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01-10-2012 | Urogenital

Quantitative elastography of renal transplants using supersonic shear imaging: a pilot study

Authors: Nicolas Grenier, Séverine Poulain, Sébastien Lepreux, Jean-Luc Gennisson, Benjamin Dallaudière, Yann Lebras, Eric Bavu, Aude Servais, Vannary Meas-Yedid, Mathieu Piccoli, Thomas Bachelet, Mickaël Tanter, Pierre Merville, Lionel Couzi

Published in: European Radiology | Issue 10/2012

Abstract

Purpose

To evaluate the reliability of quantitative ultrasonic measurement of renal allograft elasticity using supersonic shear imaging (SSI) and its relationship with parenchymal pathological changes.

Materials and methods

Forty-three kidney transplant recipients (22 women, 21 men) (mean age, 51 years; age range, 18–70 years) underwent SSI elastography, followed by biopsy. The quantitative measurements of cortical elasticity were performed by two radiologists and expressed in terms of Young’s modulus (kPa). Intra- and inter-observer reproducibility was assessed (Kruskal-Wallis test and Bland-Altman analysis), as well as the correlation between elasticity values and clinical, biological and pathological data (semi-quantitative Banff scoring). Interstitial fibrosis was evaluated semi-quantitatively by the Banff score and measured by quantitative image analysis.

Results

Intra- and inter-observer variation coefficients of cortical elasticity were 20 % and 12 %, respectively. Renal cortical stiffness did not correlate with any clinical parameters, any single semi-quantitative Banff score or the level of interstitial fibrosis; however, a significant correlation was observed between cortical stiffness and the total Banff scores of chronic lesions and of all elementary lesions (R = 0.34, P = 0.05 and R = 0.41, P = 0.03,respectively).

Conclusion

Quantitative measurement of renal cortical stiffness using SSI is a promising non-invasive tool to evaluate global histological deterioration.

Key Points

• Supersonic shear imaging elastography can measure cortical stiffness in renal transplants

• The level of cortical stiffness is correlated with the global degree of tissue lesions

• The global histological deterioration of transplanted kidneys can be quantified using elastography

Racusen LC, Solez K, Colvin RB et al (1999) The Banff 97 working classification of renal allograft pathology. Kidney Int 55:713–723PubMedCrossRef

Nankivell BJ, Borrows RJ, Fung CL, O’Connell PJ, Allen RD, Chapman JR (2003) The natural history of chronic allograft nephropathy. N Engl J Med 349:2326–2333PubMedCrossRef

Stegall MD, Park WD, Larson TS et al (2010) The histology of solitary renal allografts at 1 and 5 years after transplantation. Am J Transplant 11:698–707PubMedCrossRef

Weitzel WF, Kim K, Rubin JM et al (2004) Feasibility of applying ultrasound strain imaging to detect renal transplant chronic allograft nephropathy. Kidney Int 65:733–736PubMedCrossRef

de Ledinghen V, Vergniol J (2008) Transient elastography (FibroScan). Gastroenterol Clin Biol 32:58–67PubMedCrossRef

Nguyen-Khac E, Capron D (2006) Noninvasive diagnosis of liver fibrosis by ultrasonic transient elastography (Fibroscan). Eur J Gastroenterol Hepatol 18:1321–1325PubMedCrossRef

Sandrin L, Fourquet B, Hasquenoph JM et al (2003) Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 29:1705–1713PubMedCrossRef

Friedrich-Rust M, Wunder K, Kriener S et al (2009) Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 252:595–604PubMedCrossRef

Arndt R, Schmidt S, Loddenkemper C et al (2010) Noninvasive evaluation of renal allograft fibrosis by transient elastography – a pilot study. Transpl Int 23:871–877PubMed

10.

Syversveen T, Brabrand K, Midtvedt K et al (2010) Assessment of renal allograft fibrosis by acoustic radiation force impulse quantification – a pilot study. Transpl Int 24:100–105PubMedCrossRef

11.

Stock KF, Klein BS, Vo Cong MT et al (2010) ARFI-based tissue elasticity quantification in comparison to histology for the diagnosis of renal transplant fibrosis. Clin Hemorheol Microcirc 46:139–148PubMed

12.

Muller M, Gennisson JL, Deffieux T, Tanter M, Fink M (2009) Quantitative viscoelasticity mapping of human liver using supersonic shear imaging: preliminary in vivo feasibility study. Ultrasound Med Biol 35:219–229PubMedCrossRef

13.

Bavu E, Gennisson JL, Couade M et al (2011) Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol 37:1361–1373PubMedCrossRef

14.

Sis B, Mengel M, Haas M et al (2010) Banff '09 meeting report: antibody mediated graft deterioration and implementation of Banff working groups. Am J Transplant 10:464–471PubMedCrossRef

15.

Athanasiou A, Tardivon A, Tanter M et al (2010) Breast lesions: quantitative elastography with supersonic shear imaging – preliminary results. Radiology 256:297–303PubMedCrossRef

16.

Bercoff J, Tanter M, Fink M (2004) Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 51:396–409PubMedCrossRef

17.

Servais A, Meas-Yedid V, Buchler M et al (2007) Quantification of interstitial fibrosis by image analysis on routine renal biopsy in patients receiving cyclosporine. Transplantation 84:1595–1601PubMedCrossRef

18.

Servais A, Meas-Yedid V, Toupance O et al (2009) Interstitial fibrosis quantification in renal transplant recipients randomized to continue cyclosporine or convert to sirolimus. Am J Transplant 9:2552–2560PubMedCrossRef

19.

Matas AJ, Gillingham KJ, Humar A et al (2008) 2202 kidney transplant recipients with 10 years of graft function: what happens next? Am J Transplant 8:2410–2419PubMedCrossRef

20.

Castera L, Bernard PH, Le Bail B et al (2011) Transient elastography and biomarkers for liver fibrosis assessment and follow-up of inactive hepatitis B carriers. Aliment Pharmacol Ther 33:455–465PubMedCrossRef

21.

Ries M, Jones RA, Basseau F, Moonen CT, Grenier N (2001) Diffusion tensor MRI of the human kidney. J Magn Reson Imaging 14:42–49PubMedCrossRef

Title: Quantitative elastography of renal transplants using supersonic shear imaging: a pilot study
Authors: Nicolas Grenier
Séverine Poulain
Sébastien Lepreux
Jean-Luc Gennisson
Benjamin Dallaudière
Yann Lebras
Eric Bavu
Aude Servais
Vannary Meas-Yedid
Mathieu Piccoli
Thomas Bachelet
Mickaël Tanter
Pierre Merville
Lionel Couzi
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2471-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative elastography of renal transplants using supersonic shear imaging: a pilot study

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

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