ROLE OF SONOELASTOGRAPHY IN EVALUATION OF RENAL ALLOGRAFT DYSFUNCTION TAKING HISTOPATHOLOGY AS GOLD STANDARD

Ameet Kumar Jesrani, Syed Muhammad Faiq, Tahir Aziz, Muhammed Mubarak, Rehan Mohsin, Tariq Ali, Nida Amin Khan, Sanam Qadir

Abstract


Background:  Renal Transplant is a lifesaving surgery for patients with renal failure. There is myriad of complications which can result in failure of the grafted kidney. In order to avoid these, close watch is kept on patients’ general heath, blood and urine parameters. However, these complications often develop sub clinically and before any abnormality shows up in blood investigations, the damage is already done and possible irreversiblility in functional parameters. Hence, any noninvasive and practical method of keeping check on earliest changes in renal graft parenchyma will be renal graft saving and so, lifesaving.     

Objective: The objective of this study is to evaluate the diagnostic accuracy of shear wave elastography in the diagnosis of chronic allograft nephropathy taking histopathological findings as gold standard.

Methods:A total of 176 patients and control group of 176 are included in this study conducted from April 2021 to September 2021. Patients with reduced GFR and having increased creatinine levels along with already biopsy proven chronic renal allograft nephropathy were enrolled in this study. Shearwave Sonoelastography was performed and findings of Sonoelastography were correlated with biopsy and recorded on proforma.

Results:The average age of the patients was 36.23±10.09 years. The sensitivity, specificity, PPV and NPV and diagnostic accuracy of sonoelastography for detection of chronic allograft dysfunction was 90.90%, 97.27%%, 95.23% and 94.69% and diagnostic accuracy was 94.88% respectively.

Conclusion: Shearwave Sonoelastography is very useful non-invasive technique in evaluation of chronic allograft dysfunction which may alarm change in ongoing treatment and therefore invasive technique like biopsy can be avoided.

Key words:Shearwave, Sonoelastography, Chronic allograft dysfunction, Biopsy, Histopathology

 

 

ROLE OF SONOELASTOGRAPHY IN EVALUATION OF RENAL ALLOGRAFT DYSFUNCTION TAKING HISTOPATHOLOGY AS GOLD STANDARD


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References


Joosten SA, Sijpkens YW, van Kooten C, Paul LC. Chronic renal allograft rejection: pathophysiologic considerations. Kidney Int 2005; 68: 1–13.

Nankivell BJ, Borrows RJ, Fung CL, O’Connell PJ, Allen RD, Chapman JR. The natural history of chronic allograft nephropathy. N Engl J Med 2003; 349:2326–2333.

Seron D, Arns W, Chapman JR. Chronic allograft nephropathy— clinical guidance for early detection and early intervention strategies. Nephrol Dial Transplant 2008; 23:2467–2473

Lerner RM, Huang SR, Parker KJ. “Sonoelasticity” images derived from ultrasound

signals in mechanically vibrated tissues. Ultrasound Med Biol 1990;16(3):231–239.

Konofagou EE. Quo vadis elasticity imaging? Ultrasonics 2004;42(1-9):331–336.

Evans A, Whelehan P, Thomson K, et al. Invasive breast cancer: relationship between shear-wave elastographic findings and histologic prognostic factors. Radiology

;263(3):673–677.

Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology 2005;237(1):202–211.

Zhang Y, Tang J, Li YM, et al. Differentiation of prostate cancer from benign lesions using strain index of transrectal real-time tissue elastography. Eur J Radiol

;81(5):857–862.

Brum J, Balay G, Bia D, Armentano RL, et al. Feasibility of a transient elastography

technique for in vitro arterial elasticity assessment. Conf Proc IEEE Eng Med Biol

Soc 2010;2010:37–40.

Chen S, Sanchez W, Callstrom MR, et al. Assessment of liver viscoelasticity by using

shear waves induced by ultrasound radiation force. Radiology 2013;266(3):964–

Samir AE, Allegretti AS, Zhu Q, et al. Shear wave elastography in chronic kidney

disease: a pilot experience in native kidneys. BMC Nephrol 2015;16(1):119.

Peride I, Rădulescu D, Niculae A, Ene V, Bratu OG, Checheriță IA. Value of ultrasound elastography in the diagnosis of native kidney fibrosis. Med Ultrason

;18(3):362–369.

Khan H et al. Prevalence and risk factors for early chronic allograft nephropathy in a live related renal transplant programme. JNP Nephropathology 2014; 3(2): 69-79

Ghonge PN, Mohan M, Kashyap V, Jasuja S. Renal Allograft dysfunction: Evaluation with Shear-wave Sonoelastography. Radiology 2018; 00; 1-7

Nankivell BJ, Borrows RJ, Fung CL, O’Connell PJ, Allen RD, Chapman JR. The natural history of chronic allograft nephropathy. N Engl J Med 2003;349(24):2326– 2333.

Boas FE, Desser TS, Kamaya A. Does separating the resistive index into pre- and post-glomerular resistance and vascular compliance improve the diagnostic accuracy of renal transplant Doppler ultrasound? AJR Am J Roentgenol 2011;196(5 Suppl): A87.

Ozkan F, Yavuz YC, Inci MF, et al. Interobserver variability of ultrasound elastography in transplant kidneys: correlations with clinical-Doppler parameters. Ultrasound Med Biol 2013;39(1):4–9.

Gennisson JL, Grenier N, Combe C, Tanter M. Supersonic shear wave elastographyof in vivo pig kidney: influence of blood pressure, urinary pressure and tissue anisotropy. Ultrasound Med Biol 2012;38(9):1559–1567.

Arndt R, Schmidt S, Loddenkemper C, et al. Noninvasive evaluation of renal allograft fibrosis by transient elastography: a pilot study. Transpl Int 2010;23(9):871–877.

Brocchi S, Sportoletti C, Serra C, Zompatori M. Shearwave elastography in kidney transplantation: a new diagnostic tool to assess chronic allograft fibrosis. Available at https://doi.org/10.1594/ecr2014/C-1199.


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