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Hillaert A, Sanmiguel Serpa LC, Bogaert S, Broeckx BJG, Hesta M, Vandermeulen E, Germonpré J, Stock E, Pullens P, Vanderperren K. Assessment of pharmacologically induced changes in canine kidney function by multiparametric magnetic resonance imaging and contrast enhanced ultrasound. Front Vet Sci 2024; 11:1406343. [PMID: 38966564 PMCID: PMC11223176 DOI: 10.3389/fvets.2024.1406343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024] Open
Abstract
IntroductionDynamic contrast-enhanced (DCE) MRI and arterial spin labeling (ASL) MRI enable non-invasive measurement of renal blood flow (RBF), whereas blood oxygenation level-dependent (BOLD) MRI enables non-invasive measurement of the apparent relaxation rate (R2*), an indicator of oxygenation. This study was conducted to evaluate the potential role of these MRI modalities in assessing RBF and oxygenation in dogs. The correlation between contrast-enhanced ultrasound (CEUS) and the MRI modalities was examined and also the ability of the MRI modalities to detect pharmacologically induced changes.MethodsRBF, using CEUS, ASL- and DCE-MRI, as well as renal oxygenation, using BOLD-MRI of eight adult beagles were assessed at two time-points, 2–3 weeks apart. During each time point, the anesthetized dogs received either a control (0.9% sodium chloride) or a dopamine treatment. For each time point, measurements were carried out over 2 days. An MRI scan at 3 T was performed on day one, followed by CEUS on day two.ResultsUsing the model-free model with caudal placement of the arterial input function (AIF) region of interest (ROI) in the aorta, the DCE results showed a significant correlation with ASL measured RBF and detected significant changes in blood flow during dopamine infusion. Additionally, R2* negatively correlated with ASL measured RBF at the cortex and medulla, as well as with medullary wash-in rate (WiR) and peak intensity (PI). ASL measured RBF, in its turn, showed a positive correlation with cortical WiR, PI, area under the curve (AUC) and fall time (FT), and with medullary WiR and PI, but a negative correlation with medullary rise time (RT). During dopamine infusion, BOLD-MRI observed a significant decrease in R2* at the medulla and entire kidney, while ASL-MRI demonstrated a significant increase in RBF at the cortex, medulla and the entire kidney.ConclusionASL- and BOLD-MRI can measure pharmacologically induced changes in renal blood flow and renal oxygenation in dogs and might allow detection of changes that cannot be observed with CEUS. However, further research is needed to confirm the potential of ASL- and BOLD-MRI in dogs and to clarify which analysis method is most suitable for DCE-MRI in dogs.
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Affiliation(s)
- Amber Hillaert
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luis Carlos Sanmiguel Serpa
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stephanie Bogaert
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
| | - Bart J. G. Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Myriam Hesta
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Eva Vandermeulen
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jolien Germonpré
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Emmelie Stock
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pim Pullens
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
- Institute of Biomedical Engineering and Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Hillaert A, Sanmiguel Serpa LC, Xu Y, Hesta M, Bogaert S, Vanderperren K, Pullens P. Optimization of Fair Arterial Spin Labeling Magnetic Resonance Imaging (ASL-MRI) for Renal Perfusion Quantification in Dogs: Pilot Study. Animals (Basel) 2024; 14:1810. [PMID: 38929429 PMCID: PMC11201026 DOI: 10.3390/ani14121810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Arterial spin labeling (ASL) MRI allows non-invasive quantification of renal blood flow (RBF) and shows great potential for renal assessment. To our knowledge, renal ASL-MRI has not previously been performed in dogs. The aim of this pilot study was to determine parameters essential for ALS-MRI-based quantification of RBF in dogs: T1, blood (longitudinal relaxation time), λ (blood tissue partition coefficient) and TI (inversion time). A Beagle was scanned at 3T with a multi-TI ASL sequence, with TIs ranging from 250 to 2500 ms, to determine the optimal TI value. The T1 of blood for dogs was determined by scanning a blood sample with a 2D IR TSE sequence. The water content of the dog's kidney was determined by analyzing kidney samples from four dogs with a moisture analyzer and was subsequently used to calculate λ. The optimal TI and the measured values for T1,blood, and λ were 2000 ms, 1463 ms and 0.91 mL/g, respectively. These optimized parameters for dogs resulted in lower RBF values than those obtained from inline generated RBF maps. In conclusion, this study determined preliminary parameters essential for ALS-MRI-based RBF quantification in dogs. Further research is needed to confirm these values, but it may help guide future research.
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Affiliation(s)
- Amber Hillaert
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Luis Carlos Sanmiguel Serpa
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Yangfeng Xu
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Myriam Hesta
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Stephanie Bogaert
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Pim Pullens
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
- Institute of Biomedical Engineering and Technology (IBiTech)—MEDISP, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
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Tong X, He H, Ning Z, Shen R, Du C, Zeng X, Wang Q, He ZX, Xu D, Zhao X. Characterization of kidneys in patients with systemic sclerosis by multi-parametric magnetic resonance quantitative imaging. Magn Reson Imaging 2024; 109:203-210. [PMID: 38513788 DOI: 10.1016/j.mri.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/09/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To determine the usefulness of multiparametric magnetic resonance (MR) quantitative imaging in characterizing the kidneys in systemic sclerosis (SSc) patients. MATERIAL AND METHODS Forty-six SSc patients (47.9 ± 12.8 years, 40 females) and 22 age- and sex- matched healthy volunteers (46.1 ± 13.8 years, 20 females) were recruited and underwent renal MR imaging by acquiring blood oxygen level dependent and saturated multi-delay renal arterial spin labeling (SAMURAI) sequences. The T2* value, T1 value, renal blood flow (RBF), arterial bolus arrival time (aBAT), and tissue bolus arrival time (tBAT) of renal cortex were measured and compared among diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc (lcSSc) groups and healthy controls using One-way ANOVA and analyzed by logistic regression. RESULTS Compared to healthy volunteers, SSc patients with normal estimated glomerular filtration rate (n = 40) had significantly lower T2* value (P = 0.026) in the left renal cortex, longer T1 value (right: P = 0.015; left: P = 0.023), lower RBF (right: P < 0.001; left: P < 0.001), and shorter tBAT (right: P < 0.001; left: P = 0.005) in both right and left renal cortex after adjusting for demographics. The dcSSc patients (n = 23) had significantly lower RBF in both right (226.7 ± 65.2 mL/100 g/min vs. 278.2 ± 73.5 mL/100 g/min, P = 0.022) and left (194.5 ± 71.5 mL/100 g/min vs. 252.7 ± 84.4 mL/100 g/min, P = 0.020) renal cortex compared to the lcSSc patients (n = 23) after adjusting for demographics, but the significance of the difference was attenuated after further adjusting for modified Rodnan skin score and digital ulcers. CONCLUSION Multi-parametric MR quantitative imaging, particularly multi-delay ASL perfusion imaging, is a useful technique for characterizing the kidneys and classification of SSc patients.
