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Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...

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Explainable Machine-learning Model Based on Multimodal Ultrasound for Non-invasive Detection of Early Renal Fibrosis:

Yao Zhang1, Xingyue Huang1, Wei Xu2

  • 1Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (Y.Z., X.H., Q.D., Q.Z.).

Academic Radiology
|July 14, 2026
PubMed
Summary

This study developed a multimodal ultrasound machine learning model to non-invasively detect early kidney fibrosis in chronic kidney disease (CKD) patients. The explainable model accurately identifies fibrotic changes, aiding in risk stratification.

Keywords:
Machine LearningMultiparametric UltrasoundRenal FibrosisSHapley Additive exPlanationsSuper-resolution Ultrasound

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Area of Science:

  • Nephrology
  • Medical Imaging
  • Artificial Intelligence

Background:

  • Chronic kidney disease (CKD) affects millions globally, with early fibrosis being a key determinant of progression.
  • Non-invasive methods for detecting early renal fibrosis are crucial for timely intervention and management.
  • Current diagnostic methods often rely on invasive biopsies or less sensitive imaging techniques.

Purpose of the Study:

  • To develop and validate an interpretable, multimodal, ultrasound-based machine learning (ML) model for non-invasive identification of early renal fibrosis in CKD patients.
  • To compare the performance of various ML algorithms and imaging modalities for fibrosis detection.
  • To enhance model interpretability using SHAP analysis.

Main Methods:

  • A prospective, multicenter study involving 369 participants (161 healthy controls, 208 with mild fibrosis).
  • Development of ML models using conventional ultrasound, ultra micro angiography (UMA), shear-wave elastography (SWE), super-resolution ultrasound (SRUS), and clinical variables.
  • External validation using held-out centers and interpretability analysis via Shapley Additive exPlanations (SHAP).

Main Results:

  • The comprehensive fusion model (SRUS, SWE, conventional ultrasound, clinical variables) achieved high performance (AUC 0.948 internally, 0.823 externally).
  • The fusion model significantly outperformed the clinical baseline model in both internal and external validation.
  • SHAP analysis highlighted imaging parameters (vessel density, fractal dimension) and clinical indices (Scr, eGFR) as key predictors.

Conclusions:

  • An explainable, multimodal ultrasound-based ML model demonstrates significant promise for non-invasively identifying early renal fibrotic changes.
  • This model may serve as an adjunctive tool for risk stratification in patients with CKD.
  • The findings support the integration of advanced ultrasound techniques and ML for improved CKD management.