1
|
Yuan Q, Recchimuzzi DZ, Costa DN. Magnetic Resonance Perfusion Imaging of Prostate. Magn Reson Imaging Clin N Am 2024; 32:171-179. [PMID: 38007279 DOI: 10.1016/j.mric.2023.09.007] [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: 11/27/2023]
Abstract
Magnetic resonance (MR) perfusion imaging, both with and without exogenous contrast agents, has the potential to assess tissue perfusion and vascularity in prostate cancer. Dynamic contrast-enhanced (DCE) MRI is an important element of the clinical non-invasive multiparametric MRI, which can be used to differentiate benign from malignant lesions, to stage tumors, and to monitor response to therapy. The arterial spin labeled (ASL) and intravoxel incoherent motion (IVIM) diffusion-weighted MRI have the advantage of quantitative perfusion measurements without the concerns of gadolinium-based contrast agent safety and retention issues. The adoption of these non-contrast techniques in clinical practice needs more research and clinical evaluation.
Collapse
Affiliation(s)
- Qing Yuan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
| | - Debora Z Recchimuzzi
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Daniel N Costa
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Department of Urology, University of Texas Southwestern Medical Center, 2201 Inwood Road, TX 75390, USA
| |
Collapse
|
2
|
Xu L, Shao J, Li K, Wang C, Lai Z, Ma J, Yu X, Du F, Chen J, Liu X, Yuan J, Liu B, Wang C. Renal perfusion improvement in the perioperative period after unilateral endovascular revascularization in patients with atherosclerotic renal artery stenosis. Front Cardiovasc Med 2023; 10:1193864. [PMID: 37502187 PMCID: PMC10369776 DOI: 10.3389/fcvm.2023.1193864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/12/2023] [Indexed: 07/29/2023] Open
Abstract
Background The clinical benefits of endovascular treatment in renal artery stenosis (RAS) remain controversial. This study used an intraoperative renal perfusion imaging technique, called flat-panel detector parenchymal blood volume imaging (FD-PBV), to observe the change in renal perfusion after endovascular treatment in RAS. Materials and methods In a prospective, single-center study, we assigned 30 patients with atherosclerotic RAS who underwent endovascular treatment between March 2016 and March 2021. The preoperative and postoperative results of renal perfusion, blood pressure, and renal function, were compared. Results Both median kidney volume (p < 0.001) and median preoperative mean density of contrast medium (MDCM) (p = 0.028) increased significantly after endovascular treatment. The ratio of postoperative and preoperative MDCM differed greatly among the patients. For patients with preoperative MDCM <304.0 HU (Subgroup A, 15 cases), MDCM significantly increased after treatment (p = 0.001) and 12 (80.0%) patients had more than 10% increase in renal perfusion. For patients who had relatively high preoperative renal perfusion (MDCM ≥304.0 HU, Subgroup B, 15 cases), preoperative and postoperative MDCM were similar (p = 0.776). On the other hand, the serum creatinine levels significantly decreased in Subgroup A (p = 0.033) and fewer antihypertensive drugs were used after endovascular revascularization (p = 0.041). The preoperative and postoperative creatinine levels and number of antihypertensive drugs were similar in Subgroup B. Conclusions During the perioperative period, RAS patients with relatively low preoperative renal perfusion levels had greater improvement in renal perfusion, renal function, and blood pressure control after endovascular treatment. The improvement of renal function needs to be confirmed by long-term follow-up.
Collapse
Affiliation(s)
- Leyin Xu
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Jiang Shao
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Kang Li
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Chaonan Wang
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Zhichao Lai
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Jiangyu Ma
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Xiaoxi Yu
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Fenghe Du
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Junye Chen
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Xiaolong Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Jinghui Yuan
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Bao Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
| | - Chunyang Wang
- Department of Urology, PLA General Hospital, Beijing, China
| |
Collapse
|
3
|
Schutter R, van Varsseveld OC, Lantinga VA, Pool MBF, Hamelink TH, Potze JH, Leuvenink HGD, Laustsen C, Borra RJH, Moers C. Magnetic resonance imaging during warm ex vivo kidney perfusion. Artif Organs 2023; 47:105-116. [PMID: 35996889 PMCID: PMC10086841 DOI: 10.1111/aor.14391] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The shortage of donor organs for transplantation remains a worldwide problem. The utilization of suboptimal deceased donors enlarges the pool of potential organs, yet consequently, clinicians face the difficult decision of whether these sub-optimal organs are of sufficient quality for transplantation. Novel technologies could play a pivotal role in making pre-transplant organ assessment more objective and reliable. METHODS Ex vivo normothermic machine perfusion (NMP) at temperatures around 35-37°C allows organ quality assessment in a near-physiological environment. Advanced magnetic resonance imaging (MRI) techniques convey unique information about an organ's structural and functional integrity. The concept of applying magnetic resonance imaging during renal normothermic machine perfusion is novel in both renal and radiological research and we have developed the first MRI-compatible NMP setup for human-sized kidneys. RESULTS We were able to obtain a detailed and real-time view of ongoing processes inside renal grafts during ex vivo perfusion. This new technique can visualize structural abnormalities, quantify regional flow distribution, renal metabolism, and local oxygen availability, and track the distribution of ex vivo administered cellular therapy. CONCLUSION This platform allows for advanced pre-transplant organ assessment, provides a new realistic tool for studies into renal physiology and metabolism, and may facilitate therapeutic tracing of pharmacological and cellular interventions to an isolated kidney.
Collapse
Affiliation(s)
- Rianne Schutter
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Otis C van Varsseveld
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Veerle A Lantinga
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim H Hamelink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Hendrik Potze
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christoffer Laustsen
- Department of Clinical Medicine, The MR Research Center, Aarhus University, Aarhus, Denmark
| | - Ronald J H Borra
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
4
|
Aggarwal A, Das CJ, Sharma S. Recent advances in imaging techniques of renal masses. World J Radiol 2022; 14:137-150. [PMID: 35978979 PMCID: PMC9258310 DOI: 10.4329/wjr.v14.i6.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/04/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
Multiphasic multidetector computed tomography (CT) forms the mainstay for the characterization of renal masses whereas magnetic resonance imaging (MRI) acts as a problem-solving tool in some cases. However, a few of the renal masses remain indeterminate even after evaluation by conventional imaging methods. To overcome the deficiency in current imaging techniques, advanced imaging methods have been devised and are being tested. This review will cover the role of contrast-enhanced ultrasonography, shear wave elastography, dual-energy CT, perfusion CT, MR perfusion, diffusion-weighted MRI, blood oxygen level-dependent MRI, MR spectroscopy, positron emission tomography (PET)/prostate-specific membrane antigen-PET in the characterization of renal masses.
Collapse
Affiliation(s)
- Ankita Aggarwal
- Department of Radiology, Vardhman Mahavir Medical College& Safdarjung Hospital, Delhi 110029, India
| | - Chandan J Das
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, Delhi 110029, India
| | - Sanjay Sharma
- Department of Radiology (RPC), All India Institute of Medical Sciences, New Delhi 110029, India
| |
Collapse
|
5
|
Mani LY, Seif M, Nikles F, Tshering Vogel DW, Diserens G, Martirosian P, Burnier M, Vogt B, Vermathen P. Hip Position Acutely Affects Oxygenation and Perfusion of Kidney Grafts as Measured by Functional Magnetic Resonance Imaging Methods-The Bent Knee Study. Front Med (Lausanne) 2021; 8:697055. [PMID: 34447762 PMCID: PMC8384256 DOI: 10.3389/fmed.2021.697055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/12/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Kidney perfusion and oxygenation are two important determinants of kidney graft function. In kidney transplantation, repeated graft hypoperfusion may occur during hip flexion, for example in the sitting position, due to the progressive development of fibrotic tissue around iliac arteries. The aim of this study was to assess the changes in oxygenation and perfusion of kidney grafts during hip flexion and extension using a new functional magnetic resonance imaging (fMRI) protocol. Methods: Nineteen kidney graft recipients prospectively underwent MRI on a 3T scanner including diffusion-weighted, blood oxygenation level dependent (BOLD), and arterial spin labeling sequences in hip positions 0° and >90° before and after intravenous administration of 20 mg furosemide. Results: Unexpectedly, graft perfusion values were significantly higher in flexed compared to neutral hip position. Main diffusion-derived parameters were not affected by hip position. BOLD-derived cortico-medullary R2* ratio was significantly modified during hip flexion suggesting an intrarenal redistribution of the oxygenation in favor of the medulla and to the detriment of the cortex. Furthermore, the increase in medullary oxygenation induced by furosemide was significantly blunted during hip flexion (p < 0.001). Conclusion: Hip flexion has an acute impact on perfusion and tissue oxygenation in kidney grafts. Whether these position-dependent changes affect the long-term function and outcome of kidney transplants needs further investigation.