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Affiliation(s)
- Xinyu Tong
- Department of Nuclear Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Huilin He
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Zihan Ning
- Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Rui Shen
- Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Chenlin Du
- Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Qian Wang
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
| | - Zuo-Xiang He
- Department of Nuclear Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
| | - Dong Xu
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China.
| | - Xihai Zhao
- Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China.
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Farg HM, El-Diasty T, Ali-El-Dein B, Refaie A, Abou El-Ghar M. Functional MRI evaluation of blood oxygen dependent (BOLD) in renal allograft dysfunction: a prospective study. Acta Radiol 2024; 65:397-405. [PMID: 38146146 DOI: 10.1177/02841851231217052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND Blood oxygen level dependent-magnetic resonance imaging (BOLD-MRI) is a non-invasive functional imaging technique that can be used to assess renal allograft dysfunction. PURPOSE To evaluate the diagnostic performance of BOLD-MRI using a 3-T scanner in discriminating causes of renal allograft dysfunction in the post-transplant period. MATERIAL AND METHODS This prospective study was conducted on 112 live donor-renal allograft recipients: 53 with normal graft function, as controls; 18 with biopsy-proven acute rejection (AR); and 41 with biopsy-proven acute tubular necrosis (ATN). Multiple fast-field echo sequences were performed to obtain T2*-weighted images. Cortical R2* (CR2*) level, medullary R2* (MR2*) level, and medullary over cortical R2* ratio (MCR) were measured in all participants. RESULTS The mean MR2* level was significantly lower in the AR group (20.8 ± 2.8/s) compared to the normal group (24 ± 2.4/s, P <0.001) and ATN group (27.4 ± 1.7/s, P <0.001). The MCR was higher in ATN group (1.47 ± 0.18) compared to the AR group (1.18 ± 0.17) and normal functioning group (1.34 ± 0.2). Both MR2* (area under the curve [AUC] = 0.837, P <0.001) and MCR (AUC = 0.727, P = 0.003) can accurately discriminate ATN from AR, however CR2* (AUC = 0.590, P = 0.237) showed no significant difference between both groups. CONCLUSION In early post-transplant renal dysfunction, BOLD-MRI is a valuable non-invasive diagnostic technique that can differentiate between AR and ATN by measuring changes in intra-renal tissue oxygenation.
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Affiliation(s)
- Hashim Mohamed Farg
- Radiology Department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Tarek El-Diasty
- Radiology Department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Bedeir Ali-El-Dein
- Urology Department, Urology and Nephrology Center, Mansoura University, Egypt
| | - Ayman Refaie
- Nephrology Department, Urology and Nephrology Center, Mansoura University, Egypt
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He K, Wan D, Li S, Yuan G, Gao M, Han Y, Li Z, Hu D, Meng X, Niu Y. Non-contrast-enhanced magnetic resonance urography for measuring split kidney function in pediatric patients with hydronephrosis: comparison with renal scintigraphy. Pediatr Nephrol 2024; 39:1447-1457. [PMID: 38041747 DOI: 10.1007/s00467-023-06224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Split kidney function (SKF) is critical for treatment decision in pediatric patients with hydronephrosis and is commonly measured using renal scintigraphy (RS). Non-contrast-enhanced magnetic resonance urography (NCE-MRU) is increasingly used in clinical practice. This study aimed to investigate the feasibility of using NCE-MRU as an alternative to estimate SKF in pediatric patients with hydronephrosis, compared to RS. METHODS Seventy-five pediatric patients with hydronephrosis were included in this retrospective study. All patients underwent NCE-MRU and RS within 2 weeks. Kidney parenchyma volume (KPV) and texture analysis parameters were obtained from T2-weighted (T2WI) in NCE-MRU. The calculated split KPV (SKPV) percent and texture analysis parameters percent of left kidney were compared with the RS-determined SKF. RESULTS SKPV showed a significant positive correlation with SKF (r = 0.88, p < 0.001), while inhomogeneity was negatively correlated with SKF (r = - 0.68, p < 0.001). The uncorrected and corrected prediction models of SKF were established using simple and multiple linear regression. Bland-Altman plots demonstrated good agreement of both predictive models. The residual sum of squares of the corrected prediction model was lower than that of the uncorrected model (0.283 vs. 0.314) but not statistically significant (p = 0.662). Subgroup analysis based on different MR machines showed correlation coefficients of 0.85, 0.95, and 0.94 between SKF and SKPV for three different scanners, respectively (p < 0.05 for all). CONCLUSIONS NCE-MRU can be used as an alternative method for estimating SKF in pediatric patients with hydronephrosis when comparing with RS. Specifically, SKPV proves to be a simple and universally applicable indicator for predicting SKF.
