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Shear wave elastography in chronic kidney disease - the physics and clinical application
Kwan Hoong Ng1,2, Jeannie Hsiu Ding Wong1, Sook Sam Leong3
1Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Insights
Chronic kidney disease affects millions globally. New ultrasound shear wave elastography offers a non-invasive method to assess kidney stiffness, potentially improving diagnosis and management of this widespread condition.
Area of Science:
- Nephrology
- Medical Imaging
- Biophysics
Background:
- Chronic kidney disease (CKD) is a major global health issue affecting nearly 500 million people, leading to almost one million deaths annually.
- Current diagnostic methods like estimated glomerular filtration rate (eGFR), conventional ultrasound, and histopathology have limitations, including error margins, subjective assessments, and potential complications.
Purpose of the Study:
- To review the literature and present combined experience on renal shear wave elastography (SWE) for CKD assessment.
- To discuss confounding factors and future possibilities in ultrasound renal imaging, focusing on SWE.
Main Methods:
- Review of existing literature on renal SWE.
- Presentation of combined research experience and knowledge in the field.
- Discussion of the principles of SWE: generating and measuring shear waves to quantify tissue stiffness non-invasively.
Main Results:
- Ultrasound shear wave elastography is an emerging, non-invasive imaging technique that quantifies tissue stiffness.
- SWE involves applying acoustic pulses to generate shear waves and measuring their propagation speed to estimate tissue stiffness.
- This technique shows promise for improving the assessment of renal pathology compared to existing methods.
Conclusions:
- Renal SWE offers a promising non-invasive approach for evaluating kidney stiffness and potentially aiding in the detection and management of chronic kidney disease.
- Further research and understanding of confounding factors are crucial for optimizing the clinical application of renal SWE in ultrasound renal imaging.
Abstract:
Chronic kidney disease is a leading public health problem worldwide. The global prevalence of chronic kidney disease is nearly five hundred million people, with almost one million deaths worldwide. Estimated glomerular filtration rate, imaging such as conventional ultrasound, and histopathological findings are necessary as each technique provides specific information which, when taken together, may help to detect and arrest the development of chronic kidney disease, besides managing its adverse outcomes. However, estimated glomerular filtration rate measurements are hampered by substantial error margins while conventional ultrasound involves subjective assessment. Although histopathological assessment is the best tool for evaluating the severity of the renal pathology, it may lead to renal insufficiency and haemorrhage if complications occurred. Ultrasound shear wave elastography, an emerging imaging that quantifies tissue stiffness non-invasively has gained interest recently. This method applies acoustic force pulses to generate shear wave within the tissue that propagate perpendicular to the main ultrasound beam. By measuring the speed of shear wave propagation, the tissue stiffness is estimated. This paper reviews the literature and presents our combined experience and knowledge in renal shear wave elastography research. It discusses and highlights the confounding factors on shear wave elastography, current and future possibilities in ultrasound renal imaging and is not limited to new sophisticated techniques.