Collapse
Affiliation(s)
- Laila-Yasmin Mani
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maryam Seif
- Departments of Biomedical Research and Radiology, University of Bern, Bern, Switzerland.,Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Florence Nikles
- Departments of Biomedical Research and Radiology, University of Bern, Bern, Switzerland
| | - Dechen W Tshering Vogel
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gaëlle Diserens
- Departments of Biomedical Research and Radiology, University of Bern, Bern, Switzerland
| | - Petros Martirosian
- Section on Experimental Radiology, University of Tübingen, Tübingen, Germany
| | - Michel Burnier
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Bruno Vogt
- Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Vermathen
- Departments of Biomedical Research and Radiology, University of Bern, Bern, Switzerland
| |
Collapse
|
6
|
Schutter R, Lantinga VA, Hamelink TL, Pool MBF, van Varsseveld OC, Potze JH, Hillebrands JL, van den Heuvel MC, Dierckx RAJO, Leuvenink HGD, Moers C, Borra RJH. Magnetic resonance imaging assessment of renal flow distribution patterns during ex vivo normothermic machine perfusion in porcine and human kidneys. Transpl Int 2021; 34:1643-1655. [PMID: 34448269 PMCID: PMC9290094 DOI: 10.1111/tri.13991] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023]
Abstract
Acceptance criteria of deceased donor organs have gradually been extended toward suboptimal quality, posing an urgent need for more objective pre‐transplant organ assessment. Ex vivo normothermic machine perfusion (NMP) combined with magnetic resonance imaging (MRI) could assist clinicians in deciding whether a donor kidney is suitable for transplantation. Aim of this study was to characterize the regional distribution of perfusate flow during NMP, to better understand how ex vivo kidney assessment protocols should eventually be designed. Nine porcine and 4 human discarded kidneys underwent 3 h of NMP in an MRI‐compatible perfusion setup. Arterial spin labeling scans were performed every 15 min, resulting in perfusion‐weighted images that visualize intrarenal flow distribution. At the start of NMP, all kidneys were mainly centrally perfused and it took time for the outer cortex to reach its physiological dominant perfusion state. Calculated corticomedullary ratios based on the perfusion maps reached a physiological range comparable to in vivo observations, but only after 1 to 2 h after the start of NMP. Before that, the functionally important renal cortex appeared severely underperfused. Our findings suggest that early functional NMP quality assessment markers may not reflect actual physiology and should therefore be interpreted with caution.
Collapse
Affiliation(s)
- Rianne Schutter
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Veerle A Lantinga
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Tim L Hamelink
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Otis C van Varsseveld
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Jan Hendrik Potze
- Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Jan-Luuk Hillebrands
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Marius C van den Heuvel
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Rudi A J O Dierckx
- Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands.,Department of Nuclear Medicine, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Ronald J H Borra
- Department of Radiology, University of Groningen, University Medical Center, Groningen, The Netherlands.,Department of Nuclear Medicine, University of Groningen, University Medical Center, Groningen, The Netherlands
| |
Collapse
|
7
|
Wang R, Lin Z, Yang X, Zhao K, Wang S, Sui X, Su T, Wang X. Noninvasive Evaluation of Renal Hypoxia by Multiparametric Functional MRI in Early Diabetic Kidney Disease. J Magn Reson Imaging 2021; 55:518-527. [PMID: 34184356 DOI: 10.1002/jmri.27814] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Renal hypoxia, which caused by a mismatch between oxygen delivery and oxygen demand, may be the primary pathophysiological pathway driving diabetic kidney disease (DKD). Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) could detect hypoxia, but can be limited in distinguishing increased oxygen consumption or decreased blood supply. PURPOSE To explore multiparametric functional MRI in evaluating mechanism of the hypoxia changes in early stage of DKD. STUDY TYPE Prospective. ANIMAL MODEL Thirty-five New Zealand White rabbits were divided into control group (n = 5) and alloxan-induced diabetes mellitus (DM) groups (DM3 group: n = 15, DM7 group: n = 15). FIELD STRENGTH/SEQUENCE 3 T MRI/BOLD, arterial spin labeling (ASL), and asymmetric spin-echo (ASE). ASSESSMENT The renal oxygenation level (R2*), renal blood flow (RBF), and oxygen extraction fraction (OEF) were evaluated by BOLD, ASL, and ASE MRI, respectively. The regions of interest were manually drawn including cortex, outer stripes of outer medulla (OS), and inner stripes of outer medulla (IS). STATISTICAL TESTS Analysis of variance, independent-sample t-test, and paired-sample t-test were applied for comparisons among groups, between groups, and within the same group. P < 0.05 was considered statistically significant. RESULTS All renal regions of DM3 group at Day 3 after DM induction showed significantly higher R2* and OEF values compared to baseline. The RBF values showed no statistically significant difference (P = 0.62, 0.76, 0.09 in cortex, OS, and IS, respectively). For DM7 group at Day 7, R2*, OEF, and RBF values showed no statistically significant difference compared to baseline (P = 0.06, 0.05, 0.06 of R2*; 0.70, 0.64, 0.68 of OEF; and 0.33, 0.58, 0.48 of RBF in cortex, OS, and IS, respectively). DATA CONCLUSION BOLD MRI could detect renal hypoxia in early stage of DKD rabbit model, which was mainly revealed by increased oxygen consumption, but not affected by renal blood flow change. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 1.
