In:
Investigative Radiology, Ovid Technologies (Wolters Kluwer Health), Vol. 55, No. 4 ( 2020-4), p. 217-225
Abstract:
Autosomal dominant polycystic kidney disease (ADPKD) is a chronic progressive disorder with a significant disease burden leading to end-stage renal disease in more than 75% of the affected individuals. Although prediction of disease progression is highly important, all currently available biomarkers—including height-adjusted total kidney volume (htTKV)—have important drawbacks in the everyday clinical setting. Thus, the purpose of this study was to evaluate T2 mapping as a source of easily obtainable and accurate biomarkers, which are needed for improved patient counseling and selection of targeted treatment options. Materials and Methods A total of 139 ADPKD patients from The German ADPKD Tolvaptan Treatment Registry and 10 healthy controls underwent magnetic resonance imaging on a clinical 1.5-T system including acquisition of a Gradient-Echo-Spin-Echo T2 mapping sequence. The ADPKD patients were divided into 3 groups according to kidney cyst fraction (0%–35%, 36%–70%, 〉 70%) as a surrogate marker for disease severity. The htTKV was calculated based on standard T2-weighted imaging. Mean T2 relaxation times of both kidneys (kidney-T2) as well as T2 relaxation times of the residual kidney parenchyma (parenchyma-T2) were measured on the T2 maps. Results Calculation of parenchyma-T2 was 6- to 10-fold faster than determination of htTKV and kidney-T2 (0.78 ± 0.14 vs 4.78 ± 1.17 minutes, P 〈 0.001; 0.78 ± 0.14 vs 7.59 ± 1.57 minutes, P 〈 0.001). Parenchyma-T2 showed a similarly strong correlation to cyst fraction ( r = 0.77, P 〈 0.001) as kidney-T2 ( r = 0.76, P 〈 0.001), the strongest correlation to the serum-derived biomarker copeptin ( r = 0.37, P 〈 0.001), and allowed for the most distinct separation of patient groups divided according to cyst fraction. In contrast, htTKV showed an only moderate correlation to cyst fraction ( r = 0.48, P 〈 0.001). These observations were even more evident when considering only patients with preserved kidney function. Conclusions The rapidly assessable parenchyma-T2 shows a strong association with disease severity early in disease and is superior to htTKV when it comes to correlation with renal cyst fraction.
Type of Medium:
Online Resource
ISSN:
1536-0210
,
0020-9996
DOI:
10.1097/RLI.0000000000000633
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2041543-6
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