MR Measurements of Tolvaptan Effect on TKV: Experience in 36 ADPKD Patients

Motivation: Traditional TKV measurement methods for assessing tolvaptan response in ADPKD are variable and limits accurate identification of responders. Reliable, reproducible tools are essential to identify patients likely to benefit from tolvaptan. Goal(s): A reproducible MRI technique tracks ht-TKV growth and identifies predictive markers for tolvaptan responders. Approach: A retrospective analysis of 36 ADPKD patients used MRI with deep-learning segmentation to measure ht-TKV growth before and during tolvaptan use and incorporated demographics, urine osmolality, and spleen volume. Results: Tolvaptan reduced ht-TKV growth in over half the patients, with responders mostly male and having higher pre-treatment urine osmolality, thus emphasizing MRI's utility in individual assessment. Impact: MRI-based ht-TKV measurements and serum urine osmolality can now be used to more accurately assess individual responses to tolvaptan in ADPKD. This enables radiologists and nephrologists to tailor treatments by identifying those most likely to benefit from therapy.