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Published on: June 23, 2015
3 Tesla-Diffusion Tensor Imaging in Autosomal Dominant Polycystic Kidney Disease: The Nephrologist's Point of View
Rosaria Lupica1, Enricomaria Mormina, Antonio Lacquaniti
1Department of Clinical and Experimental Medicine, Nephrology and Dialysis Unit, University of Messina, Messina, Italy.
Background/Aims:
CT, MRI and ultrasound are currently used for screening and follow-up of individuals affected by autosomal dominant polycystic kidney disease (ADPKD). Dynamic contrast-enhanced MRI studies renal perfusion after gadolinium administration, with possible side effects, such as nephrogenic systemic fibrosis. The aim of our study was to evaluate the clinical application of 3 Tesla (3T)-diffusion tensor image (DTI) in ADPKD patients, correlating its parameters, such as fractional anisotropy (FA), and apparent diffusion coefficient (ADC) with kidney function tests.
Methods:
Eight ADPKD patients and 6 healthy volunteers (HS) were enrolled. FA and ADC mean values were calculated. And correlations between DTI-parameters, creatinine and estimated glomerular filtration rate (eGFR) were evaluated.
Results:
Parenchymal FA was significantly lower in ADPKD than HS (FA: 0.17 ± 0.03 vs. 0.22 ± 0.01; p = 0.02), whereas parenchymal ADC was higher in patients than controls (2.48 (×10-3) ± 0.16 vs. 2.28 (×10-3) ± 0.09), but a statistically significant difference was not achieved (p = 0.27). Direct correlations were revealed between eGFR and FA (r = 0.82; p = 0.0003), whereas an inverse correlation was found with creatinine (r = -0.77; p = 0.001). Similarly, ADC closely correlated with creatinine (r = 0.79; p = 0.0006) and eGFR (r = -0.620; p = 0.01).
Conclusion:
3T-DTI is a promising radiological tool that could be used by nephrologists to evaluate ADPKD patients, highlighting early micro-structure alterations, without side effects and contrast agent administration.
Insights
3 Tesla diffusion tensor imaging (DTI) shows early kidney micro-structure changes in autosomal dominant polycystic kidney disease (ADPKD). This non-invasive technique correlates with kidney function, offering a safer alternative to contrast-enhanced MRI.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Current imaging for autosomal dominant polycystic kidney disease (ADPKD) includes CT, MRI, and ultrasound.
- Dynamic contrast-enhanced MRI assesses renal perfusion but carries risks like nephrogenic systemic fibrosis.
- There is a need for safer, effective imaging modalities for ADPKD evaluation.
Purpose of the Study:
- To evaluate the clinical utility of 3 Tesla (3T) diffusion tensor imaging (DTI) in ADPKD patients.
- To correlate DTI parameters, specifically fractional anisotropy (FA) and apparent diffusion coefficient (ADC), with kidney function tests.
- To explore DTI as a non-invasive imaging tool for ADPKD.
Main Methods:
- Eight ADPKD patients and six healthy volunteers (HS) were recruited.
- Mean FA and ADC values were calculated from 3T-DTI scans.
- Correlations between DTI parameters (FA, ADC) and kidney function markers (creatinine, eGFR) were analyzed.
Main Results:
- Parenchymal FA was significantly lower in ADPKD patients compared to HS (0.17 ± 0.03 vs. 0.22 ± 0.01; p=0.02).
- Parenchymal ADC was higher in ADPKD patients (2.48(×10-3) ± 0.16 vs. 2.28(×10-3) ± 0.09), though not statistically significant (p=0.27).
- Significant correlations were observed: eGFR with FA (r=0.82; p=0.0003) and creatinine with FA (r=-0.77; p=0.001). ADC also correlated with creatinine (r=0.79; p=0.0006) and eGFR (r=-0.620; p=0.01).
Conclusions:
- 3T-DTI is a promising radiological tool for evaluating ADPKD.
- It can detect early micro-structural alterations in the kidney.
- DTI offers a safe alternative, avoiding contrast agents and their associated side effects.
