1. Patterns of cortical oxygenation may predict the response to stenting in subjects with renal artery stenosis: A radiomics-based model.
- Author
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Ebrahimi B, Gandhi D, Alsaeedi MH, and Lerman LO
- Subjects
- Animals, Oxygen blood, Time Factors, Kidney Cortex diagnostic imaging, Kidney Cortex blood supply, Kidney Cortex physiopathology, Kidney Cortex metabolism, Furosemide administration & dosage, Angioplasty, Balloon instrumentation, Renal Artery diagnostic imaging, Renal Artery physiopathology, Female, Male, Diuretics, Image Interpretation, Computer-Assisted, Treatment Outcome, Radiomics, Renal Artery Obstruction physiopathology, Renal Artery Obstruction diagnostic imaging, Renal Artery Obstruction therapy, Stents, Predictive Value of Tests, Glomerular Filtration Rate, Disease Models, Animal, Renal Circulation, Sus scrofa, Magnetic Resonance Imaging
- Abstract
Background: Percutaneous-transluminal renal angioplasty (PTRA) and stenting aim to halt the progression of kidney disease in patients with renal artery stenosis (RAS), but its outcome is often suboptimal. We hypothesized that a model incorporating markers of renal function and oxygenation extracted using radiomics analysis of blood oxygenation-level dependent (BOLD)-MRI images may predict renal response to PTRA in swine RAS., Materials and Methods: Twenty domestic pigs with RAS were scanned with CT and BOLD MRI before and 4 weeks after PTRA. Stenotic (STK) and contralateral (CLK) kidney volume, blood flow (RBF), and glomerular filtration rate (GFR) were determined, and BOLD-MRI R2 * maps were generated before and after administration of furosemide, a tubular reabsorption inhibitor. Radiomics features were extracted from pre-PTRA BOLD maps and Robust features were determined by Intraclass correlation coefficients (ICC). Prognostic models were developed to predict post-PTRA renal function based on the baseline functional and BOLD-radiomics features, using Lasso-regression for training, and testing with resampling., Results: Twenty-six radiomics features passed the robustness test. STK oxygenation distribution pattern did not respond to furosemide, whereas in the CLK radiomics features sensitive to oxygenation heterogeneity declined. Radiomics-based model predictions of post-PTRA GFR (r = 0.58, p = 0.007) and RBF (r = 0.68; p = 0.001) correlated with actual measurements with sensitivity and specificity of 92% and 67%, respectively. Models were unsuccessful in predicting post-PTRA systemic measures of renal function., Conclusions: Several radiomics features are sensitive to cortical oxygenation patterns and permit estimation of post-PTRA renal function, thereby distinguishing subjects likely to respond to PTRA and stenting., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Lilach Lerman reports financial support was provided by the National Institutes of Health. Lilach Lerman reports a relationship with CureSpec and Ribocure-Pharmaceuticals that includes: consulting or advisory. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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