Evaluation of Renal Ischemia-Reperfusion Injury Using Optical Coherence Tomography Based on Fractal Dimension

Renal ischemia-reperfusion (IR) is inevitable in partial nephrectomy and kidney transplantation. Acute tubular necrosis (ATN) induced by renal IR causes the loss of functional units in the kidney, pathologically presenting as the nonhomogeneous distribution of normal uriniferous tubules and usually used to characterize kidney activity. Optical coherence tomography (OCT) has been proven to have the ability to image the kidney microstructure in vivo and in real time. However, a fast image analysis method is needed for clinical application purpose. In this work, a new method for assessing renal IR injury was developed using a fractal-dimension-based texture of the OCT kidney image. Thirty-five Wistar rats were divided into seven groups for renal ischemia-reperfusion: control and various ischemia-time groups. A time series of 3D OCT kidney images was obtained. We calculated the fractal dimension (FD) of OCT en face images and found that the value increased gradually and finally became stable after 90 min of reperfusion. The stable value in the long-ischemia-time group was smaller than that in the short-ischemia-time group. The FD value of the OCT kidney image was highly responsive to renal IR injury. The proposed method is promising for a fast diagnostic application.