Prediction of allograft function in pre-transplant kidneys using sound touch elastography (STE): an ex vivo study.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2024-10-11 DOI:10.1186/s13244-024-01837-y

Fu-Shun Pan, Dao-Peng Yang, Guo-Dong Zhao, Shu-Qi Huang, Yan Wang, Ming Xu, Jiang Qiu, Yan-Ling Zheng, Xiao-Yan Xie, Gang Huang

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Abstract

Background: The purpose of the study was to evaluate renal quality and predict posttransplant graft function using ex vivo sound touch elastography (STE).

Methods: In this prospective study, 106 donor kidneys underwent ex vivo STE examination and biopsy from March 2022 to August 2023. The mean stiffness of the superficial cortex (STE_sc), deep cortex (STE_dc), and medulla (STE_me) was obtained and synthesized into one index (STE) through the factor analysis method. Additionally, 100 recipients were followed up for 6 months. A random forest algorithm was employed to explore significant predictive factors associated with the Remuzzi score and allograft function. The performance of parameters was evaluated by using the area under the receiver operating characteristic curve (AUC).

Results: STE had AUC values of 0.803 for diagnosing low Remuzzi and 0.943 for diagnosing high Remuzzi. Meanwhile, STE had an AUC of 0.723 for diagnosing moderate to severe ATI. Random forest algorithm identified STE and Remuzzi score as significant predictors for 6-month renal function. The AUC for STE in predicting postoperative allograft function was 0.717, which was comparable with that of the Remuzzi score (AUC = 0.756). Nevertheless, the specificity of STE was significantly higher than that of Remuzzi (0.913 vs 0.652, p < 0.001). Given these promising results, donor kidneys can be transplanted directly without the need for biopsy when STE ≤ 11.741.

Conclusions: The assessment of kidney quality using ex vivo STE demonstrated significant predictive value for the Remuzzi score and allograft function, which could help avoid unnecessary biopsy.

Critical relevance statement: Pre-transplant kidney quality measured with ex vivo STE can be used to assess donor kidney quality and avoid unnecessary biopsy.

Key points: STE has significant value for diagnosing low Remuzzi and high Remuzzi scores. STE achieved good performance in predicting posttransplant allograft function. Assessment of kidney quality using ex vivo STE could avoid unnecessary biopsies.

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利用声触弹性成像（STE）预测移植前肾脏的同种异体功能：一项体外研究。

背景：该研究旨在利用体外声触弹性成像（STE）评估肾脏质量并预测移植后的功能：该研究旨在利用体外声触弹性成像（STE）评估肾脏质量并预测移植后的功能：在这项前瞻性研究中，从 2022 年 3 月到 2023 年 8 月，106 个供体肾脏接受了体外 STE 检查和活检。方法：这项前瞻性研究在 2022 年 3 月至 2023 年 8 月期间对 106 个供体肾脏进行了体外 STE 检查和活检，获得了浅层皮质（STEsc）、深层皮质（STEdc）和髓质（STEme）的平均硬度，并通过因子分析方法将其合成为一个指数（STE）。此外，还对 100 名受者进行了为期 6 个月的随访。采用随机森林算法探索与雷姆兹评分和异体移植功能相关的重要预测因素。使用接收者操作特征曲线下面积（AUC）对参数的性能进行评估：STE诊断低雷姆齐的AUC值为0.803，诊断高雷姆齐的AUC值为0.943。同时，STE 诊断中重度 ATI 的 AUC 值为 0.723。随机森林算法确定 STE 和 Remuzzi 评分是 6 个月肾功能的重要预测指标。STE 预测术后异体移植肾功能的 AUC 为 0.717，与 Remuzzi 评分（AUC = 0.756）相当。不过，STE 的特异性明显高于 Remuzzi（0.913 对 0.652，P 结论：STE 的特异性明显高于 Remuzzi（0.913 对 0.652，P）：使用体外 STE 评估肾脏质量对 Remuzzi 评分和同种异体移植功能具有重要的预测价值，有助于避免不必要的活检：用体内外 STE 测量移植前肾脏质量可用于评估供体肾脏质量，避免不必要的活检：STE在诊断低Remuzzi和高Remuzzi评分方面具有重要价值。STE在预测移植后同种异体功能方面表现良好。使用体外 STE 评估肾脏质量可避免不必要的活组织检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.