Magnetic Resonance Kidney Parenchyma-T2 as a Novel Imaging Biomarker for Autosomal Dominant Polycystic Kidney Disease. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Siedek, Florian; Grundmann, Franziska; Weiss, Kilian; Pinto dos Santos, Daniel; Arjune, Sita; Haneder, Stefan; Persigehl, Thorsten; Müller, Roman-Ulrich; Baessler, Bettina
• Is Part Of: Investigative radiology. Volume 55:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: ADPKD -- chronic kidney disease -- polycystic kidney disease -- T2 mapping -- total kidney volume -- MRI; Diagnosis, Radioscopic -- Periodicals; Radiology, Medical -- Periodicals; 616.0757
• DOI: 10.1097/RLI.0000000000000633
• Languages: English
• ISSNs: 0020-9996

Abstract

Abstract : Objective: 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. Abstract : Supplemental digital content is available in the text.