Ultrasound elastography in chronic kidney disease: a systematic review and meta-analysis

Cè, Maurizio; Felisaz, Paolo Florent; Alì, Marco; Sartò, Giulia Vanessa Re; Cellina, Michaela

doi:10.1007/s10396-023-01304-z

Cited by 7 publications

(5 citation statements)

References 102 publications

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“…A large number of studies are available for superficial organs like the breast and thyroid gland[ 15 - 26 ]. The native kidneys are deep-seated and hence, have been little investigated by this technique[ 27 - 32 ]. In a study done to determine the elasticity of various tissues, Arda et al [ 45 ] studied normal elasticity values within the kidney cortex along with many other internal organs in 127 healthy volunteers aged 17-63 years.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have suggested that quantitative elastography is a reliable non-invasive tool to assess chronic fibrosing changes in organs like the liver[ 22 - 26 ] and kidney[ 27 - 32 ] at early stages. A few studies have investigated the usefulness of sonoelastography in the assessment of chronic fibrosing changes in the kidney allograft[ 33 - 36 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Jesrani,

Faiq,

Rashid

et al. 2024

World J Transplant

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BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results. AIM To compare the diagnostic performance of resistive index (RI) and shear wave elastography (SWE) in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results. METHODS This is a cross-sectional and comparative study. A total of 154 kidney transplant recipients were included in this study, which was conducted at the Departments of Transplantation and Radiology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from August 2022 to February 2023. All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate (GFR) after three months of transplantation were enrolled in this study. SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility. RESULTS The mean age of all patients was 35.32 ± 11.08 years. Among these, 126 (81.8%) were males and 28 (18.2%) were females. The mean serum creatinine in all patients was 2.86 ± 1.68 mg/dL and the mean estimated GFR was 35.38 ± 17.27 mL/min/1.73 m2. Kidney allograft biopsy results showed chronic changes in 55 (37.66%) biopsies. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE for the detection of chronic allograft damage were 93.10%, 96.87%%, 94.73%, and 95.87%, respectively, and the diagnostic accuracy was 95.45%. For RI, the sensitivity, specificity, PPV, and NPV were 76.92%, 83.33%, 70.17%, and 87.62%, respectively, and the diagnostic accuracy was 81.16%. CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage. It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Jesrani,

Faiq,

Rashid

et al. 2024

World J Transplant

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“…However, Cè et al. [ 40 ] reported that the relationship between USE values and eGFR in CKD patients is still elusive. Our study did not unravel a significant difference in shear wave velocity between healthy individuals and CKD patients.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive diagnosis of interstitial fibrosis in chronic kidney disease: a systematic review and meta-analysis

Wan,

Wang,

et al. 2024

Renal Failure

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“…It has been applied with promising results for the study of thyroid nodules and breast lesions, showing, for example, that breast cancer presents higher stiffness compared to glandular parenchyma [10]. In nephrology, US elastography has been applied mainly to patients with chronic kidney disease, both in native and transplanted kidneys, demonstrating an increase in parenchymal stiffness due to the progression of fibrosis, while its relationship with the glomerular filtration rate remains controversial, probably due to many confounding factors [12]. A minor setting for the application of US elastography consists of the differentiation of focal lesions, i.e., if different elasticity values could be identified between different types of renal lesions and, in particular, between AML and CCR [30].…”

Section: Us Elastographymentioning

confidence: 99%

“…However, while US elastography is widely employed in current practice, its application in nephrology presents several challenges due to technical and methodological issues [12]. Most studies have been conducted in patients with chronic kidney disease (CKD), assessing the relation between kidney elasticity, fibrotic changes, and the glomerular filtration rate, whereas the role of US elastography in the diagnosis of focal lesions to guide a referral to further imaging or follow-up has been less extensively investigated.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Elastography for the Differentiation of Benign and Malignant Solid Renal Masses: A Systematic Review and Meta-Analysis

Cè,

Cozzi,

Cellina

et al. 2023

Applied Sciences

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The incidental finding of small renal masses in CT and MRI examinations can present a diagnostic challenge. Renal cell carcinoma (RCC) and angiomyolipoma (AML) are the most common incidental malignant and benign renal lesions but may present with similar US features. US elastography is a non-invasive technique that can assess tissue elasticity, has shown promising results in many clinical settings, and could be able to differentiate between benign and malignant renal lesions based on tissue stiffness. The purpose of this article is to systematically review the applications of US elastography in the characterization of solid renal masses and to derive and compare the summary estimates of different stiffness values across different lesion subtypes. In December 2022, a systematic search was carried out on the MEDLINE (PubMed) and EMBASE databases to retrieve studies on the application of US elastography in the characterization of solid renal masses. After article selection by three researchers, 14 studies entered qualitative synthesis. A total of 1190 patients were included, and the elastography data of 959 lesions were examined: 317/959 (33%) benign and 642/959 (67%) malignant. Among the malignancies, 590 (91%) were RCC, whereas, among the 317 benign lesions, 244 (77%) were AML. All lesions were classified using a histopathological (biopsy or operative specimen) or imaging (US follow-up/CT/MRI) reference standard. After data extraction and methodological quality evaluation, quantitative synthesis was performed on 12 studies, 4 using strain elastography (SE) and 8 using shear wave elastography (SWE), with single- and double-arm random-effects meta-analyses. Lesion stiffness measured with SE was available in four studies, with an RCC strain ratio higher than the AML strain ratio both in an indirect comparison (Cochran’s Q test p = 0.014) and in a direct comparison (p = 0.021). Conversely, the SWE measurements of RCC and AML stiffness did not significantly differ either at an indirect comparison (p = 0.055) or direct comparison (p = 0.114).

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Ultrasound elastography in chronic kidney disease: a systematic review and meta-analysis

Cited by 7 publications

References 102 publications

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

Noninvasive diagnosis of interstitial fibrosis in chronic kidney disease: a systematic review and meta-analysis

Ultrasound Elastography for the Differentiation of Benign and Malignant Solid Renal Masses: A Systematic Review and Meta-Analysis

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