Natural history of simple T2-bright and complex T1-bright and diffusion restricting cysts in ADPKD

Motivation: Although kidney volume has been an established imaging biomarker for ADPKD classification and prognosis, the natural history of individual cyst growth remains unknown. Goal(s): To identify the growth patterns of simple and complex cysts in ADPKD as defined by MRI T1, T2, and DWI contrasts and allow evaluation of treatment on a cyst level. Approach: 124 individual cysts of 20 patients with an average 11-year follow-up were labeled by two experienced observers. Changes in cyst appearance on T1, T2, and DWI images and morphology were tracked over time. Results: A model for ADPKD individual cyst growth cycle is presented. Impact: This study investigated the natural history of cysts in ADPKD, establishing a model that characterizes ADPKD cyst growth, and shows the feasibility of staging ADPKD cysts using their MRI appearance.