Collapse
Affiliation(s)
- Rui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Zhiyong Lin
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Xuedong Yang
- Department of Radiology, China Academy of Chinese Medical Sciences Guanganmen Hospital, Beijing, China
| | - Kai Zhao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Suxia Wang
- Renal Pathology Center, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Xueqing Sui
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tao Su
- Department of Nephrology, Peking University First Hospital, Beijing, China
| | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| |
Collapse
|
8
|
Lu F, Yang J, Yang S, Bernd K, Fu C, Yang C, Xu H, Liu M, Zhan S, Wang C, Guo R, Wu Y. Use of Three-Dimensional Arterial Spin Labeling to Evaluate Renal Perfusion in Patients With Chronic Kidney Disease. J Magn Reson Imaging 2021; 54:1152-1163. [PMID: 33769645 DOI: 10.1002/jmri.27609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A noninvasive method for evaluating renal blood flow (RBF) in patients with chronic kidney disease (CKD) may have clinical value in disease staging, management, and prognostication. PURPOSE To evaluate effectiveness of three-dimensional pseudocontinuous arterial spin labeling (pCASL) and pulsed arterial spin labeling (PASL) in assessment of cortex and outer medulla (cortex/OM) RBF in CKD patients and healthy volunteers (HVs). STUDY TYPE Prospective, in a single institution. SUBJECTS A total of 48 CKD patients (stage 1, 2, 3, and 4-5: N = 11, 12, 13, and 12, respectively) and 18 HVs FIELD STRENGTH/SEQUENCE: 3 T, pCASL, and PASL with a three-dimensional hybrid gradient echo/spin echo sequence. ASSESSMENT Quality of RBF images derived from pCASL and PASL were evaluated and RBF in cortex/OM measured. Clinical and laboratory data were recorded. STATISTICAL TESTS Image quality differences between pCASL and PASL were evaluated with Wilcoxon signed-rank test. For both methods, analysis of variance, followed by Fisher's LSD-t test, was used to determine whether RBF differed between CKD stages and HVs. Pearson correlation coefficients were calculated to assess strength of relationships between cortex/OM RBF and data from clinical and laboratory tests. RESULTS Image quality differences were significantly higher in pCASL than PASL in both patients and HVs (both P < 0.05). For pCASL, cortex/OM RBF of patients were significantly lower than those of HVs (P < 0.05). Cortex/OM RBF were higher in S1 and S2 patients than those in S3 and S4-5 (P < 0.05). For PASL, only RBF in cortex of S1 and S2 patients were significantly higher than those of S4-5 (P < 0.05). Good correlations between pCASL RBF and estimated glomerular filtration (eGFR) were found in cortex/OM of patients (rho = 0.796 and 0.798, respectively, both P < 0.05), higher than those between PASL RBF and eGFR (rho = 0.430 and 0.374, respectively, both P < 0.05). DATA CONCLUSION Three-dimensional pCASL may potentially be a noninvasive technique to assess renal perfusion in CKD patients in different stages. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
Collapse
Affiliation(s)
- Fang Lu
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Yang
- Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuohui Yang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kuehn Bernd
- MR Applications Development, Siemens Healthcare, Erlangen, Germany
| | - Caixia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | - Chenyao Yang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huihui Xu
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengxiao Liu
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Songhua Zhan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Wang
- Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rongfang Guo
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu Wu
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
9
|
Kannenkeril D, Janka R, Bosch A, Jung S, Kolwelter J, Striepe K, Ott C, Martirosian P, Schiffer M, Uder M, Schmieder RE. Detection of Changes in Renal Blood Flow Using Arterial Spin Labeling MRI. Am J Nephrol 2021; 52:69-75. [PMID: 33677438 DOI: 10.1159/000513665] [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: 10/28/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alteration in kidney perfusion is an early marker of renal damage. The purpose of this study was to evaluate if changes in renal blood flow (RBF) could be detected using MRI with arterial spin labeling (ASL) technique. METHODS RBF as assessed by cortical (CRBF), medullary, and total renal blood flow (TRBF) were measured by MRI with arterial spin labeling (ASL-MRI) using flow-sensitive alternating inversion recovery true fast imaging with steady-state precession sequence. In 11 normotensive healthy individuals (NT) and 11 hypertensive patients (HT), RBF was measured at baseline and after both feet were covered with cold ice packs (cold pressor test) that activates the sympathetic nervous system. In another experiment, RBF was measured in 10 patients with CKD before and after a pharmacological intervention. We compared RBF measurements between the 3 study populations. RESULTS A significant reduction in CRBF (p = 0.042) and a trend in TRBF (p = 0.053) were observed in response to the activation of the sympathetic nervous system. A trend toward reduction of CRBF (p = 0.051) and TRBF (p = 0.059) has been detected after pharmacological intervention. TRBF was significantly lower in patients with HT and CKD patients compared to NT individuals (NT vs. HT, p = 0.014; NT vs. CKD, p = 0.004). TRBF was lower in patients with CKD compared to HT (p = 0.047). CONCLUSION Our data indicate that both acute and short-term changes in RBF could be detected using ASL-MRI. We were able to detect differences in RBF between healthy and diseased individuals by needing only small sample size per group. Thus, ASL-MRI offers an advantage in conducting clinical trials compared to other technologies.
Collapse
Affiliation(s)
- Dennis Kannenkeril
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Rolf Janka
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Agnes Bosch
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Susanne Jung
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
- Department of Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Julie Kolwelter
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
- Department of Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Kristina Striepe
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Christian Ott
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Petros Martirosian
- Section on Experimental Radiology, University Hospital of Tübingen, Tübingen, Germany
| | - Mario Schiffer
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Roland E Schmieder
- Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany,
| |
Collapse
|
10
|
Coronary Microvascular Dysfunction and the Role of Noninvasive Cardiovascular Imaging. Diagnostics (Basel) 2020; 10:diagnostics10090679. [PMID: 32916881 PMCID: PMC7555249 DOI: 10.3390/diagnostics10090679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023] Open
Abstract
Patients with coronary microvascular dysfunction (CMD) have significantly higher rates of cardiovascular events, including hospitalization for heart failure, sudden cardiac death, and myocardial infarction (MI). In CMD, several pathophysiological changes lead to functional and structural abnormalities in the coronary microvasculature, which disrupt the ability of the vessels to vasodilate and augment myocardial blood flow in response to increased myocardial oxygen demand, causing ischemia and angina. With the advent of more advanced non-invasive cardiac imaging techniques, the coronary microvasculature has been subjected to more intense study in the past two decades-this has led to further insights into the diagnosis, pathophysiology, treatment, prognosis and follow-up of CMD. This review will highlight and compare the salient features of the currently available non-invasive imaging modalities used in these patients, and discuss the clinical utility of these techniques in the workup and management of these patients.
Collapse
|
11
|
Ahn HS, Yu HC, Kwak HS, Park SH. Assessment of Renal Perfusion in Transplanted Kidney Patients Using Pseudo-Continuous Arterial Spin Labeling with Multiple Post-Labeling Delays. Eur J Radiol 2020; 130:109200. [PMID: 32739781 DOI: 10.1016/j.ejrad.2020.109200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/24/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate technical issues for implementing pseudo-continuous arterial spin labeling (pCASL) for renal perfusion measurements in transplanted kidney patients (TK) in the early postoperative recovery phase. METHODS Eleven subjects were scanned: TK (N = 4, 42 ± 8.1Y) and normal volunteers (NV) (N = 7, 25 ± 3Y). In 3.0 T clinical MRI, pCASL with a 2D balanced steady-state free precession readout was applied with four different post-labeling delays: 0.5/1.0/1.5/2.0 s. Perfusion images were acquired with and without background suppression and processed with and without registration for comparison. Renal blood flow (RBF) and arterial transit time (ATT) values were calculated from each pixel of images. The F-test, Wilcoxon signed-rank test, and Wilcoxon rank-sum test were used for statistical analyses. RESULTS Background suppression decreased signal variations for both NV and TK. Registration suppressed effects of kidney motion for NV, which was not critical for TK. The renal cortex showed greater perfusion than the renal medulla in both NV and TK(p < 0.01). TK showed greater renal perfusion than NV(p < 0.05). Cortical and medullary RBF values were 271.8 ± 43.5, 119.1 ± 15.1 ml/100 g/min for NV and 358.3 ± 36.4, 141.0 ± 11.5 ml/100 g/min for TK. TK showed longer ATT values than NV(p < 0.01). ATT values in the cortex and medulla were 641 ± 141 and 746 ± 150 ms for NV and 919 ± 49 and 935 ± 81 ms for TK. CONCLUSIONS We demonstrated that although there is no discernible motion of the transplanted kidney, background suppression is necessary to suppress signal fluctuations in renal perfusion measurements. Also, relatively high RBF and long ATT values were observed in the transplanted kidneys in the early postoperative recovery phase, which requires further longitudinal studies.
Collapse
Affiliation(s)
- Hyun-Seo Ahn
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Hee Chul Yu
- Department of Surgery, Jeonbuk National University Medical School and Hospital, Jeonju, South Korea
| | - Hyo Sung Kwak
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
| | - Sung-Hong Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
| |
Collapse
|
12
|
Ye J, Xu Q, Wang SA, Zheng J, Zhu QQ, Dou WQ. Differentiation between fat-poor angiomyolipoma and clear cell renal cell carcinoma: qualitative and quantitative analysis using arterial spin labeling MR imaging. Abdom Radiol (NY) 2020; 45:512-519. [PMID: 31705246 DOI: 10.1007/s00261-019-02303-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To assess the diagnostic effectiveness of arterial spin labeling (ASL) MR imaging in differentiating fat-poor AML from clear cell renal cell carcinoma (ccRCC). METHODS In this prospective study, 29 ccRCC patients and 9 fat-poor AML patients underwent routine anatomical MRI and ASL at 3T before surgery after signing written informed consent form. For each tumor, tumor blood flow (TBF) was measured in a region of interest (ROI) which was positioned to outline the edge of the target lesions on ASL perfusion maps. Additionally, the mean TBF values were obtained by standardizing the TBF using a blood flow measurement in the reference ROI. Moreover, a cluster containing more than 10 voxels was chosen from the renal cortex and medulla area in normal contralateral kidney as a reference ROI to calculate tumor-to-cortex ratio and tumor-to-medulla ratio. Independent sample t test was used to examine the alteration among the groups of fat-poor AML and ccRCC. ASL images were together analyzed by two radiologists to assess the following characteristics of the renal mass: predominant SI in the tumor on ASL images was lower than, as same as, or higher than SI of the cortex. For qualitative variables, Fisher's exact test was employed to compare the proportions of these two groups. The sensitivity, specificity ,and accuracy required for discrimination of fat-poor AML from ccRCC were quantified using receiver operating characteristic (ROC) curve. The corresponding optimal cutoff value was obtained for each parameter as well. RESULTS The TBF value was significantly higher in ccRCC group than that in fat-poor AML (270.49 ± 78.88 ml/100 g/min vs. 146.68 ± 47.21 ml/100 g/min; P < 0.01). Both tumor-to-cortex and tumor-to-medulla ratios were notably higher in ccRCC group compared with those in fat-poor AML group (1.22 ± 0.26 vs. 0.74 ± 0.14, 3.13 ± 0.94 vs. 1.77 ± 0.55; P < 0.05). The values of area under the ROC curve (AUC) for TBF, tumor-to-cortex ratio, and tumor-to-medulla ratio were 0.931, 0.964, and 0.900, respectively. No significant difference in AUC values among these three measurements was observed. For qualitative variables, the SI of fat-poor AML was equal to or slightly lower than that of renal medulla and the SI of ccRCC was found to be higher than renal cortex in ASL. CONCLUSION ASL MRI performs well in differentiating fat-poor AML from ccRCC in both qualitative and quantitative analyses.
Collapse
Affiliation(s)
- Jing Ye
- Department of Medical Imaging, Clinic Medical School, Northern Jiangsu Province Hospital, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | - Qing Xu
- Department of Medical Imaging, Clinic Medical School, Northern Jiangsu Province Hospital, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China.
| | - Shou-An Wang
- Department of Medical Imaging, Clinic Medical School, Northern Jiangsu Province Hospital, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | - Jin Zheng
- Department of Medical Imaging, Clinic Medical School, Northern Jiangsu Province Hospital, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | - Qing-Qiang Zhu
- Department of Medical Imaging, Clinic Medical School, Northern Jiangsu Province Hospital, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | | |
Collapse
|
13
|
Nery F, Buchanan CE, Harteveld AA, Odudu A, Bane O, Cox EF, Derlin K, Gach HM, Golay X, Gutberlet M, Laustsen C, Ljimani A, Madhuranthakam AJ, Pedrosa I, Prasad PV, Robson PM, Sharma K, Sourbron S, Taso M, Thomas DL, Wang DJJ, Zhang JL, Alsop DC, Fain SB, Francis ST, Fernández-Seara MA. Consensus-based technical recommendations for clinical translation of renal ASL MRI. MAGMA (NEW YORK, N.Y.) 2019. [PMID: 31833014 DOI: 10.1007/s10334‐019‐00800‐z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This study aimed at developing technical recommendations for the acquisition, processing and analysis of renal ASL data in the human kidney at 1.5 T and 3 T field strengths that can promote standardization of renal perfusion measurements and facilitate the comparability of results across scanners and in multi-centre clinical studies. METHODS An international panel of 23 renal ASL experts followed a modified Delphi process, including on-line surveys and two in-person meetings, to formulate a series of consensus statements regarding patient preparation, hardware, acquisition protocol, analysis steps and data reporting. RESULTS Fifty-nine statements achieved consensus, while agreement could not be reached on two statements related to patient preparation. As a default protocol, the panel recommends pseudo-continuous (PCASL) or flow-sensitive alternating inversion recovery (FAIR) labelling with a single-slice spin-echo EPI readout with background suppression and a simple but robust quantification model. DISCUSSION This approach is considered robust and reproducible and can provide renal perfusion images of adequate quality and SNR for most applications. If extended kidney coverage is desirable, a 2D multislice readout is recommended. These recommendations are based on current available evidence and expert opinion. Nonetheless they are expected to be updated as more data become available, since the renal ASL literature is rapidly expanding.
Collapse
Affiliation(s)
- Fabio Nery
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Aghogho Odudu
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Octavia Bane
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Katja Derlin
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - H Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marcel Gutberlet
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ananth J Madhuranthakam
- Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Philip M Robson
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Manuel Taso
- Division of MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - David L Thomas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Jeff L Zhang
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David C Alsop
- Division of MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sean B Fain
- Departments of Medical Physics, Radiology, and Biomedical Engineering, University of Wisconsin, Madison, Madison, USA
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
14
|
Nery F, Buchanan CE, Harteveld AA, Odudu A, Bane O, Cox EF, Derlin K, Gach HM, Golay X, Gutberlet M, Laustsen C, Ljimani A, Madhuranthakam AJ, Pedrosa I, Prasad PV, Robson PM, Sharma K, Sourbron S, Taso M, Thomas DL, Wang DJJ, Zhang JL, Alsop DC, Fain SB, Francis ST, Fernández-Seara MA. Consensus-based technical recommendations for clinical translation of renal ASL MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:141-161. [PMID: 31833014 PMCID: PMC7021752 DOI: 10.1007/s10334-019-00800-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022]
Abstract
Objectives This study aimed at developing technical recommendations for the acquisition, processing and analysis of renal ASL data in the human kidney at 1.5 T and 3 T field strengths that can promote standardization of renal perfusion measurements and facilitate the comparability of results across scanners and in multi-centre clinical studies. Methods An international panel of 23 renal ASL experts followed a modified Delphi process, including on-line surveys and two in-person meetings, to formulate a series of consensus statements regarding patient preparation, hardware, acquisition protocol, analysis steps and data reporting. Results Fifty-nine statements achieved consensus, while agreement could not be reached on two statements related to patient preparation. As a default protocol, the panel recommends pseudo-continuous (PCASL) or flow-sensitive alternating inversion recovery (FAIR) labelling with a single-slice spin-echo EPI readout with background suppression and a simple but robust quantification model. Discussion This approach is considered robust and reproducible and can provide renal perfusion images of adequate quality and SNR for most applications. If extended kidney coverage is desirable, a 2D multislice readout is recommended. These recommendations are based on current available evidence and expert opinion. Nonetheless they are expected to be updated as more data become available, since the renal ASL literature is rapidly expanding. Electronic supplementary material The online version of this article (10.1007/s10334-019-00800-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fabio Nery
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Aghogho Odudu
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Octavia Bane
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Katja Derlin
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - H Michael Gach
- Departments of Radiation Oncology, Radiology, and Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Xavier Golay
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marcel Gutberlet
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ananth J Madhuranthakam
- Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology and Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Philip M Robson
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Manuel Taso
- Division of MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - David L Thomas
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Jeff L Zhang
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David C Alsop
- Division of MRI Research, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sean B Fain
- Departments of Medical Physics, Radiology, and Biomedical Engineering, University of Wisconsin, Madison, Madison, USA
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
15
|
Abstract
OBJECTIVES Multiparametric renal magnetic resonance imaging (MRI), including diffusion-weighted imaging, magnetic resonance elastography, and magnetization transfer imaging (MTI), is valuable in the noninvasive assessment of renal fibrosis. However, hemodynamic changes in diseased kidneys may impede their ability to measure renal fibrosis. Because MTI assesses directly tissue content of macromolecules, we test the hypothesis that MTI would be insensitive to renal hemodynamic changes in swine kidneys with acute graded ischemia. MATERIALS AND METHODS Seven domestic pigs underwent placement of an inflatable silicone cuff around the right renal artery to induce graded renal ischemia. Multiparametric MRI was performed at baseline, 50%, 75%, and 100% renal artery stenosis as well as reperfusion. Measurements included regional perfusion, R2*, apparent diffusion coefficient (ADC), stiffness, and magnetization transfer ratio (MTR) using arterial spin-labeled MRI, blood oxygenation-dependent MRI, diffusion-weighted imaging, magnetic resonance elastography, and MTI, respectively. Histology was performed to rule out renal fibrosis. RESULTS During graded ischemia, decreases in renal perfusion were accompanied with elevated R2*, decreased ADC, and stiffness, whereas no statistically significant changes were observed in the MTR. No fibrosis was detected by histology. After release of the obstruction, renal perfusion showed only partial recovery, associated with return of kidney R2*, ADC, and stiffness to baseline levels, whereas cortical MTR decreased slightly. CONCLUSIONS Renal MTI is insensitive to decreases in renal perfusion and may offer reliable assessment of renal structural changes.
Collapse
|
16
|
Abstract
Renal transplantation is the therapy of choice for patients with end-stage renal diseases. Improvement of immunosuppressive therapy has significantly increased the half-life of renal allografts over the past decade. Nevertheless, complications can still arise. An early detection of allograft dysfunction is mandatory for a good outcome. New advances in magnetic resonance imaging (MRI) have enabled the noninvasive assessment of different functional renal parameters in addition to anatomic imaging. Most of these techniques were widely tested on renal allografts in past decades and a lot of clinical data are available. The following review summarizes the comprehensive, functional MRI techniques for the noninvasive assessment of renal allograft function and highlights their potential for the investigations of different etiologies of graft dysfunction.
Collapse
|
17
|
Abstract
Recent improvements in arterial spin labeled (ASL) and vastly undersampled dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) acquisitions are providing a new opportunity to explore the routine use of quantitative perfusion imaging for evaluation of a variety of abdominal diseases in clinical practice. In this review, we discuss different approaches for the acquisition and data analysis of ASL and DCE MRI techniques for quantification of tissue perfusion and present various clinical applications of these techniques in both neoplastic and non-neoplastic conditions in the abdomen.
Collapse
|
18
|
Donnola SB, Piccone CM, Lu L, Batesole J, Little J, Dell KM, Flask CA. Diffusion tensor imaging MRI of sickle cell kidney disease: initial results and comparison with iron deposition. NMR IN BIOMEDICINE 2018; 31:10.1002/nbm.3883. [PMID: 29350437 PMCID: PMC5822685 DOI: 10.1002/nbm.3883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/19/2017] [Accepted: 11/14/2017] [Indexed: 06/07/2023]
Abstract
Chronic kidney disease (CKD) occurs in over one-third of patients with sickle cell disease (SCD) and can progress to end-stage renal disease. Unfortunately, current clinical assessments of kidney function are insensitive to early-stage CKD. Previous studies have shown that diffusion magnetic resonance imaging (MRI) can sensitively detect regional renal microstructural changes associated with early-stage CKD. However, previous MRI studies in patients with SCD have been largely limited to the detection of renal iron deposition assessed by T2 * relaxometry. In this pilot imaging study, we compare MRI assessments of renal microstructure (diffusion) and iron deposition (T2 *) in patients with SCD and in non-SCD control subjects. Diffusion tensor imaging (DTI) and T2 * relaxometry MRI data were obtained for pediatric (n = 5) and adult (n = 4) patients with SCD, as well as for non-SCD control subjects (n = 10), on a Siemens Espree 1.5-T MRI scanner. A region-of-interest analysis was used to calculate mean medullary and cortical values for each MRI metric. MRI findings were also compared with clinical assessments of renal function and hemolysis. Patients with SCD showed a significant decrease in medullary fractional anisotropy (FA, p = 0.0001) in comparison with non-SCD subjects, indicative of microstructural alterations in the renal medulla of patients with SCD. Cortical and medullary reductions in T2 * (increased iron deposition, p = ≤0.0001) were also observed. Significant correlations were also observed between kidney T2 * assessments and multiple measures of hemolysis. This is the first DTI MRI study of patients with SCD to demonstrate reductions in medullary FA despite no overt CKD [estimated glomerular filtration rate (eGFR) > 100 mL/min/1.73 m2 ]. These medullary FA changes are consistent with previous studies in patients with CKD, and suggest that DTI MRI can provide a useful measure of kidney injury to complement MRI assessments of iron deposition.
Collapse
Affiliation(s)
- Shannon B. Donnola
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Connie M. Piccone
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA
- Divison of Hematology/Oncology, Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
| | - Lan Lu
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Joshua Batesole
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jane Little
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Division of Hematology and Oncology, University Hospitals - Cleveland Medical Center, Cleveland, Ohio, USA
| | - Katherine M. Dell
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA
- Center for Pediatric Nephrology, Cleveland Clinic Children’s, Cleveland, Ohio, USA
- CWRU Center for Kidney Research, The MetroHealth System, Cleveland, Ohio, USA
| | - Chris A. Flask
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
19
|
Non-Invasive Renal Perfusion Imaging Using Arterial Spin Labeling MRI: Challenges and Opportunities. Diagnostics (Basel) 2018; 8:diagnostics8010002. [PMID: 29303965 PMCID: PMC5871985 DOI: 10.3390/diagnostics8010002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 12/25/2017] [Accepted: 01/02/2018] [Indexed: 12/28/2022] Open
Abstract
Tissue perfusion allows for delivery of oxygen and nutrients to tissues, and in the kidneys is also a key determinant of glomerular filtration. Quantification of regional renal perfusion provides a potential window into renal (patho) physiology. However, non-invasive, practical, and robust methods to measure renal perfusion remain elusive, particularly in the clinic. Arterial spin labeling (ASL), a magnetic resonance imaging (MRI) technique, is arguably the only available method with potential to meet all these needs. Recent developments suggest its viability for clinical application. This review addresses several of these developments and discusses remaining challenges with the emphasis on renal imaging in human subjects.
Collapse
|
20
|
Cox EF, Buchanan CE, Bradley CR, Prestwich B, Mahmoud H, Taal M, Selby NM, Francis ST. Multiparametric Renal Magnetic Resonance Imaging: Validation, Interventions, and Alterations in Chronic Kidney Disease. Front Physiol 2017; 8:696. [PMID: 28959212 PMCID: PMC5603702 DOI: 10.3389/fphys.2017.00696] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 08/30/2017] [Indexed: 12/15/2022] Open
Abstract
Background: This paper outlines a multiparametric renal MRI acquisition and analysis protocol to allow non-invasive assessment of hemodynamics (renal artery blood flow and perfusion), oxygenation (BOLD T2*), and microstructure (diffusion, T1 mapping). Methods: We use our multiparametric renal MRI protocol to provide (1) a comprehensive set of MRI parameters [renal artery and vein blood flow, perfusion, T1, T2*, diffusion (ADC, D, D*, fp), and total kidney volume] in a large cohort of healthy participants (127 participants with mean age of 41 ± 19 years) and show the MR field strength (1.5 T vs. 3 T) dependence of T1 and T2* relaxation times; (2) the repeatability of multiparametric MRI measures in 11 healthy participants; (3) changes in MRI measures in response to hypercapnic and hyperoxic modulations in six healthy participants; and (4) pilot data showing the application of the multiparametric protocol in 11 patients with Chronic Kidney Disease (CKD). Results: Baseline measures were in-line with literature values, and as expected, T1-values were longer at 3 T compared with 1.5 T, with increased T1 corticomedullary differentiation at 3 T. Conversely, T2* was longer at 1.5 T. Inter-scan coefficients of variation (CoVs) of T1 mapping and ADC were very good at <2.9%. Intra class correlations (ICCs) were high for cortex perfusion (0.801), cortex and medulla T1 (0.848 and 0.997 using SE-EPI), and renal artery flow (0.844). In response to hypercapnia, a decrease in cortex T2* was observed, whilst no significant effect of hyperoxia on T2* was found. In CKD patients, renal artery and vein blood flow, and renal perfusion was lower than for healthy participants. Renal cortex and medulla T1 was significantly higher in CKD patients compared to healthy participants, with corticomedullary T1 differentiation reduced in CKD patients compared to healthy participants. No significant difference was found in renal T2*. Conclusions: Multiparametric MRI is a powerful technique for the assessment of changes in structure, hemodynamics, and oxygenation in a single scan session. This protocol provides the potential to assess the pathophysiological mechanisms in various etiologies of renal disease, and to assess the efficacy of drug treatments.
Collapse
Affiliation(s)
- Eleanor F Cox
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Charlotte E Buchanan
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Christopher R Bradley
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Benjamin Prestwich
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| | - Huda Mahmoud
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Maarten Taal
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, Royal Derby Hospital, University of NottinghamDerby, United Kingdom
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of NottinghamNottingham, United Kingdom
| |
Collapse
|
21
|
Song H, Ruan D, Liu W, Stenger VA, Pohmann R, Fernández-Seara MA, Nair T, Jung S, Luo J, Motai Y, Ma J, Hazle JD, Gach HM. Respiratory motion prediction and prospective correction for free-breathing arterial spin-labeled perfusion MRI of the kidneys. Med Phys 2017; 44:962-973. [PMID: 28074528 DOI: 10.1002/mp.12099] [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: 08/31/2016] [Revised: 12/14/2016] [Accepted: 12/27/2016] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Respiratory motion prediction using an artificial neural network (ANN) was integrated with pseudocontinuous arterial spin labeling (pCASL) MRI to allow free-breathing perfusion measurements in the kidney. In this study, we evaluated the performance of the ANN to accurately predict the location of the kidneys during image acquisition. METHODS A pencil-beam navigator was integrated with a pCASL sequence to measure lung/diaphragm motion during ANN training and the pCASL transit delay. The ANN algorithm ran concurrently in the background to predict organ location during the 0.7-s 15-slice acquisition based on the navigator data. The predictions were supplied to the pulse sequence to prospectively adjust the axial slice acquisition to match the predicted organ location. Additional navigators were acquired immediately after the multislice acquisition to assess the performance and accuracy of the ANN. The technique was tested in eight healthy volunteers. RESULTS The root-mean-square error (RMSE) and mean absolute error (MAE) for the eight volunteers were 1.91 ± 0.17 mm and 1.43 ± 0.17 mm, respectively, for the ANN. The RMSE increased with transit delay. The MAE typically increased from the first to last prediction in the image acquisition. The overshoot was 23.58% ± 3.05% using the target prediction accuracy of ± 1 mm. CONCLUSION Respiratory motion prediction with prospective motion correction was successfully demonstrated for free-breathing perfusion MRI of the kidney. The method serves as an alternative to multiple breathholds and requires minimal effort from the patient.
Collapse
Affiliation(s)
- Hao Song
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Dan Ruan
- Departments of Radiation Oncology, Biomedical Physics and Bioengineering, UCLA, Los Angeles, CA, 90095, USA
| | - Wenyang Liu
- Departments of Radiation Oncology, Biomedical Physics and Bioengineering, UCLA, Los Angeles, CA, 90095, USA
| | - V Andrew Stenger
- Department of Medicine, University of Hawai'i at Manoa, Honolulu, HI, 96813, USA
| | - Rolf Pohmann
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, 72076, Tubingen, Germany
| | | | - Tejas Nair
- DMC R&D Center, Samsung Electronics Inc., Seocho-gu, 06765, Seoul, Korea
| | - Sungkyu Jung
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Jingqin Luo
- Department of Surgery, Washington University in St. Louis, St. Louis, MO, 63110, USA
| | - Yuichi Motai
- Department of Electrical and Computer Engineering, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Jingfei Ma
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - John D Hazle
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - H Michael Gach
- Departments of Radiation Oncology and Radiology, Washington University, St. Louis, MO, 63110, USA
| |
Collapse
|
22
|
Cai YZ, Li ZC, Zuo PL, Pfeuffer J, Li YM, Liu F, Liu RB. Diagnostic value of renal perfusion in patients with chronic kidney disease using 3D arterial spin labeling. J Magn Reson Imaging 2017; 46:589-594. [PMID: 28181335 DOI: 10.1002/jmri.25601] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/05/2016] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate the diagnostic value of 3D arterial spin labeling (ASL) for noninvasive quantification of renal blood flow (RBF) in patients with chronic kidney disease (CKD). MATERIALS AND METHODS CKD patients (n = 27) and healthy volunteers (n = 36) underwent renal 3T ASL magnetic resonance imaging, with inversion times from 1200 to 2000 msec for volunteers in the preliminary test, and 1800 to 2000 msec for volunteers and CKD patients in the formal experiments. The cortical RBFs were compared, and a correlation between RBF and estimated glomerular filtration rate (eGFR) was evaluated. RESULTS For healthy volunteers, RBF values increased with TIs from 1200 to 1600 msec, but were almost constant at TIs from 1600 to 2000 msec. The cortical RBF values of CKD patients were lower than that of healthy volunteers at TIs from 1800 to 2000 msec. In addition, the CKD patients had lower cortical RBF values than the healthy volunteers (P < 0.01 for both), and their RBF values positively correlated with eGFR. CONCLUSION 3D ASL is a potential noninvasive method for measuring renal perfusion that can provide valuable information for clinical CKD diagnosis. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:589-594.
Collapse
Affiliation(s)
- Yu-Zhe Cai
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Zhi-Cheng Li
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Pan-Li Zuo
- Siemens Healthcare, MR Collaboration NE Asia, Beijing, PR China
| | - Josef Pfeuffer
- Application Development, Siemens Healthcare, Erlangen, Germany
| | - Yu-Ming Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Fang Liu
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Rong-Bo Liu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| |
Collapse
|
23
|
Kim DW, Shim WH, Yoon SK, Oh JY, Kim JK, Jung H, Matsuda T, Kim D. Measurement of arterial transit time and renal blood flow using pseudocontinuous ASL MRI with multiple post-labeling delays: Feasibility, reproducibility, and variation. J Magn Reson Imaging 2017; 46:813-819. [PMID: 28092411 DOI: 10.1002/jmri.25634] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 12/28/2016] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To evaluate the feasibility, reproducibility, and variation of renal perfusion and arterial transit time (ATT) using pseudocontinuous arterial spin labeling magnetic resonance imaging (PCASL MRI) in healthy volunteers. MATERIALS AND METHODS PCASL MRI at 3T was performed in 25 healthy volunteers on two different occasions. The ATT and ATT-corrected renal blood flow (ATT-cRBF) were calculated at four different post-labeling delay points (0.5, 1.0, 1.5, and 2.0 s) and evaluated for each kidney and subject. The intraclass correlation (ICC) and Bland-Altman plot were used to assess the reproducibility of the PCASL MRI technique. The within-subject coefficient of variance was determined. RESULTS Results were obtained for 46 kidneys of 23 subjects with a mean age of 38.6 ± 9.8 years and estimated glomerular filtration rate (eGFR) of 89.1 ± 21.2 ml/min/1.73 m2 . Two subjects failed in the ASL MRI examination. The mean cortical and medullary ATT-cRBF for the subjects were 215 ± 65 and 81 ± 21 ml/min/100 g, respectively, and the mean cortical and medullary ATT were 1141 ± 262 and 1123 ± 245 msec, correspondingly. The ICC for the cortical ATT-cRBF was 0.927 and the within-subject coefficient of variance was 14.4%. The ICCs for the medullary ATT-cRBF and the cortical and medullary ATT were poor. The Bland-Altman plot for cortical RBF showed good agreement between the two measurements. CONCLUSION PCASL MRI is a feasible and reproducible method for measuring renal cortical perfusion. In contrast, ATT for the renal cortex and medulla has poor reproducibility and high variation. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:813-819.
