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
{"title":"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。","authors":"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","doi":"10.1186/s13244-024-01837-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of the study was to evaluate renal quality and predict posttransplant graft function using ex vivo sound touch elastography (STE).</p><p><strong>Methods: </strong>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<sub>sc</sub>), deep cortex (STE<sub>dc</sub>), and medulla (STE<sub>me</sub>) 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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Critical relevance statement: </strong>Pre-transplant kidney quality measured with ex vivo STE can be used to assess donor kidney quality and avoid unnecessary biopsy.</p><p><strong>Key points: </strong>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.</p>","PeriodicalId":13639,"journal":{"name":"Insights into Imaging","volume":"15 1","pages":"245"},"PeriodicalIF":4.1000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469982/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prediction of allograft function in pre-transplant kidneys using sound touch elastography (STE): an ex vivo study.\",\"authors\":\"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\",\"doi\":\"10.1186/s13244-024-01837-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of the study was to evaluate renal quality and predict posttransplant graft function using ex vivo sound touch elastography (STE).</p><p><strong>Methods: </strong>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<sub>sc</sub>), deep cortex (STE<sub>dc</sub>), and medulla (STE<sub>me</sub>) 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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Critical relevance statement: </strong>Pre-transplant kidney quality measured with ex vivo STE can be used to assess donor kidney quality and avoid unnecessary biopsy.</p><p><strong>Key points: </strong>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.</p>\",\"PeriodicalId\":13639,\"journal\":{\"name\":\"Insights into Imaging\",\"volume\":\"15 1\",\"pages\":\"245\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469982/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Insights into Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13244-024-01837-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Insights into Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13244-024-01837-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Prediction of allograft function in pre-transplant kidneys using sound touch elastography (STE): an ex vivo study.
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 (STEsc), deep cortex (STEdc), and medulla (STEme) 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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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.
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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.
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The journal went open access in 2012, which means that all articles published since then are freely available online.
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