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Affiliation(s)
- Kangwen He
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dongyi Wan
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shichao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guanjie Yuan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mengmeng Gao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yunfeng Han
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yonghua Niu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Liu J, Wang R, Qiu J, Su T. Investigation of renal perfusion and pathological changes in patients with acute kidney disease and tubulointerstitial nephritis using intravoxel incoherent motion and arterial spin labelling MRI: a prospective, observational study protocol. BMJ Open 2024; 14:e076488. [PMID: 38531564 DOI: 10.1136/bmjopen-2023-076488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Acute kidney injury (AKI) is a critical condition with a complex aetiology and different outcomes, where haemodynamic dysfunction, renal hypoperfusion and inflammation serve as key contributors to its development and progression. Early and accurate diagnosis is vital for initiating targeted treatments like fluid resuscitation, vasoactive agents or steroid therapy, which are essential for improving patient outcomes. Intravoxel incoherent motion (IVIM) MRI assesses both capillary perfusion and tissue water diffusion, while arterial spin labelling (ASL) MRI measures renal blood flow without the need for contrast. Research on combined use of IVIM and ASL MRI in patients with AKI is rare. This study aims to investigate the MRI characteristics of IVIM and ASL in patients with tubulointerstitial nephritis (TIN) and to explore their relationship with pathological findings and renal recovery. METHODS AND ANALYSIS Single-centre, prospective, observational cohort study of 30 patients with biopsy-proven TIN. Participants will undergo renal IVIM and ASL MRI within 7 days post-biopsy. The pathological assessments of active and chronic tubulointerstitial injuries will be semiscored using modified Banff criteria. The estimated glomerular filtration rate (eGFR) during follow-up and prevalence of chronic kidney disease at 3 and 6 months will be reported. An eGFR below 45 mL/min is considered a poor renal outcome. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Ethics Committee of Peking University First Hospital and written informed consent will be obtained from all participants (2022Y503). The study results will be disseminated through publication in a relevant peer-reviewed journal and presentation at academic meetings to increase awareness and share findings with the scientific community.
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Affiliation(s)
- Jiajia Liu
- Peking University First Hospital, Beijing, China
- Department of Nephrology, Peking University First Hospital, Beijing, China
| | - Rui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Jianxing Qiu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Tao Su
- Peking University First Hospital, Beijing, China
- Department of Nephrology, Peking University First Hospital, Beijing, China
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Zou Q, Chen X, Li B, Zhang R, Pan J, Zhang X, Zhang X, Sun SK. Bioinspired BSA@polydopamine@Fe Nanoprobe with Self-Purification Capacity for Targeted Magnetic Resonance Imaging of Acute Kidney Injury. ACS NANO 2024; 18:4783-4795. [PMID: 38301134 DOI: 10.1021/acsnano.3c09193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Contrast-enhanced magnetic resonance imaging (CE-MRI) of acute kidney injury (AKI) is severely hindered by the poor targeting capacity and potential toxicity of current contrast agents. Herein, we propose one-step fabrication of a bovine serum albumin@polydopamine@Fe (BSA@PDA@Fe, BPFe) nanoprobe with self-purification capacity for targeted CE-MRI of AKI. BSA endows the BPFe nanoprobe with renal tubule-targeting ability, and PDA is capable of completely inhibiting the intrinsic metal-induced reactive oxygen species (ROS), which are always involved in Fe/Mn-based agents. The as-prepared nanoprobe owns a tiny size of 2.7 nm, excellent solubility, good T1 MRI ability, superior biocompatibility, and powerful antioxidant capacity. In vivo CE-MRI shows that the BPFe nanoprobe can accumulate in the renal cortex due to the reabsorption effect toward the serum albumin. In the AKI model, impaired renal reabsorption function can be effortlessly detected via the diminishment of renal cortical signal enhancement. More importantly, the administration of the BPFe nanoprobe would not aggravate renal damage of AKI due to the outstanding self-purification capacity. Besides, the BPFe nanoprobe is employed for CE-MR angiography to visualize fine vessel structures. This work provides an MRI contrast agent with good biosafety and targeting ability for CE-MRI of kidney diseases.
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Affiliation(s)
- Quan Zou
- School of Medical Imaging, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300203, China
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Xi Chen
- School of Medical Imaging, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300203, China
| | - Bingjie Li
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ruijie Zhang
- School of Medical Imaging, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300203, China
| | - Jinbin Pan
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xuejun Zhang
- School of Medical Imaging, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300203, China
| | - Xuening Zhang
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Shao-Kai Sun
- School of Medical Imaging, Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin 300203, China
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Rasmussen CW, Bøgh N, Bech SK, Thorsen TH, Hansen ESS, Bertelsen LB, Laustsen C. Fibrosis imaging with multiparametric proton and sodium MRI in pig injury models. NMR IN BIOMEDICINE 2023; 36:e4838. [PMID: 36151711 PMCID: PMC10078455 DOI: 10.1002/nbm.4838] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
Chronic kidney disease (CKD) is common and has huge implications for health and mortality. It is aggravated by intrarenal fibrosis, but the assessment of fibrosis is limited to kidney biopsies, which carry a risk of complications and sampling errors. This calls for a noninvasive modality for diagnosing and staging intrarenal fibrosis. The current, exploratory study evaluates a multiparametric MRI protocol including sodium imaging (23 Na-MRI) to determine the opportunities within this modality to assess kidney injury as a surrogate endpoint of fibrosis. The study includes 43 pigs exposed to ischemia-reperfusion injury (IRI) or unilateral ureteral obstruction (UUO), or serving as healthy controls. Fibrosis was determined using gene expression analysis of collagen. The medulla/cortex ratio of 23 Na-MRI decreased in the injured kidney in the IRI pigs, but not in the UUO pigs (p = 0.0180, p = 0.0754). To assess the combination of MRI parameters in estimating fibrosis, we created a linear regression model consisting of the cortical apparent diffusion coefficient, ΔR2*, ΔT1, the 23 Na medulla/cortex ratio, and plasma creatinine (R2 = 0.8009, p = 0.0117). The 23 Na medulla/cortex ratio only slightly improved the fibrosis prediction model, leaving 23 Na-MRI in an ambiguous place for evaluation of intrarenal fibrosis. Use of multiparametric MRI in combination with plasma creatinine shows potential for the estimation of fibrosis in human kidney disease, but more translational and clinical work is warranted before MRI can contribute to earlier diagnosis and evaluation of treatment for acute kidney injury and CKD.
