Noninvasive assessment of single kidney glomerular filtration rate using multiple diffusion weighted imaging models

Purpose: This study aimed to assess single kidney glomerular filtration rate (GFR) using various diffusion weighted imaging (DWI) models. Methods: We reviewed adult patients with kidney diseases who underwent magnetic resonance imaging (MRI) examination from February 2021 to December 2023. DWI with 13 b-values was performed using 3.0-T scanners. Diffusion parameters were calculated with multi-slice ROIs positioned in renal parenchyma using four DWI models, including monoexponential model (MEM), diffusion kurtosis imaging (DKI), stretched exponential model (SEM), and intravoxel incoherent motion (IVIM). The split GFRs were measured by 99mTc-DTPA scintigraphy using Gates’ method. Four different regression algorithms including the linear regression, regression tree, Gaussian regression and support vector machine (SVM) regression were employed to predict the GFR value based on different diffusion parameters. The leave-one-out cross validation was used to evaluate prediction ability of different models, and the performance of each model was quantified using the root mean square error (RMSE) and correlation coefficient. Results: Fifteen (male/female, 10/5; age, 41.60±10.83 years) patients were included in this study. Among the four DWI models, the IVIM parameters with SVM regression model achieved the best performance with 0.184 RMSE and 0.789 correlation coefficient (p<0.001). The parameters combining the four DWI models with SVM regression algorithm achieved the best performance in this study, with 0.171 RMSE and 0.815 correlation coefficient (p<0.001). Conclusion: The DWI characteristics are able to serve as imaging biomarkers for assessing the function of single kidney. The integration of DWI into clinical practice could contribute to the advancement of non-invasive diagnostic methodologies.