Intravoxel incoherent motion analysis of renal allograft diffusion with clinical and histopathological correlation in pediatric kidney transplant patients: A preliminary cross‐sectional observational study

• Published in: Pediatric transplantation Vol. 21; no. 6
• Main Authors: Poynton, Clare B., Lee, Marsha M., Li, Yi, Laszik, Zoltan, Worters, Pauline W., Mackenzie, John D., Courtier, Jesse
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.09.2017
• Subjects: Adolescent; Biopsy; Child; Cross-Sectional Studies; Diffusion Magnetic Resonance Imaging; Female; Graft Rejection - diagnostic imaging; Graft Rejection - pathology; Health risk assessment; Humans; IVIM; Kidney - diagnostic imaging; Kidney - pathology; kidney IVIM; kidney MRI; kidney transplant MRI; Kidney Transplantation; Kidney transplants; Male; Observational studies; Pediatrics; Prospective Studies; renal intravoxel incoherent motion; renal IVIM; renal MRI; Transplants & implants; Young Adult; kidney IVIM; IVIM; kidney transplant MRI; kidney MRI; renal IVIM; renal intravoxel incoherent motion; renal MRI
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/petr.12996

The purpose of this study was to compare IVIM values in pediatric renal transplants with histopathology and clinical management change. Fifteen pediatric renal transplant recipients (mean 15.7±2.9 years) were prospectively scanned on a 3T MR scanner with multi‐b DTI, prior to same‐day transplant biopsy. IVIM maps from 14 subjects were analyzed (one excluded due to motion). Mean values were computed from cortical ROIs and medullary ROIs corresponding to the biopsy site. Subjects were also grouped according to whether or not the biopsy resulted in a change in clinical management. Cortico‐medullary IVIM estimates and histopathologic Banff scores were correlated with KT. Cortico‐medullary IVIM differences between the “change” and “no change” groups was compared with Mann‐Whitney U test. Cortical Dp showed significant moderate negative correlation with Banff t and ci scores (KT=−0.497, P=.035 and KT=−0.46, P=.046) and moderate positive correlation with Banff i score (KT=0.527, P=.028). Cortical Pf showed significant moderate correlation with ci and ct scores (KT=0.489, P=.035 and KT=0.457, P=.043). Tissue diffusivity, Dt, estimated with IVIM was significantly different between the “change” and “no change” groups in medullary ROIs (U=6, P=.021). IVIM analysis has potential as a noninvasive biomarker in assessment of pediatric renal allograft pathology.