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Affiliation(s)
- Camilla W. Rasmussen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Sabrina K. Bech
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Thomas H. Thorsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Esben S. S. Hansen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Lotte B. Bertelsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Wang H, An X, Lu Y, Ling W, Peng Y. Quantitative assessment of renal damage in rhesus monkeys with diabetic nephropathy using contrast-enhanced ultrasound. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:308. [PMID: 35434018 PMCID: PMC9011263 DOI: 10.21037/atm-22-946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023]
Abstract
Background Diabetic nephropathy (DN) is a common chronic microvascular complication of diabetes. Noninvasive diagnosis of DN is difficult. Contrast-enhanced ultrasound (CEUS), as a functional imaging method, provides noninvasive real-time images and quantitative assessment of renal microvascular perfusion. This study investigated the efficacy of CEUS in discriminating between DN and normal kidneys in rhesus monkeys. Methods A total of 12 male rhesus monkeys (DN model group, n=6; normal control group, n=6) were included in this study. The following parameters were evaluated: (I) blood biochemistry; (II) CEUS; and (III) ultrasound-guided renal biopsy. Results Pathological and biochemical results showed that all subjects in the lesion group had serious renal damage. There were significant differences in the CEUS parameters, including the area under the curve, the time from peak to one half, and peak intensity between the lesion group and the normal group. The time to peak was slightly delayed in the lesion group. There was no significant difference in the rise time between the two groups. Conclusions Although the precise CEUS parameters that may best predict renal damage still require systematic evaluation, the results of these animal studies suggest that CEUS may be used as a supplemental tool in diagnosing renal damage in rhesus monkeys with DN. We hope these findings can provide insights for the application of CEUS in DN.
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Affiliation(s)
- Hong Wang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Xingxing An
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital of Sichuan University, Chengdu, China
| | - Yanrong Lu
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital of Sichuan University, Chengdu, China
| | - Wenwu Ling
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Yulan Peng
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
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Makvandi K, Hockings PD, Jensen G, Unnerstall T, Leonhardt H, Jarl LV, Englund C, Francis S, Sundgren AK, Hulthe J, Baid-Agrawal S. Multiparametric Magnetic Resonance Imaging Allows Non-Invasive Functional and Structural Evaluation of Diabetic Kidney Disease. Clin Kidney J 2022; 15:1387-1402. [PMID: 35756740 PMCID: PMC9217657 DOI: 10.1093/ckj/sfac054] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 11/15/2022] Open
Abstract
Background We sought to develop a novel non-contrast multiparametric MRI (mpMRI) protocol employing several complementary techniques in a single scan session for a comprehensive functional and structural evaluation of diabetic kidney disease (DKD). Methods In the cross-sectional part of this prospective observational study, 38 subjects ages 18‒79 years with type 2 diabetes and DKD [estimated glomerular filtration rate (eGFR) 15‒60 mL/min/1.73 m2] and 20 age- and gender-matched healthy volunteers (HVs) underwent mpMRI. Repeat mpMRI was performed on 23 DKD subjects and 10 HVs. By measured GFR (mGFR), 2 DKD subjects had GFR stage G2, 16 stage G3 and 20 stage G4/G5. A wide range of MRI biomarkers associated with kidney haemodynamics, oxygenation and macro/microstructure were evaluated. Their optimal sensitivity, specificity and repeatability to differentiate diabetic versus healthy kidneys and categorize various stages of disease as well as their correlation with mGFR/albuminuria was assessed. Results Several MRI biomarkers differentiated diabetic from healthy kidneys and distinct GFR stages (G3 versus G4/G5); mean arterial flow (MAF) was the strongest predictor (sensitivity 0.94 and 1.0, specificity 1.00 and 0.69; P = .04 and .004, respectively). Parameters significantly correlating with mGFR were specific measures of kidney haemodynamics, oxygenation, microstructure and macrostructure, with MAF being the strongest univariate predictor (r = 0.92; P < .0001). Conclusions A comprehensive and repeatable non-contrast mpMRI protocol was developed that, as a single, non-invasive tool, allows functional and structural assessment of DKD, which has the potential to provide valuable insights into underlying pathophysiology, disease progression and analysis of efficacy/mode of action of therapeutic interventions in DKD.
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Affiliation(s)
- Kianoush Makvandi
- Department of Molecular and Clinical Medicine/Nephrology, The Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Paul D Hockings
- Antaros Medical, Molndal, Sweden
- MedTech West, Chalmers University of Technology, Gothenburg, Sweden
| | - Gert Jensen
- Department of Molecular and Clinical Medicine/Nephrology, The Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Tim Unnerstall
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Henrik Leonhardt
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Susan Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Anna K Sundgren
- Late-Stage Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | | | - Seema Baid-Agrawal
- Department of Molecular and Clinical Medicine/Nephrology, The Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
- Transplant Center, Sahlgrenska University Hospital, Gothenburg, Sweden
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11
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Kim SY, Kim H, Lee J, Jung SI, Moon MH, Joo KW, Cho JY. Quantitative magnetic resonance imaging of chronic kidney disease: an experimental in vivo study using rat chronic kidney disease models. Acta Radiol 2021; 64:404-414. [PMID: 34928730 DOI: 10.1177/02841851211065143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent advances in magnetic resonance imaging (MRI) may allow it to be an alternative emerging tool for the non-invasive evaluation of renal parenchymal disease. PURPOSE To validate the usefulness of quantitative multiparametric MRI protocols and suggest the suitable quantitative MR sequence protocol to evaluate parenchymal fibrosis using an animal model of chronic kidney disease (CKD) by long-term adenine intake. MATERIAL AND METHODS In this prospective animal study, 16 male Wistar rats were analyzed and categorized into three groups. Rats in the CKD groups underwent 0.25% adenine administration for three or six weeks. Quantitative MRI protocols, including diffusion-weighted imaging (DWI), T1ρ (T1 rho), and T2* mapping were performed using a 9.4-T animal MR scanner. A semi-quantitative histopathologic analysis for renal fibrosis was conducted. Quantitative MR values measured from anatomic regions of kidneys underwent intergroup comparative analyses. RESULTS The apparent diffusion coefficient (ADC) and T1 (T1 rho) values were significantly increased in all CKD groups. Values measured from the cortex and outer medulla showed significant intergroup differences. Total ADC values tended to increase according to periods, and T1ρ values increased in three weeks and decreased in six weeks. CONCLUSION Quantitative MRI protocols could be a non-invasive assessment modality in the diagnosis and evaluation of CKD. Particularly, T1ρ may be a suitable MR sequence to quantitatively assess renal parenchymal fibrosis.
