title: Kidney transplant: usefulness of real-time elastography (RTE) in the diagnosis of graft interstitial fibrosis.
abstract: The aim of this study is to evaluate the usefulness of real-time elastography (RTE) in the diagnosis of graft interstitial fibrosis. We prospectively enrolled 50 patients clinically suspected of graft fibrosis. RTE was performed with a broadband linear transducer using a dedicated ultrasound machine. Tissue mean elasticity (TME) was calculated by two blinded operators. All patients underwent biopsy after RTE. To determine cortical fibrosis Banff score was used. The receiver operating characteristic curves analysis was performed to evaluate the accuracy of TME to discriminate between patients with mild fibrosis (F1) versus patients with moderate to severe fibrosis (F2-F3). Inverse correlation between TME values and the degree of fibrosis has been shown (p < 0.05). Patients with F1 had mean TME values significantly higher compared with TME in patients with F2 (p = 0.005) and F3 (p = 0.004). The diagnostic accuracy of TME measurement for F2-F3 evaluated by area under the curve-receiver operating characteristic analysis was 0.95. RTE was able to evaluate kidney fibrosis in a non-invasive way and could be used as complementary imaging during follow-up of renal transplant patients.
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy; Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy. Electronic address: aorlacchio@uniroma2.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Orlacchio
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Chegai
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Del Giudice
authors.affiliation: Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Anselmo
authors.affiliation: Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iaria
authors.affiliation: Institute of Anatomic Pathology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Palmieri
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Di Caprera
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Tosti
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Costanzo
authors.affiliation: Organ Transplantation Unit, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
authors.affiliation: Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001706:Biopsy / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D016030:Kidney Transplantation; D008297:Male; D015588:Observer Variation; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: Allograft biopsy; Elasticity imaging; Graft histology; Kidney transplantation; Ultrasound imaging