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Wang F, Lee SY, Adelnia F, Takahashi K, Harkins KD, He L, Zu Z, Ellinger P, Grundmann M, Harris RC, Takahashi T, Gore JC. Severity of polycystic kidney disease revealed by multiparametric MRI. Magn Reson Med 2023; 90:1151-1165. [PMID: 37093746 PMCID: PMC10805116 DOI: 10.1002/mrm.29679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/03/2023] [Accepted: 04/03/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE We aimed to compare multiple MRI parameters, including relaxation rates (R 1 $$ {R}_1 $$ ,R 2 $$ {R}_2 $$ , andR 1 ρ $$ {R}_{1\rho } $$ ), ADC from diffusion weighted imaging, pool size ratio (PSR) from quantitative magnetization transfer, and measures of exchange from spin-lock imaging (S ρ $$ {S}_{\rho } $$ ), for assessing and predicting the severity of polycystic kidney disease (PKD) over time. METHODS Pcy/Pcy mice with CD1 strain, a mouse model of autosomal dominant PKD, were imaged at 5, 9, and 26 wk of age using a 7T MRI system. Twelve-week normal CD1 mice were used as controls. Post-mortem paraffin tissue sections were stained using hematoxylin and eosin and picrosirius red to identify histological changes. RESULTS Histology detected segmental cyst formation in the early stage (week 5) and progression of PKD over time in Pcy kidneys. InT 2 $$ {T}_2 $$ -weighted images, small cysts appeared locally in cystic kidneys in week 5 and gradually extended to the whole cortex and outer stripe of outer medulla region from week 5 to week 26. Regional PSR,R 1 $$ {R}_1 $$ ,R 2 $$ {R}_2 $$ , andR 1 ρ $$ {R}_{1\rho } $$ decreased consistently over time compared to normal kidneys, with significant changes detected in week 5. Among all the MRI measures,R 2 $$ {R}_2 $$ andR 1 ρ $$ {R}_{1\rho } $$ allow highest detectability to PKD, while PSR andR 1 $$ {R}_1 $$ have highest correlation with pathological indices of PKD. Using optimum MRI parameters as regressors, multiple linear regression provides reliable prediction of PKD progression. CONCLUSION R 2 $$ {R}_2 $$ ,R 1 $$ {R}_1 $$ , and PSR are sensitive indicators of the presence of PKD. Multiparametric MRI allows a comprehensive analysis of renal changes caused by cyst formation and expansion.
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Affiliation(s)
- Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
| | - Seo Yeon Lee
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Fatemeh Adelnia
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
| | - Keiko Takahashi
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Kevin D. Harkins
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232
| | - Lilly He
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
| | - Philipp Ellinger
- Bayer AG Research & Development, Pharmaceuticals, 42113 Wuppertal, Germany
| | - Manuel Grundmann
- Bayer AG Research & Development, Pharmaceuticals, 42113 Wuppertal, Germany
| | - Raymond C. Harris
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Takamune Takahashi
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232
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Zu Z, Adelnia F, Harkins K, Wang F, Ostenson J, Gore JC. Correction of errors in estimates of T 1ρ at low spin-lock amplitudes in the presence of B 0 and B 1 inhomogeneities. NMR IN BIOMEDICINE 2023; 36:e4951. [PMID: 37070215 PMCID: PMC10619883 DOI: 10.1002/nbm.4951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
Relaxation rates R1ρ in the rotating frame measured by spin-lock methods at very low locking amplitudes (≤ 100 Hz) are sensitive to the effects of water diffusion in intrinsic gradients and may provide information on tissue microvasculature, but accurate estimates are challenging in the presence of B0 and B1 inhomogeneities. Although composite pulse preparations have been developed to compensate for nonuniform fields, the transverse magnetization comprises different components and the spin-lock signals measured do not decay exponentially as a function of locking interval at low locking amplitudes. For example, during a typical preparation sequence, some of the magnetization in the transverse plane is nutated to the Z-axis and later tipped back, and so does not experience R1ρ relaxation. As a result, if the spin-lock signals are fit to a monoexponential decay with locking interval, there are residual errors in quantitative estimates of relaxation rates R1ρ and their dispersion with weak locking fields. We developed an approximate theoretical analysis to model the behaviors of the different components of the magnetization, which provides a means to correct these errors. The performance of this correction approach was evaluated both through numerical simulations and on human brain images at 3 T, and compared with a previous correction method using matrix multiplication. Our correction approach has better performance than the previous method at low locking amplitudes. Through careful shimming, the correction approach can be applied in studies using low spin-lock amplitudes to assess the contribution of diffusion to R1ρ dispersion and to derive estimates of microvascular sizes and spacings. The results of imaging eight healthy subjects suggest that R1ρ dispersion in human brain at low locking fields arises from diffusion among inhomogeneities that generate intrinsic gradients on a scale of capillaries (~7.4 ± 0.5 μm).
