Tc-99m DMSA Radiomics in CKD: Phenotype-Specific Cortical Signatures and a Morphological Predictor of Renal Function...

Area of Science:

• Radiology
• Nephrology
• Medical Imaging Analysis

Background:

• Chronic kidney disease (CKD) diagnosis and progression monitoring are crucial.
• Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) scintigraphy is used to assess renal cortical uptake.
• Radiomics offers quantitative analysis of medical images to extract features beyond visual assessment.

Purpose of the Study:

• To evaluate radiomic features from Tc-99m DMSA planar images for distinguishing CKD subgroups.
• To assess the association between radiomic features and progressive renal function loss.

Main Methods:

• Retrospective analysis of 185 patients with CKD, categorized into three groups based on diabetes mellitus (DM) and hypertension (HTN) history.
• Intergroup comparisons using Kruskal-Wallis and Bonferroni-corrected post hoc tests.
• Exploratory analysis using Cox proportional hazards regression to correlate radiomic features with estimated glomerular filtration rate (eGFR) decline.

Main Results:

• Significant intergroup differences were found in intensity and texture-based radiomic features (e.g., Intensity Kurtosis, Mean Intensity).
• Morphological features showed limited differentiation between groups.
• Centre of Mass Shift was the only morphological feature significantly associated with time to ≥20% eGFR decline (HR: 0.74, p=0.015).

Conclusions:

• Radiomic features from Tc-99m DMSA images reveal quantitative differences in CKD subgroups, even with visually similar uptake.
• DMSA-derived radiomics may offer prognostic information regarding future eGFR decline, warranting further validation.