Technical feasibility and correlations between shear-wave elastography and histology in kidney fibrosis in children

Desvignes, C.; Dabadie, A.; Aschero, A.; Ruocco, Alix; Garaix, Florentine; Daniel, Laurent; Ferlicot, Sophie; Villes, Virginie; Loundou, Anderson; Gorincour, Guillaume; Petit, Philippe

doi:10.1007/s00247-021-05068-x

Cited by 15 publications

(12 citation statements)

References 56 publications

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“…Our findings contrast with the only available pediatric kidney transplant elastography study, which showed that there was no correlation between stiffness parameters and the degree of fibrosis (Table 2). 16 However, it is important to mention that, despite having a larger sample size, their study was limited by poor interobserver variability, biopsy sampling error in a large proportion of their cases, and a low success rate in linear probe elastography measurement 16 …”

Section: Discussionmentioning

confidence: 99%

“…Currently, correlations between elasticity and fibrosis for both native and transplanted kidneys have been published in adults, but their results are not yet conclusive for either MR or US elastography 12‐15 . In children, there is even less evidence 16 . We aim to compare ultrasound and MR elastography in order to determine normative values for pediatric kidney transplant recipients and healthy controls and evaluate their performance as independent but equivalent noninvasive imaging biomarkers.…”

Section: Introductionmentioning

confidence: 99%

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Imaging fibrosis in pediatric kidney transplantation: A pilot study

Elsingergy

Viteri

Otero

et al. 2023

Pediatric Transplantation

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Background: Noninvasive alternatives to biopsy for assessment of interstitial fibrosis and tubular atrophy (IFTA), the major determinant of kidney transplant failure, remain profoundly limited. Elastography is a noninvasive technique that propagates shear waves across tissues to measure their stiffness. We aimed to test utility of elastography for early detection of IFTA in pediatric kidney allografts. Methods:We compared ultrasound (USE) and MR elastography (MRE) stiffness measurements, performed on pediatric transplant recipients referred for clinically indicated biopsies, and healthy controls.Results: Ten transplant recipients (median age 16 years) and eight controls (median age 16.5 years) were enrolled. Three transplant recipients had "stable" allografts and seven had Banff Grade 1 IFTA. Median time from transplantation to biopsy was 12 months. Mean estimated glomerular filtration rate was 61.5 mL/min/1.73m 2 by creatinine-cystatin-C CKiD equation at time of biopsy. Mean stiffness, calculated through one-way ANOVA, was higher for IFTA allografts (23.4 kPa USE/5.6 kPa MRE) than stable allografts (13.7 kPa USE/4.4 kPa MRE) and controls (9.1 kPa USE/3.6 kPa MRE). Pearson's coefficient between USE and MRE stiffness values was strong (r = .97). AUC for fibrosis prediction in transplanted kidneys was high for both modalities (0.91 USE and 0.89 MRE), although statistically nonsignificant (p > .05). Stiffness cut-off values for USE and MRE were 13.8 kPa and 4.6 kPa, respectively. Both values yielded a sensitivity of 100% but USE specificity (72%) was slightly higher than MRE (67%). Conclusion:Elastography shows potential for detection of low-grade IFTA in allografts although a larger sample is imperative for clinical validation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Imaging fibrosis in pediatric kidney transplantation: A pilot study

Elsingergy

Viteri

Otero

et al. 2023

Pediatric Transplantation

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“…В почечных аллотрансплантатах ультразвуковое исследование и магнитно-резонансная томография (МРТ) являются двумя основными инструментальными методами оценки фиброза. Ультразвуковое измерение эластичности ткани (эластография) -подход, относительно хорошо зарекомендовавший себя в оценке фиброза печени,было предложено для корреляции с фиброзом в аллотрансплантатах почки, однако ряд исследователей не обнаружили такой корреляции [33].…”

Section: диагностика фиброза трансплантата почкиunclassified

Biomarkers of renal transplant fibrosis

Bystrova

Стаханова

Ilchuk

et al. 2022

RJTAO

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“…In the past decades, several imaging approaches have been studied for a non-invasive assessment of renal fibrosis, in both native and transplanted kidneys. Among them are ultrasound technologies that can measure renal stiffness using transient elastography (4), supersonic shear imaging (SSI) (5,6) or shear wave elastography (ARFI) (7)(8)(9). Still, these studies showed conflicting results regarding the correlation of renal stiffness with fibrosis (7,8) or no correlation at all (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

“…Among them are ultrasound technologies that can measure renal stiffness using transient elastography (4), supersonic shear imaging (5,6), and shear wave elastography (7)(8)(9). Still, these studies showed conflicting results regarding the correlation of renal stiffness with fibrosis (7,8) or no correlation at all (10)(11)(12). Other studies have tested magnetic resonance imaging (MRI)-based approaches, notably using diffusion-weighted imaging (13,14) and magnetic resonance elastography (MRE) (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study

et al. 2022

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Background: Fibrosis progression is a major prognosis factor in kidney transplantation. Its assessment requires an allograft biopsy, which remains an invasive procedure at risk of complications. Methods: We assessed renal stiffness by magnetic resonance elastography (MRE) as a surrogate marker of fibrosis in a prospective cohort of kidney transplant recipients, as compared to the histological gold standard. Interstitial fibrosis was evaluated by three methods: the semi-quantitative Banff ci score, a visual quantitative evaluation by a pathologist and a computer-assisted quantitative evaluation. MRE-derived stiffness was assessed at the superior, median and inferior poles of the allograft. Results: We initially enrolled 73 patients, but only 55 had measurements of their allograft stiffness by MRE prior to an allograft biopsy. There was no significant correlation between MRE-derived stiffness at biopsy site and the ci score (rho=-0.25, p=0.06) or with the two quantitative assessments (pathologist, rho=-0.25, p=0.07, computer-assisted, rho=-0.21, p=0.12). We observed negative correlations between the stiffness of both biopsy site and whole allograft, with either the glomerulosclerosis percentage (rho=-0.32, p=0.02 and rho=-0.31, p=0.02, respectively) and the overall nephron fibrosis percentage, defined as the mean of the percentages of glomerulosclerosis and interstitial fibrosis (rho=-0.30, p=0.02 and rho=-0.28, p=0.04, respectively). At patient level, mean MRE-derived stiffness was similar across the three poles of the allograft (± 0.25 kPa). However, a high variability of mean stiffness was found between patients, suggesting a strong influence of confounding factors. Finally, no significant correlation was found between mean MRE-derived stiffness and the slope of eGFR (p=0.08). Conclusions: MRE-derived stiffness does not directly reflect the extent of fibrosis in kidney transplantation.

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Technical feasibility and correlations between shear-wave elastography and histology in kidney fibrosis in children

Cited by 15 publications

References 56 publications

Imaging fibrosis in pediatric kidney transplantation: A pilot study

Imaging fibrosis in pediatric kidney transplantation: A pilot study

Biomarkers of renal transplant fibrosis

Magnetic Resonance Elastography as Surrogate Marker of Interstitial Fibrosis in Kidney Transplantation: A Prospective Study

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