Utility of the combination of IVIM-DWI MRI and baseline eGFR for identifying a high risk of chronic kidney disease progression.

IF 3.1 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Frontiers in Medicine Pub Date : 2025-02-19 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1532210
Yazhen Yu, Wei Zhang, Lina Zhu, Han Zhou, Shaoshan Liang, Longjiang Zhang, Zhihong Liu, Jiong Zhang
{"title":"Utility of the combination of IVIM-DWI MRI and baseline eGFR for identifying a high risk of chronic kidney disease progression.","authors":"Yazhen Yu, Wei Zhang, Lina Zhu, Han Zhou, Shaoshan Liang, Longjiang Zhang, Zhihong Liu, Jiong Zhang","doi":"10.3389/fmed.2025.1532210","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, the baseline estimated glomerular filtration rate (eGFR), the urine albumin level and renal fibrosis are the common risk and prognostic factors for chronic kidney disease (CKD). Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) is a proven noninvasive tool for assessing renal fibrosis. The aim of this study was to evaluate whether IVIM-DWI could be used to identify high-risk patients with CKD during long-term follow-up.</p><p><strong>Methods: </strong>In this exploratory study, 62 CKD patients who were followed for 5 years and who underwent renal biopsy and IVIM-DWI magnetic resonance imaging (MRI) at the National Clinical Research Center of Kidney Disease in China were enrolled. We recorded baseline data, including clinical, pathology and MRI parameters, and evaluated the associations between baseline parameters and renal outcomes. The value of DWI parameters in predicting end-stage kidney disease (ESKD) was compared with that of clinical and pathological data.</p><p><strong>Results: </strong>The mean baseline eGFR was 78.1 ± 28.05 ml/min/1.73 m<sup>2</sup>, and the median eGFR slope was -0.07 (-0.43-0.06) ml/min/1.73 m<sup>2</sup>/yr. Sixteen patients eventually developed ESKD. The values of perfusion fraction (f) were positively correlated with the eGFR slope (<i>r<sub>s</sub></i> = 0.54, <i>p</i> = 0.028). The results of the receiver operating characteristic (ROC) analysis demonstrated that the areas under the curve (AUCs) of total apparent diffusion coefficient (ADC<sub>T</sub>), true diffusion coefficient (D) and f in distinguishing ESKD were 0.778 (95% confidence interval [95% CI] 0.65-0.906; <i>p</i> = 0.001), 0.893 (95% CI 0.816-0.97; <i>p</i> <0.001), and 0.823 (95% CI 0.706-0.939; <i>p</i> < 0.001), respectively. For the combination of baseline eGFR with both D and f, the AUC was significantly greater than that for the combination of baseline eGFR and interstitial extracellular matrix volume [AUC 0.955 (95% CI, 0.909 to 1.000) vs. AUC 0.886 (95% CI, 0.803 to 0.969), <i>p</i> = 0.049]. Cox proportional hazard regression revealed that f was a risk and prognostic factor for ESKD after adjustment for baseline variables (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>The combination of baseline eGFR and IVIM-DWI outperforms pathological factors alone in the diagnosis of long-term kidney dysfunction. This study indicated that IVIM-DWI could be a promising tool for identifying patients at high risk of CKD progression.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1532210"},"PeriodicalIF":3.1000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880002/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1532210","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Currently, the baseline estimated glomerular filtration rate (eGFR), the urine albumin level and renal fibrosis are the common risk and prognostic factors for chronic kidney disease (CKD). Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) is a proven noninvasive tool for assessing renal fibrosis. The aim of this study was to evaluate whether IVIM-DWI could be used to identify high-risk patients with CKD during long-term follow-up.

Methods: In this exploratory study, 62 CKD patients who were followed for 5 years and who underwent renal biopsy and IVIM-DWI magnetic resonance imaging (MRI) at the National Clinical Research Center of Kidney Disease in China were enrolled. We recorded baseline data, including clinical, pathology and MRI parameters, and evaluated the associations between baseline parameters and renal outcomes. The value of DWI parameters in predicting end-stage kidney disease (ESKD) was compared with that of clinical and pathological data.

Results: The mean baseline eGFR was 78.1 ± 28.05 ml/min/1.73 m2, and the median eGFR slope was -0.07 (-0.43-0.06) ml/min/1.73 m2/yr. Sixteen patients eventually developed ESKD. The values of perfusion fraction (f) were positively correlated with the eGFR slope (rs = 0.54, p = 0.028). The results of the receiver operating characteristic (ROC) analysis demonstrated that the areas under the curve (AUCs) of total apparent diffusion coefficient (ADCT), true diffusion coefficient (D) and f in distinguishing ESKD were 0.778 (95% confidence interval [95% CI] 0.65-0.906; p = 0.001), 0.893 (95% CI 0.816-0.97; p <0.001), and 0.823 (95% CI 0.706-0.939; p < 0.001), respectively. For the combination of baseline eGFR with both D and f, the AUC was significantly greater than that for the combination of baseline eGFR and interstitial extracellular matrix volume [AUC 0.955 (95% CI, 0.909 to 1.000) vs. AUC 0.886 (95% CI, 0.803 to 0.969), p = 0.049]. Cox proportional hazard regression revealed that f was a risk and prognostic factor for ESKD after adjustment for baseline variables (p = 0.006).

Conclusion: The combination of baseline eGFR and IVIM-DWI outperforms pathological factors alone in the diagnosis of long-term kidney dysfunction. This study indicated that IVIM-DWI could be a promising tool for identifying patients at high risk of CKD progression.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Frontiers in Medicine
Frontiers in Medicine Medicine-General Medicine
CiteScore
5.10
自引率
5.10%
发文量
3710
审稿时长
12 weeks
期刊介绍: Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信