Detecting early kidney allograft fibrosis with multi-b-value spectral diffusion MRI

Area of Science:

• Nephrology
• Radiology
• Biomedical Engineering

Background:

• Kidney allograft fibrosis signifies chronic kidney disease (CKD) and predicts graft failure.
• Early detection of fibrosis is crucial for managing kidney allograft health and function.

Purpose of the Study:

• To evaluate spectral diffusion magnetic resonance imaging (MRI) for detecting early and mild-to-moderate fibrosis in kidney allografts.
• To assess the relationship between diffusion MRI parameters and pathological fibrosis scores.

Main Methods:

• Prospective, two-center study involving 99 kidney allograft recipients.
• Multi-b-value diffusion-weighted imaging (DWI) with spectral diffusion, intravoxel incoherent motion (IVIM), and apparent diffusion coefficient (ADC) analysis.
• Pathologic interstitial fibrosis and tubular atrophy (IFTA) scoring and estimated glomerular filtration rate (eGFR) calculation.

Main Results:

• Spectral diffusion MRI detected fibrosis in patients with normal or stable renal function.
• Mild-to-moderate fibrosis (IFTA=2-4) was detected by spectral diffusion and ADC.
• eGFR, time-from-transplant, and allograft size did not correlate with early fibrosis detection.

Conclusions:

• Spectral diffusion MRI can detect mild-to-moderate kidney allograft fibrosis before a decline in function.
• This technique shows potential for early detection of CKD development and fibrosis progression in kidney allografts.