Non-Invasive Kidney Quantification for Hydronephrosis:

Key Personnel

  • Marius George Linguraru, DPhil 
  • Craig Peters, MD 
  • Juan Cerrolaza, PhD 
  • James Jago, PhD, Philips Healthcare

Synopsis
The most common pediatric ultrasound studies are of the kidney (10-30 cases daily at Children’s National); the most common abnormal finding in these studies is hydronephrosis (2-2.5 percent of children). Ultrasound is the mainstay of imaging for pediatric hydronephrosis, yet is limited by its subjective assessment, absence of a consistently interpreted grading system, and apparent lack of correlation with functional imaging modalities. When hydronephrosis is found with ultrasound, the patient is often required to undertake a diuretic renogram, an invasive and ionizing exam to determine the severity of hydronephrosis.

The goal of our project is to characterize hydronephrosis more precisely, non-invasively and without radiation, and permit the routine adoption (at our center and others) of a quantitative, robust and reproducible ultrasound-based technique to evaluate and follow hydronephrosis. For this purpose, we have developed new ultrasound-based quantitative imaging biomarkers of pediatric hydronephrosis in order to limit the need for diuretic renograms in young patients. The underlying hypothesis of the study is that renal morphology can be quantitatively correlated with the severity of obstruction and possibly with renal function. The project has shown positive bench test results on 2D ultrasound data from routine clinical examinations. Further pre-clinical evaluations are ongoing while also transitioning to 3D image data in collaboration with Philips Healthcare.