Comparison of Shear Wave Elastography and Dimercaptosuccinic Acid Findings in the Evaluation of Renal Parenchyma

Purpose: Dimercaptosuccinic acid (DMSA) renal cortical scintigraphy is the reference standard for the non-invasive diagnosis of renal scar tissue; however, it involves exposure to low doses of radiation. Shear wave elastography (SWE) has recently emerged as a radiation-free, easily applicable technique to measure renal stiffness in renal scar tissue examination. This study aimed to compare the results of DMSA and SWE tests and evaluate whether SWE could serve as an alternative to DMSA in patients. Materials and Methods: This study included 72 patients who underwent elastography of both kidneys prospectively between January 2017 and May 2024 in patients who underwent DMSA examination for various indications. SWE values and stiffness average, standard deviation (SD), median, interquartile range (IQR), and IQR/median values were recorded. Regions of interest were measured in nine areas, three from each of the upper, middle, and lower poles, and mean values were calculated. Results: The mean age of the patients was 21.8±12.9 years. Among the patients, 47 (33.1%) had ectopic kidneys, and 48 (33.8%) had horseshoe kidneys. The mean SWE value was 7.06±1.1 kPa, the stiffness average was 8.63±5.2 kPa, the stiffness SD was 5.77±3.5 kPA, the stiffness median was 4.15±2.3 kPa, the stiffness IQR was 1.20±1.0 kPa, and the stiffness IQR/median was 16.9±15.1%. A statistically significant correlation was observed between the SWE value and DMSA results (p=0.002). Conclusion: The SWE value is successful in evaluating renal parenchyma and shows significant correlation with DMSA results.