Selection for biopsy of kidney transplant patients by diffusion-weighted MRI.

Steiger, Philipp; Barbieri, Sebastiano; Kruse, Anja; Ith, Michael; Thöny, Harriet C. (2017). Selection for biopsy of kidney transplant patients by diffusion-weighted MRI. European radiology, 27(10), pp. 4336-4344. Springer 10.1007/s00330-017-4814-z

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OBJECTIVES To assess retrospectively whether diffusion-weighted magnetic resonance imaging (DW-MRI) allows physicians to determine the severity of histopathologic findings in biopsies of renal allograft patients with deteriorating renal function. METHODS Forty consecutive kidney transplant patients underwent DW-MRI and biopsy. Patients were assigned to one group with severe and to another group with normal or mild histopathologic findings. These two groups were compared based on a qualitative DW-MRI assessment (homo-/heterogeneity) and the combination of qualitative and quantitative DW-MRI parameters (ADC, and intravoxel incoherent motion, IVIM, parameters: D, f, D*). Sensitivity, specificity, and accuracy were determined for each parameter. RESULTS Biopsy findings were severe in 25 patients and normal or mild in 15 patients. Qualitative DW-MRI led to a sensitivity of 44.0% and a specificity of 93.3%. Combined qualitative and quantitative DW-MRI led to an accuracy of 80% for both the minimal ADC (ADCmin) and the minimal perfusion fraction (fmin) with a sensitivity of 84.0% and 92.0% and a specificity of 73.3% and 60.0%, respectively. CONCLUSION Combined qualitative and quantitative DW-MRI might allow physicians to determine the severity of histopathologic findings in biopsies of a high number of kidney transplant patients. KEY POINTS • Qualitative DW-MRI is highly specific when predicting the severity of kidney transplant biopsy. • Allografts appearing heterogeneous on ADC are associated with severe histopathologic findings. • Combining qualitative and quantitative DW-MRI parameters improves the classification's sensitivity and accuracy. • Kidney transplant biopsies might be spared by combining qualitative and quantitative DW-MRI.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Steiger, Philipp; Barbieri, Sebastiano; Ith, Michael and Thöny, Harriet C.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0938-7994

Publisher:

Springer

Language:

English

Submitter:

Philipp Steiger

Date Deposited:

23 Feb 2018 12:44

Last Modified:

23 Oct 2019 13:16

Publisher DOI:

10.1007/s00330-017-4814-z

PubMed ID:

28374076

Uncontrolled Keywords:

Anatomy & histology Biopsy Diffusion-weighted magnetic resonance imaging Echo-planar imaging Renal transplant

BORIS DOI:

10.7892/boris.99568

URI:

https://boris.unibe.ch/id/eprint/99568

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