Reduced Flow in Delayed Graft Function as Assessed by <scp>IVIM</scp> Is Associated With Time to Recovery Following Kidney Transplantation
Bibliographic record
Abstract
Background Delayed graft function (DGF), defined as the need for dialysis in the first week after kidney transplantation, frequently complicates posttransplantation care. The most common cause of DGF is ischemia–reperfusion injury (IRI). To date, no clinical tools can accurately estimate its severity, nor the time required for recovery of kidney function. Purpose To investigate if parameters related to directed flow and diffusion of water, as determined by intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI), could be used to differentiate DGF from normal graft function posttransplantation, predict time to recovery from DGF, and hence serve as a surrogate measure of IRI severity. Study Type Prospective, cross‐sectional cohort study. Population Fifty consecutive kidney transplant recipients within 3–10 days posttransplantation at our hospital. Field Strength/Sequence 3.0T/IVIM‐DWI. Assessment The following IVIM‐DWI parameters were studied: flow‐fraction ( f ), apparent diffusion coefficient ( ADC ), and total‐ADC ( ADC T ). Mean intrarenal resistive index (R.I.) from Doppler ultrasound was also included for a comparison of IVIM‐DWI with the clinical standard of care. Statistical Tests Welch's t ‐test, Spearman's correlation, and linear regression. Results f was significantly reduced in DGF compared to non‐DGF patients in the cortex, medulla, and whole renal parenchyma ( P < 0.05). Time to recovery with respect to MRI correlated negatively with f ( P < 0.05; rho = −0.52 (cortex), and −0.65 [parenchyma]), ADC ( P < 0.05; rho = −0.59 [cortex], 0.59 [medulla], and −0.59 [parenchyma]) and ADC T ( P < 0.05; rho = −0.54 [cortex], and −0.52 [medulla]). Whole renal parenchymal f predicted time to recovery relative to MRI ( P < 0.05, adjusted r‐squared = 0.36). R.I. was significantly different between the groups but did not correlate with time to recovery with respect to MRI (rho = 0.43, P = 0.096). Data Conclusion Quantification of renal flow using IVIM‐DWI has the potential to serve as a surrogate measure of IRI severity to estimate the degree of and recovery from DGF. Level of Evidence 2 Technical Efficacy Stage 3
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".