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Affiliation(s)
- Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Fatemeh Adelnia
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin Harkins
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jason Ostenson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Deparment of Physics and Astronomy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Wang P. Adiabatically prepared spin-lock could reduce the R 1ρ dispersion. Quant Imaging Med Surg 2023; 13:763-775. [PMID: 36819267 PMCID: PMC9929376 DOI: 10.21037/qims-21-959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
Background R1ρ (or spin-lock) imaging is prone to artifacts arising from field inhomogeneities that may impact the R1ρ quantification. Previous research has proposed two types of method to manage the artifacts in continuous-wave constant amplitude spin-lock, one is based on the composite block pulses to compensate for the field imperfections, another category uses adiabatic pulses in the R1ρ pre-pulse to excite and reverse the magnetization (named adiabatic prepared approach). Although both methods have proved their efficiency in alleviating artifacts, we observed that the adiabatic pulse approach could produce much lower R1ρ dispersion in human knee cartilage than the block pulse method (characterized by the R1ρ difference ∆R1ρ =11.4 Hz (from spin-lock field 50 to 500 Hz) for the block pulse method vs. ∆R1ρ =4.5 Hz for the adiabatic pulse approach). Prompted by this observation, the purpose of this study was to investigate the underlying factors that may affect the R1ρ dispersion through numerical simulations based on the two-pool exchanging Bloch-McConnell equations. Methods The effects of free water pool size Pa (from 0.80 to 0.95), chemical exchange rate kb (from the bound to free water pool, ranged from 500 to 3,000 Hz), adiabatic pulse duration Tp (from 5.0 to 25 ms), and the chemical shift of the bound pool ppmb (from 1.0 to 5.0 ppm) were examined on the degree of the R1ρ dispersion for the two R1ρ imaging methods. Results In general, the greater the ppmb, kb, Tp, and the smaller Pa, the more significant difference in R1ρ dispersion between the block and adiabatic approaches, with the dispersion curve of the adiabatic method becoming flatter. Conclusions The adiabatic prepared approach may compromise the R1ρ dispersion, the effect is determined by the combination of the tissue and radiofrequency (RF) pulse properties. It is suggested that care should be taken when using the adiabatically prepared approach to study R1ρ dispersion.
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Wang F, Otsuka T, Adelnia F, Takahashi K, Delgado R, Harkins KD, Zu Z, de Caestecker MP, Harris RC, Gore JC, Takahashi T. Multiparametric magnetic resonance imaging in diagnosis of long-term renal atrophy and fibrosis after ischemia reperfusion induced acute kidney injury in mice. NMR IN BIOMEDICINE 2022; 35:e4786. [PMID: 35704387 PMCID: PMC10805124 DOI: 10.1002/nbm.4786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/31/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
Tubular atrophy and fibrosis are pathological changes that determine the prognosis of kidney disease induced by acute kidney injury (AKI). We aimed to evaluate multiple magnetic resonance imaging (MRI) parameters, including pool size ratio (PSR) from quantitative magnetization transfer, relaxation rates, and measures from spin-lock imaging ( R 1 ρ and S ρ ), for assessing the pathological changes associated with AKI-induced kidney disease. Eight-week-old male C57BL/6 J mice first underwent unilateral ischemia reperfusion injury (IRI) induced by reperfusion after 45 min of ischemia. They were imaged using a 7T MRI system 56 days after the injury. Paraffin tissue sections were stained using Masson trichrome and picrosirius red to identify histopathological changes such as tubular atrophy and fibrosis. Histology detected extensive tubular atrophy and moderate fibrosis in the cortex and outer stripe of the outer medulla (CR + OSOM) and more prominent fibrosis in the inner stripe of the outer medulla (ISOM) of IRI kidneys. In the CR + OSOM region, evident decreases in PSR, R 1 , R 2 , R 1 ρ , and S ρ showed in IRI compared with contralateral kidneys, with PSR and S ρ exhibiting the most significant changes. In addition, the exchange parameter S ρ dropped by the largest degree among all the MRI parameters, whileR 2 * increased significantly. In the ISOM of IRI kidneys, PSR increased while S ρ kept decreasing. R 2 , R 1 ρ , andR 2 * all increased due to more severe fibrosis in this region. Among MRI measures, PSR and R 1 ρ showed the highest detectability of renal changes no matter whether tubular atrophy or fibrosis dominated.R 2 * and S ρ could be more specific to a single pathological event than other MRI measures because onlyR 2 * increased and S ρ decreased consistently when either fibrosis or tubular atrophy dominated, and their correlations with fibrosis scores were higher than other MRI measures. Multiparametric MRI may enable a more comprehensive analysis of histopathological changes following AKI.
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Affiliation(s)
- Feng Wang
- Vanderbilt University Institute of Imaging Science,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Radiology and Radiological Sciences,
Vanderbilt University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Tadashi Otsuka
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
| | - Fatemeh Adelnia
- Vanderbilt University Institute of Imaging Science,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Keiko Takahashi
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Rachel Delgado
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Kevin D. Harkins
- Vanderbilt University Institute of Imaging Science,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Radiology and Radiological Sciences,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Biomedical Engineering, Vanderbilt
University, Nashville, TN 37232
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Radiology and Radiological Sciences,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Mark P. de Caestecker
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - Raymond C. Harris
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Radiology and Radiological Sciences,
Vanderbilt University Medical Center, Nashville, TN 37232
- Department of Biomedical Engineering, Vanderbilt
University, Nashville, TN 37232
| | - Takamune Takahashi
- Division of Nephrology and Hypertension, Vanderbilt
University Medical Center, Nashville, TN 37232
- Vanderbilt O’Brien Kidney Research Center,
Vanderbilt University Medical Center, Nashville, TN 37232
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Wang F, Otsuka T, Takahashi K, Narui C, Colvin DC, Harris RC, Takahashi T, Gore JC. Renal tubular dilation and fibrosis after unilateral ureter obstruction revealed by relaxometry and spin-lock exchange MRI. NMR IN BIOMEDICINE 2021; 34:e4539. [PMID: 33963778 PMCID: PMC10805126 DOI: 10.1002/nbm.4539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
We evaluated the use of quantitative MRI relaxometry, including the dispersion of spin-lock relaxation with different locking fields, for detecting and assessing tubular dilation and fibrosis in a mouse model of unilateral ureter obstruction (UUO). C57BL/6 J and BALB/c mice that exhibit different levels of tubular dilation and renal fibrosis after UUO were subjected to MR imaging at 7 T. Mice were imaged before UUO surgery, and at 5, 10 and 15 days after surgery. We acquired maps of relaxation rates and fit the dispersion of spin-lock relaxation rates R1ρ at different locking fields (frequencies) to a model of exchanging water pools, and assessed the sensitivity of the derived quantities for detecting tubular dilation and fibrosis in kidney. Histological scores for tubular dilation and fibrosis, based on luminal space and positive fibrotic areas in sections, were obtained for comparison. Histology detected extensive tubular dilation and mild to moderate fibrosis in the UUO kidneys, in which enlargement of luminal space, deposition of collagen, and reductions in capillary density were observed in the cortex and outer stripe of the outer medulla. Relaxation rates R1 , R2 and R1ρ clearly decreased in these regions of UUO kidneys longitudinally. While R1 showed the highest detectability to tubular dilation and overall changes in UUO kidneys, Sρ , a parameter derived from R1ρ dispersion data, showed the highest correlation with renal fibrosis in UUO. While relaxation parameters are sensitive to tubular dilation in UUO kidneys, Sρ depends primarily on the average exchange rate between water and other chemically shifted resonances such as hydroxyls and amides, and provides additional specific information for evaluating fibrosis in kidney disease.