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Affiliation(s)
- Sang Youn Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Radiation Medicine and Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyeonjin Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Radiation Medicine and Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Joongyub Lee
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Il Jung
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Min Hoan Moon
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeong Yeon Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Radiation Medicine and Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
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12
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Bane O, Said D, Weiss A, Stocker D, Kennedy P, Hectors SJ, Khaim R, Salem F, Delaney V, Menon MC, Markl M, Lewis S, Taouli B. 4D flow MRI for the assessment of renal transplant dysfunction: initial results. Eur Radiol 2020; 31:909-919. [PMID: 32870395 DOI: 10.1007/s00330-020-07208-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/07/2020] [Accepted: 08/19/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES (1) Determine inter-observer reproducibility and test-retest repeatability of 4D flow parameters in renal allograft vessels; (2) determine if 4D flow measurements in the renal artery (RA) and renal vein (RV) can distinguish between functional and dysfunctional allografts; (3) correlate haemodynamic parameters with estimated glomerular filtration rate (eGFR), perfusion measured with dynamic contrast-enhanced MRI (DCE-MRI) and histopathology. METHODS Twenty-five prospectively recruited renal transplant patients (stable function/chronic renal allograft dysfunction, 12/13) underwent 4D flow MRI at 1.5 T. 4D flow coronal oblique acquisitions were performed in the transplant renal artery (RA) (velocity encoding parameter, VENC = 120 cm/s) and renal vein (RV) (VENC = 45 cm/s). Test-retest repeatability (n = 3) and inter-observer reproducibility (n = 10) were assessed by Cohen's kappa, coefficient of variation (CoV) and Bland-Altman statistics. Haemodynamic parameters were compared between patients and correlated to the estimated glomerular filtration rate, DCE-MRI parameters (n = 10) and histopathology from allograft biopsies (n = 15). RESULTS For inter-observer reproducibility, kappa was > 0.99 and 0.62 and CoV of flow was 12.6% and 7.8% for RA and RV, respectively. For test-retest repeatability, kappa was > 0.99 and 0.5 and CoV of flow was 27.3% and 59.4%, for RA and RV, respectively. RA (p = 0.039) and RV (p = 0.019) flow were both significantly reduced in dysfunctional allografts. Both identified chronic allograft dysfunction with good diagnostic performance (RA: AUC = 0.76, p = 0.036; RV: AUC = 0.8, p = 0.018). RA flow correlated negatively with histopathologic interstitial fibrosis score ci (ρ = - 0.6, p = 0.03). CONCLUSIONS 4D flow parameters had better repeatability in the RA than in the RV. RA and RV flow can identify chronic renal allograft dysfunction, with RA flow correlating with histopathologic interstitial fibrosis score. KEY POINTS • Inter-observer reproducibility of 4D flow measurements was acceptable in both the transplant renal artery and vein, but test-retest repeatability was better in the renal artery than in the renal vein. • Blood flow measurements obtained with 4D flow MRI in the renal artery and renal vein are significantly reduced in dysfunctional renal transplants. • Renal transplant artery flow correlated negatively with histopathologic interstitial fibrosis score.
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Affiliation(s)
- Octavia Bane
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Daniela Said
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Amanda Weiss
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Daniel Stocker
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Paul Kennedy
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Stefanie J Hectors
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA.,Department of Radiology, Weill Cornell Medicine, New York, New York, NY, USA
| | - Rafael Khaim
- Division of Renal Medicine, Recanati Miller Transplantation Institute, ISMMS, New York, NY, USA
| | - Fadi Salem
- Department of Pathology, ISMMS, New York, NY, USA
| | - Veronica Delaney
- Division of Renal Medicine, Recanati Miller Transplantation Institute, ISMMS, New York, NY, USA
| | - Madhav C Menon
- Division of Renal Medicine, Recanati Miller Transplantation Institute, ISMMS, New York, NY, USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Sara Lewis
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA
| | - Bachir Taouli
- Department of Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA. .,BioMedical Engineering and Imaging Institute, ISMMS, New York, NY, USA.
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13
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Pan L, Chen J, Zha T, Zou L, Zhang J, Jin P, Luo J, Xing W. Evaluation of renal ischemia-reperfusion injury by magnetic resonance imaging texture analysis: An experimental study. Magn Reson Med 2020; 85:346-356. [PMID: 32726485 DOI: 10.1002/mrm.28403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To explore the value of MRI texture analysis in evaluating the presence and severity of early renal ischemia-reperfusion injury (IRI). METHODS Healthy New Zealand rabbits were used (IRI group, N = 54; control group, N = 8). Rabbits in the IRI group underwent left renal artery clamping for 60 minutes. Magnetic resonance imaging was performed before and at 1, 12, 24, and 48 hours after IRI. The relationship between MRI texture features and histopathology parameters was assessed using Pearson's correlation coefficients. The diagnostic performance of texture features in kidney differentiation at different time points was assessed by receiver operating characteristic curve analysis. RESULTS T2 WI_S(3,-3)Inverse_Difference_Moment had the strongest correlation with brush border destruction, tubular epithelial edema, necrosis, and cast (r = 0.56, -0.58, 0.62, and 0.69, respectively; all P < .001). BOLD_S(4,-4)Correlation had the strongest correlation with interstitial inflammatory cell infiltration (r = 0.63, P < .001). SWI_S(4,4)Difference_Entropy had the strongest correlation with microvessel density (r = 0.61, P < .001). The areas under the curve for T2 WI_S(3,-3)Inverse_Difference_Moment, SWI_S(4,4)Difference_Entropy, and BOLD_S(4,-4)Correlation in kidney differentiation before IRI and that at 1 and 12 hours after reperfusion were 0.76, 0.72, and 0.70, respectively; the values before IRI and at 24 and 48 hours after reperfusion were 0.84, 0.81, and 0.69, respectively. The area under the curve for T2 WI_S(3,-3)Inverse_Difference_Moment in kidney differentiation at 1 and 12 hours after reperfusion and that at 24 and 48 hours after reperfusion was 0.66. CONCLUSION Magnetic resonance imaging texture analysis can be used for evaluating the presence and severity of early renal IRI.
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Affiliation(s)
- Liang Pan
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jie Chen
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Tingting Zha
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Liqiu Zou
- Department of Radiology, Sixth Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jinggang Zhang
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Peijie Jin
- Department of Public Health, Nanjing Medical University, Nanjing, China
| | - Jiao Luo
- Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangzhou Huayin Health Technology Co., Ltd., Guangzhou, China
| | - Wei Xing
- Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China
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14
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Hu G, Liang W, Wu M, Lai C, Mei Y, Li Y, Xu J, Luo L, Quan X. Comparison of T1 Mapping and T1rho Values with Conventional Diffusion-weighted Imaging to Assess Fibrosis in a Rat Model of Unilateral Ureteral Obstruction. Acad Radiol 2019; 26:22-29. [PMID: 29705280 DOI: 10.1016/j.acra.2018.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/14/2018] [Accepted: 03/19/2018] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to investigate the potential of magnetic resonance imaging (MRI) T1 mapping and T1 relaxation time in the rotating frame (T1rho) for assessment of renal fibrosis in a rat model of unilateral ureteral obstruction (UUO). MATERIALS AND METHODS UUO was created in 36 rats. Six rats were scanned at each of the six time points (on days 0, 1, 3, 5, 10, and 15 after UUO). The contralateral kidneys were examined as controls. Hematoxylin-eosin, Masson's trichrome, and alpha-smooth muscle actin (α-SMA) antibody staining assays were performed. MRI data obtained with a 3.0T scanner were analyzed with α-SMA expression and Masson's staining. RESULTS The T1 relaxation times and T1rho values increased, and the mean apparent diffusion coefficient (ADC) values decreased with time after UUO. Simple regression analysis indicated that the mean ADCs, T1 relaxation times, and T1rho values had strong correlations with the α-SMA expression levels (R2 = 0.34, R2 = 0.66, R2 = 0.71, respectively; P< .001) and positive Masson's staining (R2 = 0.38, R2 = 0.67, R2 = 0.65, respectively; P< .001). CONCLUSIONS The T1 mapping and T1rho parameters had better correlations with α-SMA expression and Masson's staining than ADC values.
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15
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Hu G, Yang Z, Liang W, Lai C, Mei Y, Li Y, Xu J, Luo L, Quan X. Intravoxel Incoherent Motion and Arterial Spin Labeling MRI Analysis of Reversible Unilateral Ureteral Obstruction in Rats. J Magn Reson Imaging 2018; 50:288-296. [PMID: 30328247 DOI: 10.1002/jmri.26536] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Renal fibrosis is a common consequence of chronic kidney disease (CKD) and is the mechanism by which various forms of CKD progress to endstage renal failure. Accurate assessment of renal fibrosis is important for treatment. PURPOSE To measure longitudinal changes of intravoxel incoherent motion (IVIM) and arterial spin labeling (ASL) before and after reversible unilateral ureteral obstruction in an animal model. STUDY TYPE Self-controlled animal study. ANIMAL MODEL Surgical obstruction of the ureters was performed and then removed after 5 days. Rats were scanned on Days 0, 1, 3, and 5 after creating the obstruction and on Days 4, 7, and 12 after releasing the obstruction. FIELD STRENGTH/SEQUENCE 3.0T/IVIM/ASL. ASSESSMENT The apparent diffusion coefficient (ADC), pure molecular diffusion (D), perfusion fraction (f), pseudodiffusion (D*), and renal blood flow (RBF) obtained from the ASL were measured. STATISTICAL TESTS Using SPSS v. 20.0 software, P < 0.05 were considered statistically significant. The data from each timepoint were compared using one-way analysis of variance and correlation analysis was applied to various parameters. RESULTS The postobstruction kidneys showed renal tubule swelling and increased collagen fiber content. Renal tubule swelling was relieved after reversing the obstruction, but Masson staining and cell density analysis revealed progressive changes that were primarily localized to the medulla. In general, ADC, D, f, D*, and RBF decreased with time during the 5 days of obstruction, and increased after release of the obstruction. ADC positively correlated with D, f, D*, and RBF (r = 0.415, r = 0.634, r = 0.465 r = 0.586, P < 0.001, respectively) in the cortex in this study. Also, ADC showed a positive correlation with D, f, and D* (r = 0.724, r = 0.749, r = 0.151, P < 0.001, respectively) in the medulla. DATA CONCLUSION Kidney perfusion was the major factor affecting ADC. Functional imaging may be useful for following progression of CKD. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:288-296.
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Affiliation(s)
- Genwen Hu
- Department of Radiology, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University), Shenzhen, P.R. China
| | - Zhong Yang
- Department of Radiology, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University), Shenzhen, P.R. China
| | - Wen Liang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Caiyong Lai
- Department of Urology, First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Yingjie Mei
- MR Clinical Science, Philips Healthcare, GuangZhou, P.R. China
| | - Yufa Li
- Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Jianmin Xu
- Department of Radiology, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University), Shenzhen, P.R. China
| | - Liangping Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Xianyue Quan
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, P.R. China
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16
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Abstract
PURPOSE OF REVIEW In this article, we describe the basics of how magnetic resonance urography (MRU) is performed in the pediatric population as well as the common indications and relative performance compared to standard imaging modalities. RECENT FINDINGS Although MRU is still largely performed in major academic or specialty imaging centers, more and more applications in the pediatric setting have been described in the literature. MRU is a comprehensive imaging modality for evaluating multiple pediatric urologic conditions combining excellent anatomic detail with functional information previously only available via renal scintigraphy. While generally still reserved for problem solving, MRU should be considered for some conditions as an early imaging technique.
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17
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Intravoxel incoherent motion MRI-derived parameters and T2* relaxation time for noninvasive assessment of renal fibrosis: An experimental study in a rabbit model of unilateral ureter obstruction. Magn Reson Imaging 2018; 51:104-112. [DOI: 10.1016/j.mri.2018.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/29/2018] [Accepted: 04/29/2018] [Indexed: 12/20/2022]
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18
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Sławińska A, Serafin Z, Zawada E, Białecki M, Wypych K, Woderska A, Słupski M, Włodarczyk Z. Noninvasive evaluation of renal tissue oxygenation with blood oxygen level-dependent magnetic resonance imaging early after transplantation has a limited predictive value for the delayed graft function. Pol J Radiol 2018; 83:e389-e393. [PMID: 30655915 PMCID: PMC6334089 DOI: 10.5114/pjr.2018.78622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the feasibility of renal oxygenation assessment using blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) in the early period after kidney transplantation and to estimate its prognostic value for delayed graft function. MATERIAL AND METHODS Examinations were performed in 50 subjects: 40 patients within a week after the kidney transplantation and 10 healthy controls, using T2*-weighted sequence. Measurements in transplant patients were correlated to basic laboratory parameters in the early period after transplantation and at follow-up. RESULTS Examinations of seven patients (18%) were rejected due to their poor technical quality. Mean R2* values in transplant recipients were lower than in controls (11.6 vs. 15.9 Hz; p = 0.0001). An R2* value of 0.28 Hz was calculated as the minimal detectable change. There was no relation between R2* values and laboratory parameters. However, patients eGFR ≥ 40 ml/min/1.73 m2 presented higher R2* values than recipients eGFR < 40 ml/min/1.73 m2 (12.0 vs. 11.1 Hz; p = 0.0189). In ROC analysis R2* of ≤ 11.7 predicted an early reduced graft function with 0.82 sensitivity and 56% specificity (AUC = 0.708; p = 0.024) but was not useful for delayed graft function prediction (p > 0.7). CONCLUSIONS Evaluation of renal graft oxygenation using BOLD MRI is technically challenging in the early period after transplantation. An R2* value of 0.28 Hz may in practice be considered as the minimal detectable change. The delayed graft function seems not to be dependent on early oxygenation values. Further, large-scale studies are necessary to confirm the latter observation.
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Affiliation(s)
- Agata Sławińska
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Elżbieta Zawada
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Marcin Białecki
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Katarzyna Wypych
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Aleksandra Woderska
- Department of General and Transplant Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Maciej Słupski
- Department of Hepatobiliary and General Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Zbigniew Włodarczyk
- Department of General and Transplant Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
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Zhang JG, Xing ZY, Zha TT, Tian XJ, Du YN, Chen J, Xing W. Longitudinal assessment of rabbit renal fibrosis induced by unilateral ureteral obstruction using two-dimensional susceptibility weighted imaging. J Magn Reson Imaging 2017; 47:1572-1577. [PMID: 29236342 DOI: 10.1002/jmri.25915] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies indicated that two-dimensional-susceptibility weighted imaging (2D-SWI) could serve as a useful biomarker for differentiating the grade of liver fibrosis. PURPOSE To evaluate the feasibility of 2D-SWI in the dynamic quantification of renal fibrosis in a rabbit model. STUDY TYPE Longitudinal study. ANIMAL MODEL Twenty-Four New Zealand White Rabbits including control group (n = 4); and renal fibrosis group (n = 20), by means of a unilateral ureteral obstruction (UUO) model. FIELD STRENGTH/SEQUENCE The 3.0 T SWI using a 2D gradient-echo sequence. ASSESSMENT The relative SWI signal ratio(r) of cortical and medulla (r = SIrenal /SImuscle ) was longitudinally assessed before ligation and on weeks 2, 4, 6, and 8 following ligation. Sirius Red staining was used to assess the degree of fibrosis in five high-power fields. STATISTICAL TESTS The repeated measures of analysis of variance and linear regression analysis. RESULTS Both the cortical and medullary r values were significantly higher in the UUO kidneys at week 2 compared with the kidneys before ligation. Over the course of UUO progression, significant changes occurred in the cortical and medullary r values in vivo and fibrosis scores in vitro (all P values < 0.05). The r values gradually decreased, while the fibrosis scores gradually increased over 8 weeks following ligation. The linear regression analysis showed a strong and significant correlation between cortical and medullary r values and the pathologic fibrosis scores (R2 = 0.91, 0.81, respectively). DATA CONCLUSION The SWI sequence could provide a quantitative evaluation of renal fibrosis during UUO progression. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1572-1577.