Collapse
Affiliation(s)
- Dong Won Kim
- Department of Radiology, Dong-A University College of Medicine, Busan, South Korea
| | - Woo Hyun Shim
- Department of Radiology, Research Institute of Radiology, Bioimaging Infrastructure, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seong Kuk Yoon
- Department of Radiology, Dong-A University College of Medicine, Busan, South Korea
| | - Jong Yeong Oh
- Department of Radiology, Dong-A University College of Medicine, Busan, South Korea
| | - Jeong Kon Kim
- Department of Radiology, Research Institute of Radiology, Bioimaging Infrastructure, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Center for Bioimaging of New Drug Development, Asan Institute for life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hoesu Jung
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | | |
Collapse
|
24
|
Abstract
Multiparametric MR imaging (mpMRI) combine different sequences that, properly tailored, can provide qualitative and quantitative information about the tumor microenvironment beyond traditional tumor size measures and/or morphologic assessments. This article focuses on mpMRI in the evaluation of urogenital tract malignancies by first reviewing technical aspects and then discussing its potential clinical role. This includes insight into histologic subtyping and grading of renal cell carcinoma and assessment of tumor response to targeted therapies. The clinical utility of mpMRI in the staging and grading of ureteral and bladder tumors is presented. Finally, the evolving role of mpMRI in prostate cancer is discussed.
Collapse
|
25
|
Gillis KA, McComb C, Patel RK, Stevens KK, Schneider MP, Radjenovic A, Morris STW, Roditi GH, Delles C, Mark PB. Non-Contrast Renal Magnetic Resonance Imaging to Assess Perfusion and Corticomedullary Differentiation in Health and Chronic Kidney Disease. Nephron Clin Pract 2016; 133:183-92. [PMID: 27362585 DOI: 10.1159/000447601] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/10/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS Arterial spin labelling (ASL) MRI measures perfusion without administration of contrast agent. While ASL has been validated in animals and healthy volunteers (HVs), application to chronic kidney disease (CKD) has been limited. We investigated the utility of ASL MRI in patients with CKD. METHODS We studied renal perfusion in 24 HVs and 17 patients with CKD (age 22-77 years, 40% male) using ASL MRI at 3.0T. Kidney function was determined using estimated glomerular filtration rate (eGFR). T1 relaxation time was measured using modified look-locker inversion and xFB02;ow-sensitive alternating inversion recovery true-fast imaging and steady precession was performed to measure cortical and whole kidney perfusion. RESULTS T1 was higher in CKD within cortex and whole kidney, and there was association between T1 time and eGFR. No association was seen between kidney size and volume and either T1, or ASL perfusion. Perfusion was lower in CKD in cortex (136 ± 37 vs. 279 ± 69 ml/min/100 g; p < 0.001) and whole kidney (146 ± 24 vs. 221 ± 38 ml/min/100 g; p < 0.001). There was significant, negative, association between T1 longitudinal relaxation time and ASL perfusion in both the cortex (r = -0.75, p < 0.001) and whole kidney (r = -0.50, p < 0.001). There was correlation between eGFR and both cortical (r = 0.73, p < 0.01) and whole kidney (r = 0.69, p < 0.01) perfusion. CONCLUSIONS Significant differences in renal structure and function were demonstrated using ASL MRI. T1 may be representative of structural changes associated with CKD; however, further investigation is required into the pathological correlates of reduced ASL perfusion and increased T1 time in CKD.
Collapse
Affiliation(s)
- Keith A Gillis
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Shimizu K, Kosaka N, Fujiwara Y, Matsuda T, Yamamoto T, Tsuchida T, Tsuchiyama K, Oyama N, Kimura H. Arterial Transit Time-corrected Renal Blood Flow Measurement with Pulsed Continuous Arterial Spin Labeling MR Imaging. Magn Reson Med Sci 2016; 16:38-44. [PMID: 27170422 PMCID: PMC5600042 DOI: 10.2463/mrms.mp.2015-0117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose: The importance of arterial transit time (ATT) correction for arterial spin labeling MRI has been well debated in neuroimaging, but it has not been well evaluated in renal imaging. The purpose of this study was to evaluate the feasibility of pulsed continuous arterial spin labeling (pcASL) MRI with multiple post-labeling delay (PLD) acquisition for measuring ATT-corrected renal blood flow (ATC-RBF). Materials and Methods: A total of 14 volunteers were categorized into younger (n = 8; mean age, 27.0 years) and older groups (n = 6; 64.8 years). Images of pcASL were obtained at three different PLDs (0.5, 1.0, and 1.5 s), and ATC-RBF and ATT were calculated using a single-compartment model. To validate ATC-RBF, a comparative study of effective renal plasma flow (ERPF) measured by 99mTc-MAG3 scintigraphy was performed. ATC-RBF was corrected by kidney volume (ATC-cRBF) for comparison with ERPF. Results: The younger group showed significantly higher ATC-RBF (157.68 ± 38.37 mL/min/100 g) and shorter ATT (961.33 ± 260.87 ms) than the older group (117.42 ± 24.03 mL/min/100 g and 1227.94 ± 226.51 ms, respectively; P < 0.05). A significant correlation was evident between ATC-cRBF and ERPF (P < 0.05, r = 0.47). With suboptimal single PLD (1.5 s) settings, there was no significant correlation between ERPF and kidney volume-corrected RBF calculated from single PLD data. Conclusion: Calculation of ATT and ATC-RBF by pcASL with multiple PLD was feasible in healthy volunteers, and differences in ATT and ATC-RBF were seen between the younger and older groups. Although ATT correction by multiple PLD acquisitions may not always be necessary for RBF quantification in the healthy subjects, the effect of ATT should be taken into account in renal ASL–MRI as debated in brain imaging.
Collapse
Affiliation(s)
- Kazuhiro Shimizu
- Department of Radiology, Faculty of Medical Sciences, University of Fukui
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Ren T, Wen CL, Chen LH, Xie SS, Cheng Y, Fu YX, Oesingmann N, de Oliveira A, Zuo PL, Yin JZ, Xia S, Shen W. Evaluation of renal allografts function early after transplantation using intravoxel incoherent motion and arterial spin labeling MRI. Magn Reson Imaging 2016; 34:908-14. [PMID: 27114341 DOI: 10.1016/j.mri.2016.04.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 03/25/2016] [Accepted: 04/17/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate renal allografts function early after transplantation using intravoxel incoherent motion (IVIM) and arterial spin labeling (ASL) MRI. METHODS This prospective study was approved by the local ethics committee, and written informed consent was obtained from all participants. A total of 82 participants with 62 renal allograft recipients (2-4weeks after kidney transplantation) and 20 volunteers were enrolled to be scanned using IVIM and ASL MRI on a 3.0T MR scanner. Recipients were divided into two groups with either normal or impaired function according to the estimated glomerular filtration rate (eGFR) with a threshold of 60ml/min/1.73m(2). The apparent diffusion coefficient (ADC) of pure diffusion (ADCslow), the ADC of pseudodiffusion (ADCfast), perfusion fraction (PF), and renal blood flow (RBF) of cortex were compared among three groups. The correlation of ADCslow, ADCfast, PF and RBF with eGFR was evaluated. The receiver operating characteristic (ROC) curve and binary logistic regression analyses were performed to assess the diagnostic efficiency of using IVIM and ASL parameters to discriminate allografts with impaired function from normal function. P<0.05 was considered statistically significant. RESULTS In allografts with normal function, no significant difference of mean cortical ADCslow, ADCfast, and PF was found compared with healthy controls (P>0.05). Cortical RBF in allografts with normal function was statistically lower than that of healthy controls (P<0.001). Mean cortical ADCslow, ADCfast, PF and RBF were lower for allografts with impaired function than that with normal function (P<0.05). Mean cortical ADCslow, ADCfast, PF and RBF showed a positive correlation with eGFR (all P<0.01) for recipients. The combination of IVIM and ASL MRI showed a higher area under the ROC curve (AUC) (0.865) than that of ASL MRI alone (P=0.02). CONCLUSION Combined IVIM and ASL MRI can better evaluate the diffusion and perfusion properties for allografts early after kidney transplantation.
