Renal Allograft Cortical Perfusion Quantification by 3D-Arterial Spin Labeling Could Be Used to Identify Subclinical Antibody-Mediated Rejection
1Nanjing Medical University, Jinling School of Medicine, Nanjing, China
2Jinling Hospital, Nanjing University School of Medicine, National Clinical Research Center of Kidney Diseases, Nanjing, China
3Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Meeting: 2018 American Transplant Congress
Abstract number: C35
Keywords: Kidney transplantation, Magnetic resonance imaging, Non-invasive diagnosis, Rejection
Session Information
Session Name: Poster Session C: Kidney Chronic Antibody Mediated Rejection
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Antibody-mediated rejection (AMR) is now the most principal post-surgical complication complicating allograft long-term survival. Therefore, its early detection before serum creatinine rises/estimated glomerular filtration rate decrease serves to timely management and thus improved outcome. 3D-arterial spin labeling(3D-ASL) is a functional magnetic resonance imaging modality that could noninvasively quantify renal allograft cortical perfusion(RACP).
Methods; A total of 109 kidney transplant recipients scheduled for allograft biopsy were prospectively enrolled to undergo magnetic resonance 3D-ASL in a 3.0 Tesla clinical imager. 3D-ASL parameter were measured manually using Functool software package by a nephrologist without knowledge of biopsy results. Allograft biopsy were interpreted according to 2015 Banff schema by an experienced pathologist blinded to MR results.
Results: Data from 6 patients with de novo DSA but noraml biopsy findings(Group A), 8 patients with biopsy-proven subclinical AMR (Group B) and 17 patients with biopsy-proven clinically conspicuous AMR (Group B) were analyzed and compared. Another group comprising 9 patients with biopsy-proven normal allograft served as control group (Group D). RACP as quantified by 3D-ASL was statistically not different between Group D and Group A (238.22ml/100g/min VS 211.30 ml/100g/min,P=0.225) . Combining Group D and Group A as new normal control group (Group E), we observed that decreased RACP in subclinical AMR and more prominently decreased RACP in clinically conspicuous AMR when compared to Group E (114.46 ml/100g/min in subclinical AMR VS 89.74 ml/100g/min in clinically conspicuous AMR VS 227.45 ml/100g/min in Group E, P=0.000) . Using 161.7 ml/100g/min as cutoff criterion, the diagnostic performance for differentiating subclinical AMR from normal allograft is excellent: sensitivity 100% and specificity 100% . Using this cutoff criterion, the diagnostic performance for differentiating AMR from normal allograft is also excellent: sensitivity 92.0% and specificity 100% .
Conclusion: Functional magnetic resonance imaging of 3D-ASL may be used to used as noninvasive method to detect subclinical AMR.
CITATION INFORMATION: Wang W., Wen J., Xu F., Yu Y., Zhang L., Liu Z. Renal Allograft Cortical Perfusion Quantification by 3D-Arterial Spin Labeling Could Be Used to Identify Subclinical Antibody-Mediated Rejection Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Wang W, Wen J, Xu F, Yu Y, Zhang L, Liu Z. Renal Allograft Cortical Perfusion Quantification by 3D-Arterial Spin Labeling Could Be Used to Identify Subclinical Antibody-Mediated Rejection [abstract]. https://atcmeetingabstracts.com/abstract/renal-allograft-cortical-perfusion-quantification-by-3d-arterial-spin-labeling-could-be-used-to-identify-subclinical-antibody-mediated-rejection/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress