Bodard Sylvain, Denis Louise, Chabouh Georges, Anglicheau Dany, Hélénon Olivier, Correas Jean-Michel, Couture Olivier
AP-HP, Hôpital Necker Enfants Malades, Service d'Imagerie Adulte, Université de Paris Cité, F-75015, Paris, France.
Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France.
Theranostics. 2025 Jan 1;15(1):233-244. doi: 10.7150/thno.100897. eCollection 2025.
Renal pseudotumors, which mimic tumors on imaging, pose diagnostic challenges that can lead to unnecessary interventions. Sensing ultrasound localization microscopy (sULM) is an advanced imaging technique that uses ultrasound imaging and microbubbles as sensors to visualize kidney functional units. This study aims to investigate whether sULM could differentiate between renal pseudotumors and tumors based on the presence of glomeruli. Eleven patients (6 tumors, 6 pseudotumors - 1 patient with 2 pseudotumors) were included. Data on patient demographics, tumor characteristics, and sULM metrics were collected. Glomeruli were quantified and compared among tumors, pseudotumors, and renal cortex using sULM. Additional metrics, i.e., normalized speed and dispersity, were also analyzed. Renal tumors exhibited fewer detected glomeruli paths (mean: 10 ± 6 /cm [range: 4-20]) compared to pseudotumors (26 ± 5 /cm [19-32], p < 0.001) and normal renal cortex (26 ± 6 /cm [15-35], p < 0.01). Tumors displayed lower dispersity (0.13 ± 0.06 arbitrary units [a.u.] [0.07-0.20]) than both the renal cortex (0.3 ± 0.1 a.u. [0.1-0.4], p = 0.0012) and pseudotumors (0.22 ± 0.05 a.u. [0.16-0.25], p = 0.0389), and lower normalized speeds of 0.08 ± 0.04 without units (w.u.) [range: 0.03-0.17] compared to the renal cortex (0.18 ± 0.07 w.u. [0.11-0.28], p = 0.0014) and pseudotumors (0.14 ± 0.02 w.u. [0.12-0.16], p = 0.0497). sULM could effectively differentiate renal pseudotumors from tumors based on glomerular detection and metrics estimation. This initial exploration into the clinical utility of sULM suggests it could provide a noninvasive tool to support patient management, particularly for individuals with contraindications to conventional imaging methods. Further studies are needed to confirm these preliminary findings.
肾假瘤在影像学上酷似肿瘤，给诊断带来挑战，可能导致不必要的干预。传感超声定位显微镜（sULM）是一种先进的成像技术，它利用超声成像和微泡作为传感器来可视化肾脏功能单位。本研究旨在探讨sULM能否基于肾小球的存在来区分肾假瘤和肿瘤。纳入了11例患者（6例肿瘤、6例假瘤——1例患者有2例假瘤）。收集了患者人口统计学、肿瘤特征和sULM指标的数据。使用sULM对肿瘤、假瘤和肾皮质中的肾小球进行定量和比较。还分析了其他指标，即归一化速度和离散度。与假瘤（26±5个/cm[19 - 32]，p<0.001）和正常肾皮质（26±6个/cm[15 - 35]，p<0.01）相比，肾肿瘤检测到的肾小球路径较少（平均：10±6个/cm[范围：4 - 20]）。肿瘤的离散度（0.13±0.06任意单位[a.u.][0.07 - 0.20]）低于肾皮质（0.3±0.1 a.u.[0.1 - 0.4]，p = 0.0012）和假瘤（0.22±0.05 a.u.[0.16 - 0.25]，p = 0.0389），归一化速度也较低，为0.08±0.04无单位（w.u.）[范围：0.03 - 0.17]，低于肾皮质（0.18±0.07 w.u.[0.11 - 0.28]，p = 0.0014）和假瘤（0.14±0.02 w.u.[0.12 - 0.16]，p = 0.0497）。sULM能够基于肾小球检测和指标估计有效地区分肾假瘤和肿瘤。对sULM临床应用的这一初步探索表明，它可以提供一种非侵入性工具来支持患者管理，特别是对于有传统成像方法禁忌证的个体。需要进一步研究来证实这些初步发现。
