Non‐invasive assessment of kidney allograft fibrosis with shear wave elastography: A radiological‐pathological correlation analysis

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....

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Bibliographic Details
Published in:International journal of urology 2018-05, Vol.25 (5), p.450-455
Main Authors: Ma, Maggie KM, Law, Helen KW, Tse, Kin Sun, Chan, Kwok Wah, Chan, Gary CW, Yap, Desmond YH, Mok, Maggie MY, Kwan, Lorraine PY, Tang, Sydney CW, Choy, Bo Ying, Chan, Tak Mao
Format: Article
Language:English
Subjects:
Adult
Allografts
Biopsy
chronic allograft nephropathy
Correlation analysis
Creatinine
Elasticity Imaging Techniques
Female
Fibrosis
Graft Survival
Hong Kong
Humans
kidney
Kidney - diagnostic imaging
Kidney - pathology
Kidney Diseases - diagnostic imaging
Kidney Diseases - pathology
Kidney Transplantation
Male
Middle Aged
Proteinuria
Reproducibility of Results
ROC Curve
shear wave elastography
transplantation
ultrasound
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Summary: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.
ISSN:0919-8172
1442-2042
DOI:10.1111/iju.13536