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2017 ; 12
(5
): e0178488
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Kidney volume measurement methods for clinical studies on autosomal dominant
polycystic kidney disease
#MMPMID28558028
Sharma K
; Caroli A
; Quach LV
; Petzold K
; Bozzetto M
; Serra AL
; Remuzzi G
; Remuzzi A
PLoS One
2017[]; 12
(5
): e0178488
PMID28558028
show ga
BACKGROUND: In autosomal dominant polycystic kidney disease (ADPKD), total kidney
volume (TKV) is regarded as an important biomarker of disease progression and
different methods are available to assess kidney volume. The purpose of this
study was to identify the most efficient kidney volume computation method to be
used in clinical studies evaluating the effectiveness of treatments on ADPKD
progression. METHODS AND FINDINGS: We measured single kidney volume (SKV) on two
series of MR and CT images from clinical studies on ADPKD (experimental dataset)
by two independent operators (expert and beginner), twice, using all of the
available methods: polyline manual tracing (reference method), free-hand manual
tracing, semi-automatic tracing, Stereology, Mid-slice and Ellipsoid method.
Additionally, the expert operator also measured the kidney length. We compared
different methods for reproducibility, accuracy, precision, and time required. In
addition, we performed a validation study to evaluate the sensitivity of these
methods to detect the between-treatment group difference in TKV change over one
year, using MR images from a previous clinical study. Reproducibility was higher
on CT than MR for all methods, being highest for manual and semiautomatic
contouring methods (planimetry). On MR, planimetry showed highest accuracy and
precision, while on CT accuracy and precision of both planimetry and Stereology
methods were comparable. Mid-slice and Ellipsoid method, as well as kidney length
were fast but provided only a rough estimate of kidney volume. The results of the
validation study indicated that planimetry and Stereology allow using an
importantly lower number of patients to detect changes in kidney volume induced
by drug treatment as compared to other methods. CONCLUSIONS: Planimetry should be
preferred over fast and simplified methods for accurately monitoring ADPKD
progression and assessing drug treatment effects. Expert operators, especially on
MR images, are required for performing reliable estimation of kidney volume. The
use of efficient TKV quantification methods considerably reduces the number of
patients to enrol in clinical investigations, making them more feasible and
significant.