Fingerprinting the polycystic kidney: radiomics of the noncystic parenchyma for earlier ADPKD detection.

Autosomal dominant polycystic kidney disease risk stratification relies on total kidney volume, a validated marker of cyst burden and progression. Kremer et al.'s pilot study used rapid breath-hold magnetic resonance fingerprinting with radiomics to evaluate noncystic renal parenchyma in children and young adults. Quantitative T1/T2 texture features distinguished autosomal dominant polycystic kidney disease from controls independently of total kidney volume, cyst fraction, age, or body size, suggesting early tissue changes. Small, cross-sectional, unmatched data require longitudinal validation of reproducibility, prognostic value, and clinical utility.