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Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease

  • Ultrasound
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Abstract

Objectives

Chronic kidney disease (CKD), a progressive and irreversible pathological syndrome, is the major cause of renal failure. Renal fibrosis is the principal process underlying the progression of CKD. Acoustic radiation force impulse (ARFI) quantification is a promising noninvasive method for assessing tissue stiffness. We evaluated whether the technique could reveal renal tissue fibrosis in CKD patients.

Methods

ARFI assessments were performed in 45 patients with CKD referred for renal biopsies to measure cortical shear wave velocity (SWV). During measurement, a standardized method was employed, which aimed to minimize the potential impact of variation of transducer force, sampling error of non-cortical tissue and structural anisotropy of the kidney. Then SWV was compared to patients’ CKD stage and pathological fibrosis indicators.

Results

ARFI could not predict the different stages of CKD. Spearman correlation analysis showed that SWV did not correlate with any pathological indicators of fibrosis.

Conclusion

ARFI assesses tissue stiffness of CKD kidneys by measuring cortical SWV. However, SWV did not show significant correlations with CKD stage and fibrosis indicators despite using standardized measurement methods. We therefore suggest that it would be necessary to evaluate the effect of pathological complexity and tissue perfusion of the kidney on stiffness assessment in future studies.

Key points

Acoustic radiation force impulse (ARFI) can quantify tissue elasticity of CKD kidney.

Despite standardized measurement, ARFI-estimated elasticity did not correlate with renal fibrosis.

Effects of pathological complexity and tissue perfusion on renal stiffness warrant further study.

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Acknowledgements

The scientific guarantor of this publication is Ke Lv, the lead author of this article. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by Key Project of Chinese National Program for Fundamental Research and Development (973 Program 2012CB517803 to C.L.), National Natural Scientific Foundation, China (81170674 to C.L). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported.

Methodology: prospective, diagnostic, performed at one institution.

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Correspondence to Ke Lv.

Additional information

Liang Wang and Peng Xia contributed equally to this study.

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Wang, L., Xia, P., Lv, K. et al. Assessment of renal tissue elasticity by acoustic radiation force impulse quantification with histopathological correlation: preliminary experience in chronic kidney disease. Eur Radiol 24, 1694–1699 (2014). https://doi.org/10.1007/s00330-014-3162-5

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  • DOI: https://doi.org/10.1007/s00330-014-3162-5

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