultsmentioning

confidence: 83%

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Three‐dimensional NMR microscopy of zebrafish specimens

et al. 2018

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While zebrafish embryos in the first five days after fertilization are clear and amenable to optical analysis, older juveniles and adults are not, due to pigmentation development and tissue growth. Thus other imaging methods are needed to image adult specimens. NMR is a versatile tool for studies of biological systems and has been successfully used for in vivo zebrafish microscopy. In this work we use NMR microscopy (MRM) for assessment of zebrafish specimens, which includes imaging of formalin fixed (FF), formalin fixed and paraffin embedded (FFPE), fresh (unfixed), and FF gadolinium doped specimens. To delineate the size and shape of various organs we concentrated on 3D MRM. We have shown that at 7 T a 3D NMR image can be obtained with isotropic resolution of 50 μm/pxl within 10 min and 25 μm/pxl within 4 h. Also, we have analyzed sources of contrast and have found that in FF specimens the best contrast is obtained by T1 weighting (3D FLASH, 3D FISP), whereas in FFPE specimens T2 weighting (3D RARE) is the best. We highlight an approach to perform segmentation of the organs in order to study morphological changes associated with mutations. The broader implication of this work is development of NMR methodology for high contrast and high resolution serial imaging and automated analysis of morphology of various zebrafish mutants.

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Section: Resultsmentioning

confidence: 83%

“…(We report here only geometrical errors (less than 0.5%), which are much smaller than the variability introduced by different operators (~5%). 42 ).…”

Section: Organ Segmentationmentioning

confidence: 99%

Three‐dimensional NMR microscopy of zebrafish specimens

et al. 2018

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“…performed kidney segmentation semi-automatically utilizing the MIROS software package (https://github.com/TLKline/PyCysticImage) 46 . The software package has an interactive viewer that allows visualization of the image data in coronal, sagittal, and axial planes.…”

Section: Methodsmentioning

confidence: 99%

Image texture features predict renal function decline in patients with autosomal dominant polycystic kidney disease

Kline

Korfiatis

Edwards

et al. 2017

Kidney International

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Magnetic resonance imaging (MRI) examinations provide high-resolution information about the anatomic structure of the kidneys and are used to measure total kidney volume (TKV) in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Height adjusted TKV (HtTKV) has become the gold-standard imaging biomarker for ADPKD progression at early stages of the disease when estimated glomerular filtration rate (eGFR) is still normal. However, HtTKV does not take advantage of the wealth of information provided by MRI. Here we tested whether image texture features provide additional insights into the ADPKD kidney that may be used as complementary information to existing biomarkers. A retrospective cohort of 122 patients from The Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP study) was identified who had T2-weighted MRIs, and eGFR values over 70 mL/min/1.73m2 at the time of their baseline scan. We computed nine distinct image texture features for each patient. The ability of each feature to predict subsequent progression to CKD stage 3A, 3B, and 30% reduction in eGFR at eight-year follow up was assessed. A multiple linear regression model was developed incorporating age, baseline eGFR, HtTKV, and three image texture features identified by stability feature selection (Entropy, Correlation, and Energy). Including texture in a multiple linear regression model (predicting percent change in eGFR) improved Pearson correlation coefficient from -0.51 (using age, eGFR, and HtTKV) to -0.70 (adding texture). Thus, texture analysis offers an approach to refine ADPKD prognosis and should be further explored for its utility in individualized clinical decision making and outcome prediction.

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“…Variants of these methods have been automated and validated and we expect that they will become increasingly accessible and available for disease prognostication. 29,30 Once a patient is determined to have typical ADPKD, the Mayo class should be ascertained (Figure 4). Patients in class 1A progress slowly and should not be treated.…”

Section: Step 2 Confirm the Diagnosis Of Rapidly Progressive Diseasementioning

confidence: 99%

A Practical Guide for Treatment of Rapidly Progressive ADPKD with Tolvaptan

Chebib

Perrone

Chapman

et al. 2018

JASN

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In the past, the treatment of autosomal dominant polycystic kidney disease (ADPKD) has been limited to the management of its symptoms and complications. Recently, the US Food and Drug Administration (FDA) approved tolvaptan as the first drug treatment to slow kidney function decline in adults at risk of rapidly progressing ADPKD. Full prescribing information approved by the FDA provides helpful guidelines but does not address practical questions that are being raised by nephrologists, internists, and general practitioners taking care of patients with ADPKD, and by the patients themselves. In this review, we provide practical guidance and discuss steps that require consideration before and after prescribing tolvaptan to patients with ADPKD to ensure that this treatment is implemented safely and effectively. These steps include confirmation of diagnosis; identification of rapidly progressive disease; implementation of basic renal protective measures; counseling of patients on potential benefits and harms; exclusions to use; education of patients on aquaresis and its expected consequences; initiation, titration, and optimization of tolvaptan treatment; prevention of aquaresis-related complications; evaluation and management of liver enzyme elevations; and monitoring of treatment efficacy. Our recommendations are made on the basis of published evidence and our collective experiences during the randomized, clinical trials and open-label extension studies of tolvaptan in ADPKD.

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Semiautomated Segmentation of Polycystic Kidneys in T2-Weighted MR Images

Cited by 37 publications

References 37 publications

Three‐dimensional NMR microscopy of zebrafish specimens

Three‐dimensional NMR microscopy of zebrafish specimens

Image texture features predict renal function decline in patients with autosomal dominant polycystic kidney disease

A Practical Guide for Treatment of Rapidly Progressive ADPKD with Tolvaptan

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