In vivo NMR imaging and spectroscopic investigation of renal pathology in lean and obese rat kidneys

Analysis Protocols for MRI Mapping of Renal T1

The computation of T₁ maps from MR datasets represents an important step toward the precise characterization of kidney disease models in small animals. Here the main strategies to analyze renal T₁ mapping datasets derived from small rodents are presented. Suggestions are provided with respect to essential software requirements, and advice is provided as to how dataset completeness and quality may be evaluated. The various fitting models applicable to T₁ mapping are presented and discussed. Finally, some methods are proposed for validating the obtained results.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol chapter is complemented by two separate chapters describing the basic concept and experimental procedure.

Assessment of unilateral ureter obstruction with multi-parametric MRI

PURPOSE

Quantitative multi-parametric MRI (mpMRI) methods may allow the assessment of renal injury and function in a sensitive and objective manner. This study aimed to evaluate an array of MRI methods that exploit endogenous contrasts including relaxation rates, pool size ratio (PSR) derived from quantitative magnetization transfer (qMT), chemical exchange saturation transfer (CEST), nuclear Overhauser enhancement (NOE), and apparent diffusion coefficient (ADC) for their sensitivity and specificity in detecting abnormal features associated with kidney disease in a murine model of unilateral ureter obstruction (UUO).

METHODS

MRI scans were performed in anesthetized C57BL/6N mice 1, 3, or 6 days after UUO at 7T. Paraffin tissue sections were stained with Masson trichrome following MRI.

RESULTS

Compared to contralateral kidneys, the cortices of UUO kidneys showed decreases of relaxation rates R₁ and R₂ , PSR, NOE, and ADC. No significant changes in CEST effects were observed for the cortical region of UUO kidneys. The MRI parametric changes in renal cortex are related to tubular cell death, tubular atrophy, tubular dilation, urine retention, and interstitial fibrosis in the cortex of UUO kidneys.

CONCLUSION

Measurements of multiple MRI parameters provide comprehensive information about the molecular and cellular changes produced by UUO. Magn Reson Med 79:2216-2227, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Longitudinal assessment of mouse renal injury using high-resolution anatomic and magnetization transfer MR imaging

The purpose of this study is to evaluate the utility of high-resolution non-invasive endogenous high-field MRI methods for the longitudinal structural and quantitative assessments of mouse kidney disease using the model of unilateral ureter obstruction (UUO). T1-weighted, T2-weighted and magnetization transfer (MT) imaging protocols were optimized to improve the regional contrast in mouse kidney. Conventional T1 and T2 weighted images were collected in UUO mice on day 0 (~3h), day 1, day 3 and day 6 after injury, on a 7 T small animal MRI system. Cortical and medullary thickness, corticomedullary contrast and Magnetization Transfer Ratio (MTR) were assessed longitudinally. Masson trichrome staining was used to histologically assess changes in tissue microstructure. Over the course of UUO progression there were significant (p<0.05) changes in thickness of cortex and outer medulla, and regional changes in T2 signal intensity and MTR values. Histological changes included tubular cell death, tubular dilation, urine retention, and interstitial fibrosis, assessed by histology. The MRI measures of renal cortical and medullary atrophy, cortical-medullary differentiation and MTR changes provide an endogenous, non-invasive and quantitative evaluation of renal morphology and tissue composition during UUO progression.

Renal Functional Contrast-Enhanced Magnetic Resonance Imaging

OBJECTIVES

The objective of the present study was to compare P792, a new rapid clearance blood pool agent characterized by negligible interstitial diffusion but unrestricted glomerular filtration, with Gd-DOTA in both qualitative and quantitative aspects of renal functional magnetic resonance imaging.

MATERIALS AND METHODS

Dynamic imaging was performed with a fast T1-weighted gradient-echo sequence on a 1.5-T magnet in 25 Sprague-Dawley rats, after injection of 13 micromol Gd/kg-1 of P792 (n = 10), 100 (n = 10), or 50 micromol Gd/kg-1 of Gd-DOTA (n = 5). Signal-time curves from 6 regions of interest (ROIs), including renal parenchyma and contents, were analyzed.

RESULTS

Qualitative analysis depicted a typical pattern of temporal enhancement as previously described with extracellular gadolinium chelates, including early and brief enhancement of the aorta, renal vessels and cortex, quickly followed by enhancement of the medulla and then renal pelvis. However, a decrease in signal intensity was noted in the inner medulla and the renal pelvis approximately 90 seconds after bolus injection, being more marked when using the full dose of Gd-DOTA. Curve analysis showed a similar vascular phase within each parenchymal ROI, confirmed by similar upslopes, which ranged from 0.015 +/- 0.007 to 0.019 +/- 0.005. Following this initial phase, T1-enhancement appeared greater and longer within the medulla and renal pelvis, and subsequently in the whole kidney ROI with P792 (time to maximal enhancement (sec)/ enhancement rate: 85.5 +/- 15.9/3.1 +/- 0.4) as compared with Gd-DOTA full (53.0 +/- 18.9/ 2.7 +/- 0.3) or half dosage (65.2 +/- 20.1/ 2.2 +/- 0.2). The subsequent decrease in signal intensity, characterized by a downslope during the minute following maximal enhancement, was faster with Gd-DOTA (0.006 +/- 0.002) as compared either to P792 or half dosage Gd-DOTA (0.003 +/- 0.001).

CONCLUSIONS

Due to its physicochemical and pharmacokinetic properties, P792 allows the use of a reduced dosage of gadolinium, resulting in less T2* effect without compromising T1 enhancement. Thus, P792 appears suitable for renal functional MR imaging.

Effect of essential hypertension on kidney function as measured in rat by dynamic MRI

In this study, dynamic MRI was applied to investigate the effect of genetic hypertension on the renal clearance of Gd(DTPA). Assuming that the paramagnetic agent was essentially cleared through the kidney by glomerular filtration, a first-order kinetic model was used to estimate a rate constant k(cl) describing the transport from the renal cortex to the inner medulla. Experiments were carried out on 12-15-week-old spontaneously hypertensive rats (young-SHR) and age-matched Wistar-Kyoto rats (young-WKY). An additional group of 22-25-week-old SHR (old-SHR) was investigated to assess the long-term effect of chronic hypertension on kidney function. The glomerular filtration rate as measured by the inulin method correlated well with k(cl) results as measured by MRI. A clearance index 30% lower than young-WKY was observed in young-SHR, reflective of a kidney dysfunction. In old-SHR, k(cl) was only 50% of the young-WKY value. As computed from Gd(DTPA) concentration profiles, this translated into delayed time-to-peak (TTP) values, decreased peak Gd(DTPA) concentrations ([Gd](peak)), and a slow elimination of Gd(DTPA) from the blood pool, renal cortex, and inner medulla (e.g., high t(1/2) values). Finally, using the same MRI approach, the data showed that the acute administration of the calcium antagonist verapamil at an antihypertensive dose was followed by a near normalization of SHR renal function. These results indicate that chronic hypertension remains a major pathogenic factor in the progression of glomerular degeneration, as opposed to a primary glomerular defect independent of systemic pressure.

Quantitative assessment of rat kidney function by measuring the clearance of the contrast agent Gd(DOTA) using dynamic MRI

Magnetic resonance imaging (MRI) has been applied to assess kidney function in normal rats by monitoring the passage of the extracellular contrast agent GdDOTA. High-resolution images have been obtained using either the rapid acquisition with relaxation enhancement (RARE) or the snapshot pulse sequence. The latter was superior in anatomic definition due to the shorter echo delays used. The GdDOTA induced signal enhancements in the various renal structures were theoretically modeled and the results of the regression analysis then used to estimate local tissue concentrations in renal cortex, inner medulla and outer medulla/pelvis. The concentration-time curves in vena cava and renal cortex were similar and distinctly different from the ones in medulla and pelvis. This is reflected in the time-to-peak (TTP) values, which were TTP (blood) = 0.18 +/- 0.03 < TTP (cortex) = 0.26 +/- 0.05 < TTP (outer medulla) = 0.62 +/- 0.03 < TTP (inner medulla/pelvis) = 0.92 +/- 0.16 min. The initial tracer uptake rates depended linearly on the dose of GdDOTA administered, the value of the uptake rate in the cortex being significantly higher than those in the outer and inner medulla, which were identical within error limits. The initial medullar tracer uptake followed a first-order kinetics. The rate constant k(cl) = (dc[medulla]/dt)/c[cortex] = 3.4 +/- 0.5 min(-1) for the transition from cortex (predominantly blood signal) to medulla (predominantly urine) was considered a measure for the renal clearance. Intravenous administration of furosemide at doses 2.5, 5, and 10 mg/kg led to a dose-dependent decrease of k(cl). This reflects the inhibitory effect of the diuretic furosemide on medullary water resorption and thus the dilution of the GdDOTA in urine.

In vivo magnetic resonance methods in pharmaceutical research: current status and perspectives

In the last decade, in vivo MR methods have become established tools in the drug discovery and development process. In this review, several successful and potential applications of MRI and MRS in stroke, rheumatoid and osteo-arthritis, oncology and cardiovascular disorders are dealt with in detail. The versatility of the MR approach, allowing the study of various pathophysiological aspects in these disorders, is emphasized. New indication areas, for the characterization of which MR methods have hardly been used up to now, such as respiratory, gastro-intestinal and skin diseases, are outlined in a subsequent section. A strength of MRI, being a non-invasive imaging modality, is the ability to provide functional, i.e. physiological, readouts. Functional MRI examples discussed are the analysis of heart wall motion, perfusion MRI, tracer uptake and clearance studies, and neuronal activation studies. Functional information may also be derived from experiments using target-specific contrast agents, which will become important tools in future MRI applications. Finally the role of MRI and MRS for characterization of transgenic and knock-out animals, which have become a key technology in modern pharmaceutical research, is discussed. The advantages of MRI and MRS are versatility, allowing a comprehensive characterization of a diseased state and of the drug intervention, and non-invasiveness, which is of relevance from a statistical, economical and animal welfare point of view. Successful applications in drug discovery exploit one or several of these aspects. In addition, the link between preclinical and clinical studies makes in vivo MR methods highly attractive methods for pharmaceutical research.