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Use of intravoxel incoherent motion diffusion-weighted imaging to detect early changes in diabetic kidneys

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Abstract

Objective

The purpose of the study was to examine differences in kidney intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in early-stage diabetic patients versus healthy controls.

Materials and methods

Nineteen type 2 diabetic patients (group A) with a urinary albumin-to-creatinine ratio (ACR) < 30 mg/g and an estimated glomerular filtration rate (eGFR) of 80–120 mL/(min 1.73 m2) and twelve healthy volunteers (group B) were recruited. Kidneys were scanned with 1.5-Tesla IVIM-DWI. Nine b values (0, 50, 100, 150, 200, 300, 400, 600, and 800 s/mm2) were used. The parameters derived from IVIM-DWI were calculated for each kidney by two radiologists and included the perfusion fraction (f), diffusion coefficient (D), and pseudo-diffusion coefficient (D*). The mean values of f, D, and D* were calculated by selecting multiple regions of interest in the kidney. The diagnostic performance of the f, D, and D* values for the diagnosis of early diabetic kidney changes was determined by receiver operating characteristic analysis. Three radiologists independently measured the parameters derived from IVIM-DWI in the two groups by free-hand placing regions of interest, and the interclass coefficients (ICCs) were analyzed by SPSS.16.0 software.

Results

The f values of the kidneys were significantly higher in diabetic patients than in healthy volunteers. The D value of the kidneys was significantly lower in diabetic patients than in healthy volunteers. No significant differences in the D* values of the kidneys were observed between diabetic patients and healthy volunteers. The D values of the right kidneys were significantly higher than those of the left kidneys in both groups. The results of the receiver operating characteristic analysis were as follows: left kidney—f value AUC = 0.650 (cutoff point ≥ 27.49%) and D value AUC = 0.752 (cutoff point ≤ 1.68 × 10−3 mm2/s); and right kidney—f value AUC = 0.650 (cutoff point ≥ 28.24%) and D value AUC = 0.752 (cutoff point ≤ 1.81 × 10−3 mm2/s). The diagnostic performance of the D* value was very low (AUC < 0.6). No significant differences were present between the areas under the curves of the f and D values (P > 0.05). The ICCs of the f value and D value were between 0.637 and 0.827. The ICC of the D* value was less than 0.3.

Conclusion

The results of our study suggest that changes in kidneys detected by IVIM-DWI may serve as indicators of early diabetic kidney disease.

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Authors and Affiliations

  1. The First Affiliated Hospital, Jinan University, Guangzhou, 510632, People’s Republic of China

    Yi Deng

  2. Department of Medical imaging, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, People’s Republic of China

    Yi Deng, Biran Yang, Yan Peng, Zhiqiang Liu, Jinwen Luo & Guoxin Du

Authors
  1. Yi Deng
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  2. Biran Yang
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  3. Yan Peng
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  4. Zhiqiang Liu
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  5. Jinwen Luo
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  6. Guoxin Du
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Correspondence to Yi Deng.

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No funding was received for this study.

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All authors declare that they have no conflicts of interest.

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Informed consent was obtained from all participants included in the study.

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Deng, Y., Yang, B., Peng, Y. et al. Use of intravoxel incoherent motion diffusion-weighted imaging to detect early changes in diabetic kidneys. Abdom Radiol 43, 2728–2733 (2018). https://doi.org/10.1007/s00261-018-1521-4

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  • DOI: https://doi.org/10.1007/s00261-018-1521-4

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