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Affiliation(s)
- Jing-Gang Zhang
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Zhao-Yu Xing
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ting-Ting Zha
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao-Juan Tian
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya-Nan Du
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jie Chen
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Wei Xing
- Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Kronik Böbrek Hastalığında Böbrek Fonksiyonlarının Difüzyon Ağırlıklı Manyetik Rezonans Görüntüleme ile Değerlendirilmesi. JOURNAL OF CONTEMPORARY MEDICINE 2017. [DOI: 10.16899/gopctd.359279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Fibrosis imaging: Current concepts and future directions. Adv Drug Deliv Rev 2017; 121:9-26. [PMID: 29108860 DOI: 10.1016/j.addr.2017.10.013] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 02/08/2023]
Abstract
Fibrosis plays an important role in many different pathologies. It results from tissue injury, chronic inflammation, autoimmune reactions and genetic alterations, and it is characterized by the excessive deposition of extracellular matrix components. Biopsies are routinely employed for fibrosis diagnosis, but they suffer from several drawbacks, including their invasive nature, sampling variability and limited spatial information. To overcome these limitations, multiple different imaging tools and technologies have been evaluated over the years, including X-ray imaging, computed tomography (CT), ultrasound (US), magnetic resonance imaging (MRI), positron emission tomography (PET) and single-photon emission computed tomography (SPECT). These modalities can provide anatomical, functional and molecular imaging information which is useful for fibrosis diagnosis and staging, and they may also hold potential for the longitudinal assessment of therapy responses. Here, we summarize the use of non-invasive imaging techniques for monitoring fibrosis in systemic autoimmune diseases, in parenchymal organs (such as liver, kidney, lung and heart), and in desmoplastic cancers. We also discuss how imaging biomarkers can be integrated in (pre-) clinical research to individualize and improve anti-fibrotic therapies.
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Translational science in chronic kidney disease. Clin Sci (Lond) 2017; 131:1617-1629. [PMID: 28667063 DOI: 10.1042/cs20160395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 12/16/2022]
Abstract
The KDIGO definition of chronic kidney disease (CKD) allowed a more detailed characterization of CKD causes, epidemiology and consequences. The picture that has emerged is worrisome from the point of view of translation. CKD was among the fastest growing causes of death in the past 20 years in age-adjusted terms. The gap between recent advances and the growing worldwide mortality appears to result from sequential roadblocks that limit the flow from basic research to clinical development (translational research type 1, T1), from clinical development to clinical practice (translational research T2) and result in deficient widespread worldwide implementation of already available medical advances (translational research T3). We now review recent advances and novel concepts that have the potential to change the practice of nephrology in order to improve the outcomes of the maximal number of individuals in the shortest possible interval. These include: (i) updating the CKD concept, shifting the emphasis to the identification, risk stratification and care of early CKD and redefining the concept of aging-associated 'physiological' decline of renal function; (ii) advances in the characterization of aetiological factors, including challenging the concept of hypertensive nephropathy, the better definition of the genetic contribution to CKD progression, assessing the role of the liquid biopsy in aetiological diagnosis and characterizing the role of drugs that may be applied to the earliest stages of injury, such as SGLT2 inhibitors in diabetic kidney disease (DKD); (iii) embracing the complexity of CKD as a network disease and (iv) exploring ways to optimize implementation of existing knowledge.
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Pan L, Chen J, Xing W, Xing Z, Zhang J, Peng Y, Zhang Z. Magnetic resonance imaging evaluation of renal ischaemia-reperfusion injury in a rabbit model. Exp Physiol 2017; 102:1000-1006. [PMID: 28470945 DOI: 10.1113/ep086203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 04/24/2017] [Indexed: 02/06/2023]
Abstract
NEW FINDINGS What is the central question of this study? Renal ischaemia-reperfusion injury occurs in various clinical settings. The clinical diagnosis of ischaemia-reperfusion injury is routinely based on biochemical and haematological tests, which cannot evaluate the function of a single kidney. New magnetic resonance imaging techniques to identify the pathophysiological changes in the renal outer medulla were evaluated. What is the main finding and its importance? This study demonstrated that susceptibility-weighted imaging is a feasible non-invasive tool for imaging and evaluating physipathological changes in the renal outer medulla after ischaemia-reperfusion injury. The aim was to evaluate the feasibility of susceptibility-weighted imaging (SWI) as a tool to identify the changes in the renal outer medulla (OM) in a rabbit model of renal ischaemia-reperfusion injury (IRI). New Zealand rabbits were used (control group n = 10; IRI group n = 40). The rabbits in the IRI group were subjected to left renal artery clamping for 60 min. T2-weighted (T2WI) and SWI examinations were performed at 1, 12, 24 or 48 h after reperfusion (each n = 10). After the examinations, the kidneys were submitted to histological evaluation. The contrast-to-noise ratio (CNR) for the left renal OM was measured using T2WI and SWI. The T2WI and SWI scores of the integrity of the renal OM were evaluated. There were significant differences between T2WI CNRs and SWI CNRs in the control group and the IRI 1, 12 and 48 h time points (all P < 0.05). No significant difference was found between T2WI and SWI CNRs at IRI 24 h (P > 0.05). The mean SWI scores of renal OM in the IRI 1 and 12 h subgroups were both significantly lower than that in the control group (all P < 0.05). The only significant difference in the mean T2WI scores of renal OM was observed between the control and IRI 1 h groups (P < 0.05). Susceptibility-weighted imaging has a significant advantage in evaluation of healthy renal OM over conventional magnetic resonance imaging, and it is a feasible non-invasive tool for imaging and evaluating changes in the renal OM after IRI.
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Affiliation(s)
- Liang Pan
- Department of Radiology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China
| | - Jie Chen
- Department of Radiology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China.,Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China
| | - Wei Xing
- Department of Radiology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China
| | - Zhaoyu Xing
- Department of Urology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China
| | - Jinggang Zhang
- Department of Radiology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China
| | - Yan Peng
- Department of Pathology, the Third Affiliated Hospital of Suzhou University, Changzhou, People's Republic of China
| | - Zhuoli Zhang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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