Title | Non-invasive assessment of kidney allograft fibrosis with shear wave elastography: A radiological-pathological correlation analysis. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Ma MKm, Law HKw, Tse KSun, Chan KWah, Chan GCw, Yap DYh, Mok MMy, Kwan LPy, Tang SCw, Choy BYing, Chan TMao |
Journal | Int J Urol |
Volume | 25 |
Issue | 5 |
Pagination | 450-455 |
Date Published | 2018 May |
ISSN | 1442-2042 |
Abstract | OBJECTIVES: To evaluate the use of shear wave elastography in assessment of kidney allograft tubulointerstitial fibrosis. METHODS: Shear wave elastography assessment was carried out by two independent operators in kidney transplant recipients who underwent allograft biopsy for clinical indications (i.e. rising creatinine >15% or proteinuria >1 g/day). Allograft biopsies were interpreted by the same pathologist according to the 2013 Banff Classification. RESULTS: A total of 40 elastography scans were carried out (median creatinine 172.5 μmol/L [interquartile range 133.8-281.8 μmol/L]). Median tissue stiffness at the cortex (22.6 kPa [interquartile range 18.8-25.7 kPa] vs 22.3 kPa [interquartile range 19.0-26.5 kPa], P = 0.70) and medulla (15.0 kPa [interquartile range 13.7-18.0 kPa] vs 15.6 kPa [interquartile range 14.4-18.2 kPa]) showed no significant differences between the two observers. Interobserver agreement was satisfactory (intraclass correlation coefficient of the cortex 0.84, 95% CI 0.70-0.92 and intraclass correlation coefficient of the medulla 0.88, 95% CI 0.78-0.94). The areas under the receiver operating characteristic curves for detection of tubulointerstitial fibrosis were estimated to be 0.75 (95% CI 0.61-0.89), 0.85 (95% CI 0.75-0.95) and 0.65 (95% CI 0.53-0.78) for cortical, medullary tissue stiffness and serum creatinine, respectively. CONCLUSIONS: Shear wave elastography can be used as a non-invasive tool to evaluate kidney allograft fibrosis with reasonable interobserver agreement and superior test performance to serum creatinine in detecting early tubulointerstitial fibrosis. |
DOI | 10.1111/iju.13536 |
Alternate Journal | Int. J. Urol. |
PubMed ID | 29444550 |
Submitted by kej2006 on June 6, 2018 - 4:13pm