MP30-06 DYNAMIC CONTRAST-ENHANCED ULTRASOUND CAN DIAGNOSE KIDNEY OBSTRUCTION

Abstract

You have accessJournal of UrologyImaging/Uroradiology II (MP30)1 May 2024MP30-06 DYNAMIC CONTRAST-ENHANCED ULTRASOUND CAN DIAGNOSE KIDNEY OBSTRUCTION Kourosh Kalayeh, Sapan N. Ambani, J. Brian Fowlkes, Man Zhang, William W. Schultz, and Bryan S. Sack Kourosh KalayehKourosh Kalayeh , Sapan N. AmbaniSapan N. Ambani , J. Brian FowlkesJ. Brian Fowlkes , Man ZhangMan Zhang , William W. SchultzWilliam W. Schultz , and Bryan S. SackBryan S. Sack View All Author Informationhttps://doi.org/10.1097/01.JU.0001009416.90901.7b.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current imaging techniques, such as nuclear medicine (NM) scans, fail to confidently determine kidney obstruction. We hypothesize that dynamic contrast-enhanced ultrasound (DCEUS) has the ability to identify differences between normal and obstructed kidneys. METHODS: Adult human subjects were eligible for inclusion in an IRB approved protocol if they were diagnosed with a ureteropelvic junction obstruction based on symptoms, anatomic and functional imaging, had a normal contralateral kidney, and elected to undergo pyeloplasty. Five subjects with median age of 48 years (25–73) were enrolled. Four had left and one had right obstructions. The NM diuretic t1/2 for obstructed and normal contralateral kidneys were 1000, 30, 41, 100 and 28 min and 7, 7, 3, 5 and 8 min, respectively, with corresponding split differential function of the obstructed kidneys of 33, 19, 45, 45 and 54%. Clinical GE LOGIQ® E9 and E10 ultrasound scanners, equipped with C1-6 probes, were used for DCEUS imaging of the kidneys. DEFINITY® ultrasound contrast microbubbles were administered intravenously at a dose of 0.3 mL per kidney (within the FDA guidelines). Each bolus injection was followed by a 10 mL saline flush. RESULTS: Example time-intensity curves for a normal kidney and its contralateral obstructed counterpart are shown in panels (a) and (b) of the Figure 1, respectively. Among the time-related variables extracted from DCEUS — specifically, time to peak, full width at half maximum, and mean transient time (MTT) — MTT exhibited the largest statistical significance between normal and obstructed kidneys. The bar graph comparing MTT for normal and obstructed kidneys from n=5 subjects is shown in panel (c) of the Figure 1. The MTT between normal (mean±standard error: 18.6±3.6 s) and obstructed kidney (45.0±10.2 s) was statistically significantly different (p=0.04). CONCLUSIONS: These preliminary results suggest that MTT of DCEUS offers a viable alternative to existing diagnostic methods for identifying kidney obstruction. As a next step, by expanding the sample size, we will increase the statistical power and confidence in our findings and allow for a formal comparison to nuclear medicine drainage times. Download PPT Source of Funding: Department of Urology, University of Michigan © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e492 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kourosh Kalayeh More articles by this author Sapan N. Ambani More articles by this author J. Brian Fowlkes More articles by this author Man Zhang More articles by this author William W. Schultz More articles by this author Bryan S. Sack More articles by this author Expand All Advertisement PDF downloadLoading ...