One-stop early noninvasive evaluation of renal allograft rejection and fibrosis: microstructural mapping via time-dependent diffusion MRI.
Liao, Z., et al.E Bio Medicine. 2025 Dec;122:106034
Aims
The aim of this study was to examine whether time-dependent diffusion (td-dMRI) is able to accurately diagnose renal allograft rejection and fibrosis.
Interventions
This was a prospective observational study which compared td-dMRI with six other conventional diffusion MRI models.
Participants
100 renal allograft patients.
Outcomes
The main outcomes of interest were fibrosis and graft rejection.
Follow-up
N/A
CET Conclusions
This interesting prospective observational study from China recruited 100 kidney transplant recipients undergoing for-cause biopsy and undertook functional time-dependent diffusion MRI (td-dMRI) at the time of biopsy. The authors demonstrate that Td-dMRI-derived parameters are able to distinguish both grade of fibrosis as well as presence or absence of acute rejection with high overall accuracy. Addition of MRI-derived parameters outperform a baseline clinical model depending on serum creatinine, proteinuria and mean arterial pressure. AUC for the combined model for differentiating acute rejection was 0.931. These results suggest that a combination of traditional clinical biomarkers and functional MRI may provide a sensitive alternative to invasive biopsy for the detection of acute and chronic rejection in kidney transplant recipients. Future studies will need to assess generalisability and clinical utility in a prospective, multicentre setting.
Trial registration
N/A