Reliable volume measurements in ADPKD patients: a study of MRI sequences
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BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is characterized by gradual kidney enlargement and cyst growth prior to loss of kidney function. The Consortium for Radiologic Imaging Studies in Polycystic Kidney Disease (CRISP) created a standard magnetic resonance imaging (MRI) protocol to be used for ADPKD patients to determine if changes in total kidney volumes can be detected over a short period of time, and if they correlate with decline in renal function early in the disease course. CRISP guided researchers and physicians to use a T1-weighted sequence with gadolinium contrast to measure kidney volumes. After the Food and Drug Administration discouraged the use of gadolinium contrast in individuals with kidney diseases, total kidney volume measured by MRI for ADPKD patients was done using the T1-weighted pulse sequence without contrast enhancement. STUDY OBJECTIVE: The retrospective cohort study will aim to assess reliability of the T2 sequence and total kidney volume measurements compared to total kidney volume measurements performed on a T1 sequence. METHODS: The study collected intra-reader and inter-reader cases from four imaging studies, each with an abdominal MRI performed. Repeated volume measurements were performed within an individual reader (intra-reader) and between different readers (inter-readers). The stereology method was used to quantify kidney volume from T1 images for three studies and T2 images for one study. Mean and standard deviation were used to analyze volume differences between repeated measurements for intra-reader and inter-reader data for each MRI sequence. The intra-class correlation coefficient and Bland-Altman plot were used to describe correlation between kidney volumes, for intra-reader and inter-reader data respectively. RESULTS: Analyses show a significant difference in the repeated volume measurements from the T1 sequence in inter-reader data. Reliability for the T2 and T1 sequence was represented by high correlations in both the intra-reader and inter-reader total kidney volumes. CONCLUSION: MR measures of total kidney volume are reliable in patients when measured on both the T1 sequence and the T2 sequence. ADPKD kidney volumes for future clinical trials can be reliably measured on either sequence.
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