Key result
Quantitative Dixon MRI medullary R2* discriminates mild CKD from healthy controls with an AUC of ~0.97.
Why the study?
Renal ectopic lipid accumulation and oxygenation changes are implicated in CKD progression, but a comprehensive quantitative assessment of renal fat content and oxygenation across CKD stages is lacking.
Does 3.0T qDixon MRI accurately quantify renal fat fraction and relaxation rate changes across chronic kidney disease stages compared to healthy controls?
Cross-Sectional (n=95)
Double-blind (image assessors)
No
Does 3.0T qDixon MRI accurately quantify renal fat fraction and relaxation rate changes across chronic kidney disease stages compared to healthy controls?
Effect estimate: AUC 0.972 (95% CI 0.916-1.000)
qDixon MRI provides a noninvasive, quantitative method to assess renal ectopic fat deposition and oxygenation changes across different stages of chronic kidney disease.
qDixon MRI detects stage-specific renal FF and R2* shifts in CKD; leaves open clinical monitoring role pending validation.
Renal ectopic lipid accumulation and oxygenation-related alterations have been implicated in CKD progression, highlighting the necessity for precise noninvasive monitoring. However, a comprehensive quantitative assessment of renal fat content and oxygenation across CKD stages is lacking. To investigate changes in renal fat fraction (FF) and relaxation rate (R2*) values based on qDixon MRI across CKD stages and to evaluate their performance in distinguishing renal impairment and CKD severity. A total of 25 healthy volunteers (controls) and 70 patients with CKD (Stages 1–5) underwent 3.0T qDixon MRI to quantify FF an R2*. Patients with CKD were stratified based on estimated glomerular filtration rate (eGFR). Differences in FF and R2* among groups were analyzed using one-way ANOVA and Welch’s ANOVA, respectively. Spearmen’s correlation assessed relationships with variable, and receiver operating characteristic (ROC) curve analysis evaluated stage-specific diagnostic performance. Cortical and medullary FF differed significantly across CKD stages and were higher in the advanced-stage groups, particularly CKD stages 4 and 5. However, R2* values were higher in CKD stages 1 and 2 than in controls, but lower in the later-stage groups. In mild CKD (stages 1–2), only medullary R2* correlated negatively with eGFR ( r = -0.456, p = 0.003); FF showed no correlation. While, in moderate-severe CKD (stages 3–5), both FF and R2* values in renal cortex and medulla were significantly correlated with eGFR. Notably, R2* showed good performance in identifying mild CKD from controls (cortex, AUC = 0.967; medulla, AUC = 0.972), and all parameters showed good ability to differentiate mild from moderate-severe CKD. qDixon MRI may provide quantitative information on renal ectopic fat deposition and oxygenation-related alterations reflected by R2* in patients with CKD, with potential value for evaluating renal involvement across CKD stages.
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Zhang et al. (2026) conducted a cross-sectional in Chronic Kidney Disease (n=95). qDixon-MRI vs. Healthy controls was evaluated on Diagnostic performance of medullary R2* for discriminating mild CKD (stages 1-2) from healthy controls (AUC 0.972, 95% CI 0.916-1.000). Quantitative Dixon MRI demonstrated high diagnostic performance in evaluating renal involvement, with medullary R2* effectively discriminating mild chronic kidney disease from healthy controls (AUC 0.972).
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