Evaluation of renal function in chronic kidney disease (CKD) by mDIXON-Quant and Amide Proton Transfer weighted (APTw) imaging

Y Ju; Y Wang; R N Luo; N Wang; J Z Wang; L J Lin; Q W Song; A L Liu

doi:10.1016/j.mri.2023.07.005

Evaluation of renal function in chronic kidney disease (CKD) by mDIXON-Quant and Amide Proton Transfer weighted (APTw) imaging

Magn Reson Imaging. 2023 Nov:103:102-108. doi: 10.1016/j.mri.2023.07.005. Epub 2023 Jul 13.

Authors

Y Ju¹, Y Wang¹, R N Luo², N Wang¹, J Z Wang³, L J Lin³, Q W Song¹, A L Liu⁴

Affiliations

¹ Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, PR China.
² Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, PR China; Department of Nephrology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, PR China.
³ Clinical & Technical Support, Philips Healthcare, 100016 Beijing, PR China.
⁴ Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, PR China; Dalian Medical Imaging Artificial Intelligence Engineering Technology Research Center, Dalian 116011, Liaoning, PR China. Electronic address: liuailian@dmu.edu.cn.

PMID: 37451519
DOI: 10.1016/j.mri.2023.07.005

Abstract

Background: Chronic kidney disease (CKD) is a long-term condition that affects >10% of the adult population worldwide. Noninvasive assessment of renal function has important clinical significance for disease diagnosis and prognosis evaluation.

Objective: To explore the value of mDIXON-Quant combined with amide proton transfer weighted (APTw) imaging for accessing renal function in chronic kidney disease (CKD).

Materials and methods: Twenty-two healthy volunteers (HVs) and 30 CKD patients were included in this study, and the CKD patients were divided into the mild CKD (mCKD) group (14 cases) and moderate-to-severe CKD (msCKD) group (16 cases) according to glomerular filtration rate (eGFR). The cortex APT (cAPT), medulla APT (mAPT), cortex R2^⁎ (cR2^⁎), medulla R2^⁎ (mR2^⁎), cortex FF (cFF) and medulla FF (mFF) values of the right renal were independently measured by two radiologists. Intra-group correlation coefficient (ICC) test was used to test the inter-observer consistency. The analysis of variance (ANOVA) was used to compare the difference among three groups. Mann-Whitney U test was used to analyze the differences of R2^⁎, FF and APT values among the patient and HV groups. Area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the diagnostic efficiency. The corresponding threshold, sensitivity, and specificity were obtained according to the maximum approximate index. The combined diagnostic efficacy of R2^⁎, FF, and APT values was analyzed by binary Logistic regression, and the AUC of combined diagnosis was compared with the AUC of the single parameter by the Delong test.

Results: The cAPT value of the HV, mCKD and msCKD groups increased gradually. The mAPT value and cR2^⁎ values of the mCKD and msCKD groups were higher than those of the HV group, while the mFF value of the mCKD group was lower than HV group (all P < 0.05). The cAPT and mAPT values showed good diagnostic efficacy in evaluating different degrees of renal damage, while cR2^⁎ and mFF values showed moderate diagnostic efficacy. When combining the APT, R2^⁎, and FF values, the diagnostic efficiency was significantly improved.

Conclusion: mDIXON-Quant combined APTw imaging can be used for improved diagnosis of CKD.

Keywords: Amide proton transfer weighted; Chronic kidney disease; MRI; mDIXON-Quant.

MeSH terms

Adult
Amides
Humans
Kidney / diagnostic imaging
Kidney / physiology
Magnetic Resonance Imaging / methods
Protons*
Renal Insufficiency, Chronic* / diagnostic imaging

Substances

Protons
Amides