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Abstract #1020

Spectral diffusion MRI detects early fibrosis in renal allografts in a pilot clinical translational study

Mira Liu1, Jonathan Dyke2, Thomas Gladytz3, Jonas Jasse4, Ian Bolger1, Sergio Calle1, Swathi Pavuluri5, Tanner Crews2, Surya Seshan6, Steven Salvatore6, Isaac Stillman7, Thangamani Muthukumar8, Bachir Taouli1,9, Samira Farouk10, Octavia Bane1,9, and Sara Lewis1
1Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 2Weill Cornell Medicine, New York, NY, United States, 3Max-Delbrück-Centrum für Molekulare Medizin, Berlin, Germany, 4Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany, 5Radiology, Icahn School of Medicine at Mount Sinai, NYC, NY, United States, 6Pathology, Weill Cornell Medicine, New York, NY, United States, 7Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 8Nephrology and Kidney Transplantation Medicine, Weill Cornell Medicine, New York, NY, United States, 9BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, 10Transplant Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Synopsis

Keywords: Kidney, IVIM

Motivation: The current reference standard of kidney allograft fibrosis is histopathology, which requires invasive biopsy, and fibrosis can develop silently as time for intervention is lost and irreversible kidney damage occurs.

Goal(s): We evaluate non-contrast spectral diffusion, IVIM, and ADC, MRI for diagnosis and quantification of early fibrosis and function in kidney allografts.

Approach: A prospective two-center study of kidney transplant recipients with either percutaneous clinically indicated biopsies or percutaneous protocol biopsies due to the presence of donor specific antibodies.

Results: Spectral diffusion detected mild/moderate fibrosis, and detected fibrosis in allografts presenting with normal/stable function that ADC, eGFR, time-from-transplant, and allograft size did not.

Impact: Initial experience supports clinical relevance of advanced diffusion MRI for early fibrosis development in renal transplant patients who have not shown a decrease in eGFR, allowing preventative modification in medication regimen and treatment.

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Keywords