In Vivo Assessment of Diabetic Kidney Disease using Ultrasound Localization Microscopy

Diabetes mellitus can lead to diabetic kidney disease (DKD), which is a kind of chronic kidney diseases (CKDs). Compared with other renal diseases, DKD deteriorates more rapidly to end-stage renal disease, and the 5-year renal survival rate is about 61%. Therefore, monitoring of progression of DKD is vital for improving the survival rate and quality of life for diabetic patients. However, non-invasive and quantitative diagnostic tools are still lacking currently. It has been reported that the occurrence and development of DKD would lead to the changes of renal microvasculature and perfusion. Recently, ultrasound localization microscopy (ULM) has been demonstrated to break the diffraction limit of ultrasound and obtain the microvasculature morphology and blood flow speed map by localizing and tracking the flowing microbubbles. In this study, ULM was performed on kidneys of DKD rat models and control rats to investigate its feasibility in assessment of DKD in vivo. In addition, conventional clinical inspections (urine and serum tests) and conventional ultrasound imaging (Doppler and contrast-enhanced ultrasound imaging) were performed to verify the successful development of diabetes for DKD group. Statistical differences are observed between the clinical inspections-related parameters (urine and serum), CEUS-related parameters [time to peak (TTP) and area under curve (AUC)], and ULM-related parameter (mean blood flow speed of interlobular arterioles). In conclusion, this study shows the potential of ULM in the assessment of DKD in vivo.