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| Item Type: | Article |
|---|---|
| Title: | Detecting early kidney allograft fibrosis with multi-b-value spectral diffusion MRI |
| Creators Name: | Liu, Mira M., Dyke, Jonathan, Gladytz, Thomas, Jasse, Jonas, Bolger, Ian, Calle, Sergio, Pavuluri, Swathi, Crews, Tanner, Kimm-Drapeau, Ananda L., Seshan, Surya, Salvatore, Steven, Stillman, Isaac, Muthukumar, Thangamani, Taouli, Bachir, Farouk, Samira, Bane, Octavia and Lewis, Sara |
| Abstract: | Kidney allograft fibrosis is a manifestation of chronic kidney disease (CKD) and predicts functional decline, and eventual allograft failure. This study evaluates whether spectral diffusion magnetic resonance imaging (MRI) detects early development and mild/moderate fibrosis in kidney allografts. In a prospective two-center study of kidney allografts, pathologic interstitial fibrosis and tubular atrophy (IFTA) was scored and eGFR was calculated from serum creatinine. Multi-b-value diffusion-weighted imaging (DWI) (bvalues=[0, 10, 30, 50, 80, 120, 200, 400, 800mm(2)/s]) was post-processed with spectral diffusion, intravoxel incoherent motion (IVIM), and apparent diffusion coefficient (ADC). Relationships between imaging parameters and biological processes were measured by Mann-Whitney U-test and Spearman’s rank; diagnostic ability was measured by five-fold cross-validation univariate and multi-variate logistic regression. Quality control analyses included volunteer MRI (n=4) and interobserver analysis (n=19). 99 patients were included (50±13yrs, 64 M/35F, 39 IFTA=0, 22 IFTA=2, 20 IFTA=4, 18 IFTA=6, 46 eGFR≤45mL/min/1.73m(2), mean eGFR=47.5±21.3mL/min/1.73m(2)). Spectral diffusion detected fibrosis (IFTA > 0) in patients with normal/stable eGFR > 45ml/min/1.73m(2) [AUC (95% CI)=0.72 (0.56, 0.87), p=0.007]. Spectral diffusion detected mild/ moderate fibrosis (IFTA=2–4) [AUC (95% CI)=0.65 (0.52, 0.71), p=0.023], as did ADC [AUC (95% CI)=0.71 (0.54, 0.87), p=0.013]. eGFR, time-from-transplant, and allograft size could not. Interobserver correlation was ≥0.50 in 24/40 diffusion parameters. Spectral diffusion MRI showed detection of mild/moderate fibrosis and fibrosis before decline in function. It is a promising method to detect early development of fibrosis and CKD before progression. |
| Keywords: | MRI, Diffusion, Kidney, Kidney Disease, Allografts, Fibrosis |
| Source: | Scientific Reports |
| ISSN: | 2045-2322 |
| Publisher: | Springer Nature |
| Volume: | 15 |
| Number: | 1 |
| Page Range: | 40959 |
| Date: | 20 November 2025 |
| Official Publication: | https://doi.org/10.1038/s41598-025-24701-5 |
| PubMed: | View item in PubMed |
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