Diagnostic performance of mDIXON-Quant imaging in assessing glomerulosclerosis severity for chronic kidney disease: a comparative study of R2* and fat fraction parameters

Objective To compare two region-of-interest (ROI) measurement methods based on mDIXON-Quant for distinguishing healthy volunteers (HV), chronic kidney disease (CKD) patients with low (≤ 15%) and high (> 15%) glomerulosclerosis (GS), and establish a non-invasive auxiliary protocol.Methods A total of 42 CKD patients and 25 HV underwent mDIXON-Quant MRI. CKD patients were stratified into low (n = 24) and high (n = 18) GS groups via renal biopsy. Two ROI methods were applied: Method 1 (cortex/medulla separation, 15-20 mm² circular ROIs at renal hilum, upper/lower poles) and Method 2 (whole-kidney contour tracing). R2* and fat fraction (FF) parameters were analyzed using ANOVA, LSD tests, and DeLong tests for diagnostic efficacy (AUC).Results R2* parameters (RcR2*, RR2*) showed significant differences across groups (P  0.05). RcR2* outperformed medullary parameters (P Conclusion The present study demonstrates that employing the Method 2(whole-kidney contour tracing) based on mDIXON-Quant technology enables auxiliary quantitative assessment of the severity of GS via the R2 parameter of the right kidney, thereby confirming its role as an adjunctive tool in GS evaluation.