Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis
Introduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Superso...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-01-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/11/2/365 |
| _version_ | 1827758496404209664 |
|---|---|
| author | Felix-Mihai Maralescu Adrian Vaduva Adalbert Schiller Ligia Petrica Ioan Sporea Alina Popescu Roxana Sirli Alis Dema Madalina Bodea Iulia Grosu Flaviu Bob |
| author_facet | Felix-Mihai Maralescu Adrian Vaduva Adalbert Schiller Ligia Petrica Ioan Sporea Alina Popescu Roxana Sirli Alis Dema Madalina Bodea Iulia Grosu Flaviu Bob |
| author_sort | Felix-Mihai Maralescu |
| collection | DOAJ |
| description | Introduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue’s stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Materials and methods: Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. Results: In total, 26 men and 14 women with a mean age of 52.35 ± 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 ± 35.49 mL/min/1.73m<sup>2</sup>, and a mean proteinuria of 6.39 ± 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of <20.77 kPa with the area under the curve (AUC) of 0.860, a <i>p</i> < 0.001 with 88.89% sensitivity, and a 75% specificity for the 2D SWE PLUS measures and a cut-off value of <2.8 Pa.s with an AUC of 0.792, a <i>p</i> < 0.001 with 94% sensitivity, and a 60% specificity for the Vi PLUS measures. We also found a cut-off value of <19.75 kPa for the 2D SWE PLUS measures (with an AUC of 0.789, <i>p</i> = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of <1.28 Pa.s for the Vi PLUS measures (with an AUC 0.829, <i>p</i> = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (<i>r</i> = 0.7065, <i>p</i> < 0.0001) and Vi PLUS values (<i>r</i> = 0.3637, <i>p</i> < 0.0211). C reactive protein (CRP) correlates with the Vi PLUS measures (r = −0.3695, <i>p</i> = 0.0189) but not with the 2D SWE PLUS measures (<i>r</i> = −0.2431, <i>p</i> = 0.1306). Conclusion: Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice. |
| first_indexed | 2024-03-11T09:07:11Z |
| format | Article |
| id | doaj.art-a28e5c1b03bd469ea2652b9d121d2eb4 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T09:07:11Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-a28e5c1b03bd469ea2652b9d121d2eb42023-11-16T19:17:08ZengMDPI AGBiomedicines2227-90592023-01-0111236510.3390/biomedicines11020365Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic GlomerulonephritisFelix-Mihai Maralescu0Adrian Vaduva1Adalbert Schiller2Ligia Petrica3Ioan Sporea4Alina Popescu5Roxana Sirli6Alis Dema7Madalina Bodea8Iulia Grosu9Flaviu Bob10Division of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaCounty Emergency Hospital, L. Rebreanu Street, Nr. 156, 300723 Timisoara, RomaniaDivision of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDivision of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaCounty Emergency Hospital, L. Rebreanu Street, Nr. 156, 300723 Timisoara, RomaniaCounty Emergency Hospital, L. Rebreanu Street, Nr. 156, 300723 Timisoara, RomaniaCounty Emergency Hospital, L. Rebreanu Street, Nr. 156, 300723 Timisoara, RomaniaCounty Emergency Hospital, L. Rebreanu Street, Nr. 156, 300723 Timisoara, RomaniaDivision of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDivision of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDivision of Nephrology, Department of Internal Medicine II, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, RomaniaIntroduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue’s stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Materials and methods: Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. Results: In total, 26 men and 14 women with a mean age of 52.35 ± 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 ± 35.49 mL/min/1.73m<sup>2</sup>, and a mean proteinuria of 6.39 ± 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of <20.77 kPa with the area under the curve (AUC) of 0.860, a <i>p</i> < 0.001 with 88.89% sensitivity, and a 75% specificity for the 2D SWE PLUS measures and a cut-off value of <2.8 Pa.s with an AUC of 0.792, a <i>p</i> < 0.001 with 94% sensitivity, and a 60% specificity for the Vi PLUS measures. We also found a cut-off value of <19.75 kPa for the 2D SWE PLUS measures (with an AUC of 0.789, <i>p</i> = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of <1.28 Pa.s for the Vi PLUS measures (with an AUC 0.829, <i>p</i> = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (<i>r</i> = 0.7065, <i>p</i> < 0.0001) and Vi PLUS values (<i>r</i> = 0.3637, <i>p</i> < 0.0211). C reactive protein (CRP) correlates with the Vi PLUS measures (r = −0.3695, <i>p</i> = 0.0189) but not with the 2D SWE PLUS measures (<i>r</i> = −0.2431, <i>p</i> = 0.1306). Conclusion: Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice.https://www.mdpi.com/2227-9059/11/2/365renal biopsyfibrosisinflammationstiffnessviscosity |
| spellingShingle | Felix-Mihai Maralescu Adrian Vaduva Adalbert Schiller Ligia Petrica Ioan Sporea Alina Popescu Roxana Sirli Alis Dema Madalina Bodea Iulia Grosu Flaviu Bob Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis Biomedicines renal biopsy fibrosis inflammation stiffness viscosity |
| title | Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis |
| title_full | Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis |
| title_fullStr | Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis |
| title_full_unstemmed | Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis |
| title_short | Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis |
| title_sort | relationship between novel elastography techniques and renal fibrosis preliminary experience in patients with chronic glomerulonephritis |
| topic | renal biopsy fibrosis inflammation stiffness viscosity |
| url | https://www.mdpi.com/2227-9059/11/2/365 |
| work_keys_str_mv | AT felixmihaimaralescu relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT adrianvaduva relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT adalbertschiller relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT ligiapetrica relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT ioansporea relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT alinapopescu relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT roxanasirli relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT alisdema relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT madalinabodea relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT iuliagrosu relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis AT flaviubob relationshipbetweennovelelastographytechniquesandrenalfibrosispreliminaryexperienceinpatientswithchronicglomerulonephritis |