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Affiliation(s)
- Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
| | - Tadashi Otsuka
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Keiko Takahashi
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Chikage Narui
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
| | - Daniel C. Colvin
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
| | - Raymond C. Harris
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
| | - Takamune Takahashi
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center
- Vanderbilt O’Brien Kidney Research Center, Vanderbilt University Medical Center
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
- Department of Biomedical Engineering, Vanderbilt University Nashville, TN 37232
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Katagiri D, Wang F, Gore JC, Harris RC, Takahashi T. Clinical and experimental approaches for imaging of acute kidney injury. Clin Exp Nephrol 2021; 25:685-699. [PMID: 33835326 PMCID: PMC8154759 DOI: 10.1007/s10157-021-02055-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/17/2021] [Indexed: 12/23/2022]
Abstract
Complex molecular cell dynamics in acute kidney injury and its heterogeneous etiologies in patient populations in clinical settings have revealed the potential advantages and disadvantages of emerging novel damage biomarkers. Imaging techniques have been developed over the past decade to further our understanding about diseased organs, including the kidneys. Understanding the compositional, structural, and functional changes in damaged kidneys via several imaging modalities would enable a more comprehensive analysis of acute kidney injury, including its risks, diagnosis, and prognosis. This review summarizes recent imaging studies for acute kidney injury and discusses their potential utility in clinical settings.
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Affiliation(s)
- Daisuke Katagiri
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, S-3223 MCN, Nashville, TN, 37232, USA.
- Department of Nephrology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt In Vivo Mouse Kidney Imaging Core, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John C Gore
- Vanderbilt In Vivo Mouse Kidney Imaging Core, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Raymond C Harris
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, S-3223 MCN, Nashville, TN, 37232, USA
| | - Takamune Takahashi
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, S-3223 MCN, Nashville, TN, 37232, USA.
- Vanderbilt In Vivo Mouse Kidney Imaging Core, Vanderbilt University Medical Center, Nashville, TN, USA.
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Tissue characterization using R 1rho dispersion imaging at low locking fields. Magn Reson Imaging 2021; 84:1-11. [PMID: 34052306 DOI: 10.1016/j.mri.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 11/22/2022]
Abstract
Measurements of the variations of spin-locking relaxation rates (R1ρ) with locking field amplitude allow the derivation of quantitative parameters that describe different dynamic processes, such as slow molecular motions, chemical exchange and diffusion. In some samples, changes in R1ρ values between locking frequency 0 and 200 Hz may be dominated mainly by diffusion of water in intrinsic field gradients, while those at higher locking fields are due to exchange processes. The exchange and diffusion effects act independently of each other, as confirmed by simulation and experimentally. In tissues, the relevant intrinsic field gradients may arise from the magnetic inhomogeneities caused by microvascular blood so that R1ρ dispersion over weak locking field amplitudes (≤ 200 Hz) is affected by changes in capillary density and geometry. Here we first review the theoretical and experimental background to the interpretation of R1ρ dispersions caused by intrinsic magnetic susceptibility variations within the tissue. We then provide new empirical results of R1ρ dispersion imaging of the human brain and skeletal muscle at low locking field amplitudes for the first time and identify potential applications of R1ρ dispersion imaging in clinical studies.
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Hectors SJ. Is MRI relaxometry parameter T 1ρ specific to fibrosis or confounded by concomitant pathological features? Quant Imaging Med Surg 2020; 10:2408-2410. [PMID: 33269241 PMCID: PMC7596401 DOI: 10.21037/qims-20-1089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/22/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Stefanie J Hectors
- Department of Radiology, Weill Cornell Medicine, New York, NY 10021, USA
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