The role of diffusion weighted (DWI) MRI and apparent diffusion coefficient (ADC) in assessment of diabetic kidney disease.

Objective: To evaluate the diagnostic value of ADC derived from DW-MRI in staging and assessing progression of DKD. Study Design: Cross-sectional Validation study. Setting: Department of Radiology, Allied Hospital Faisalabad. Period: [6/12]-month period between January and July 2025. Methods: Using a 1.5-Tesla MRI scanner a total of 120 adult patients with DKD and 20 age- and sex-matched healthy volunteers were enrolled. All subjects underwent renal DW-MRI and ADC mapping. ADC values were measured from multiple regions of interest in both kidneys. Clinical and laboratory parameters, including serum creatinine and eGFR, were recorded for correlation. Results: Mean ADC values were significantly reduced in DKD patients compared with controls (2.1 ± 0.3 × 10⁻³ mm²/s vs 2.4 ± 0.1 × 10⁻³ mm²/s; p < 0.001). A progressive decline in ADC was observed with advancing disease stage, showing inverse correlation with serum creatinine and positive correlation with eGFR. Conclusion: ADC values derived from DW-MRI reliably reflect renal dysfunction and disease progression in DKD. ADC may serve as a noninvasive biomarker for staging and early detection, potentially guiding therapeutic decisions and improving prognostic evaluation.