Collapse
Affiliation(s)
- Tao Ren
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Cheng-Long Wen
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Li-Hua Chen
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Shuang-Shuang Xie
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Yue Cheng
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Ying-Xin Fu
- Department of Transplantation Surgery, Tianjin First Center Hospital, 300192, Tianjin, China.
| | | | | | - Pan-Li Zuo
- Siemens Healthcare, MR Collaborations NE Asia, 100010,Beijing, China.
| | - Jian-Zhong Yin
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Shuang Xia
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| | - Wen Shen
- Department of Radiology, Tianjin Medical University First Center Hospital, 300192, Tianjin, China.
| |
Collapse
|
28
|
Hammon M, Janka R, Siegl C, Seuss H, Grosso R, Martirosian P, Schmieder RE, Uder M, Kistner I. Reproducibility of Kidney Perfusion Measurements With Arterial Spin Labeling at 1.5 Tesla MRI Combined With Semiautomatic Segmentation for Differential Cortical and Medullary Assessment. Medicine (Baltimore) 2016; 95:e3083. [PMID: 26986143 PMCID: PMC4839924 DOI: 10.1097/md.0000000000003083] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Magnetic resonance imaging with arterial spin labeling (ASL) is a noninvasive approach to measure organ perfusion. The purpose of this study was to evaluate the reproducibility of ASL kidney perfusion measurements with semiautomatic segmentation, which allows separate quantification of cortical and medullary perfusion. The right kidneys of 14 healthy volunteers were examined 6 times on 2 occasions (3 times at each occasion). There was a 10-minute pause between each examination and a 14-day interval between the 2 occasions. Cortical, medullary, and whole kidney parenchymal perfusion was determined with customized semiautomatic segmentation software. Coefficient of variances (CVs) and intraclass correlations (ICCs) were calculated. Mean whole, cortical, and medullary kidney perfusion was 307.26 ± 25.65, 337.10 ± 34.83, and 279.61 ± 26.73 mL/min/100 g, respectively. On session 1, mean perfusion for the whole kidney, cortex, and medulla was 307.08 ± 26.91, 336.79 ± 36.54, and 279.60 ± 27.81 mL/min/100 g, respectively, and on session 2, 307.45 ± 24.65, 337.41 ± 33.48, and 279.61 ± 25.94 mL/min/100 g, respectively (P > 0.05; R² = 0.60/0.59/0.54). For whole, cortical, and medullary kidney perfusion, the total ICC/CV were 0.97/3.43 ± 0.86%, 0.97/4.19 ± 1.33%, and 0.96/4.12 ± 1.36%, respectively. Measurements did not differ significantly and showed a very good correlation (P > 0.05; R² = 0.75/0.76/0.65). ASL kidney measurements combined with operator-independent semiautomatic segmentation revealed high correlation and low variance of cortical, medullary, and whole kidney perfusion.
Collapse
Affiliation(s)
- Matthias Hammon
- From the Department of Radiology (MH, RJ, HS, MU), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz, Erlangen, Germany; Department of Computer Graphics (CS, RG), Friedrich-Alexander-Universität Erlangen-Nürnberg, Cauerstraße, Erlangen, Germany; Experimental Radiology, Department of Diagnostic and Interventional Radiology (PM), University Hospital Tübingen, Otfried-Müller-Straße, Tübingen, Germany; and Department of Nephrology and Hypertension (RES, IK), University Hospital Erlangen, Ulmenweg, Erlangen, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Robson PM, Madhuranthakam AJ, Smith MP, Sun MRM, Dai W, Rofsky NM, Pedrosa I, Alsop DC. Volumetric Arterial Spin-labeled Perfusion Imaging of the Kidneys with a Three-dimensional Fast Spin Echo Acquisition. Acad Radiol 2016; 23:144-54. [PMID: 26521186 DOI: 10.1016/j.acra.2015.09.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 07/06/2015] [Accepted: 09/27/2015] [Indexed: 11/16/2022]
Abstract
RATIONALE AND OBJECTIVES Renal perfusion measurements using noninvasive arterial spin-labeled (ASL) magnetic resonance imaging techniques are gaining interest. Currently, focus has been on perfusion in the context of renal transplant. Our objectives were to explore the use of ASL in patients with renal cancer, and to evaluate three-dimensional (3D) fast spin echo (FSE) acquisition, a robust volumetric imaging method for abdominal applications. We evaluate 3D ASL perfusion magnetic resonance imaging in the kidneys compared to two-dimensional (2D) ASL in patients and healthy subjects. MATERIALS AND METHODS Isotropic resolution (2.6 × 2.6 × 2.8 mm(3)) 3D ASL using segmented FSE was compared to 2D single-shot FSE. ASL used pseudo-continuous labeling, suppression of background signal, and synchronized breathing. Quantitative perfusion values and signal-to-noise ratio (SNR) were compared between 3D and 2D ASL in four healthy volunteers and semiquantitative assessments were made by four radiologists in four patients with known renal masses (primary renal cell carcinoma). RESULTS Renal cortex perfusion in healthy subjects was 284 ± 21 mL/100 g/min, with test-retest repeatability of 8.8%. No significant differences were found between the quantitative perfusion value and SNR in volunteers between 3D ASL and 2D ASL, or in 3D ASL with synchronized or free breathing. In patients, semiquantitative assessment by radiologists showed no significant difference in image quality between 2D ASL and 3D ASL. In one case, 2D ASL missed a high perfusion focus in a mass that was seen by 3D ASL. CONCLUSIONS 3D ASL renal perfusion imaging provides isotropic-resolution images, with comparable quantitative perfusion values and image SNR in similar imaging time to single-slice 2D ASL.
Collapse
Affiliation(s)
- Philip M Robson
- Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, AN-226, Boston, MA 02215.
| | | | - Martin P Smith
- Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, AN-226, Boston, MA 02215
| | - Maryellen R M Sun
- Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, AN-226, Boston, MA 02215
| | - Weiying Dai
- Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, AN-226, Boston, MA 02215
| | - Neil M Rofsky
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ivan Pedrosa
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - David C Alsop
- Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, AN-226, Boston, MA 02215
| |
Collapse
|
30
|
Zhang Y, Kapur P, Yuan Q, Xi Y, Carvo I, Signoretti S, Dimitrov I, Cadeddu JA, Margulis V, Muradyan N, Brugarolas J, Madhuranthakam AJ, Pedrosa I. Tumor Vascularity in Renal Masses: Correlation of Arterial Spin-Labeled and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Assessments. Clin Genitourin Cancer 2016; 14:e25-36. [PMID: 26422014 PMCID: PMC4698181 DOI: 10.1016/j.clgc.2015.08.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/12/2015] [Accepted: 08/24/2015] [Indexed: 01/18/2023]
Abstract
UNLABELLED Arterial spin-labeled (ASL) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) have been proposed to quantitatively assess vascularity in renal cell carcinoma (RCC). However, there are intrinsic differences between these 2 imaging methods, such as the relative contribution of vascular permeability and blood flow to signal intensity for DCE MRI. We found a correlation between ASL perfusion and the DCE-derived volume transfer constant and rate constant parameters in renal masses > 2 cm in size and these measures correlated with microvessel density in clear cell RCC. BACKGROUND The objective of this study was to investigate potential correlations between perfusion using arterial spin-labeled (ASL) magnetic resonance imaging (MRI) and dynamic contrast-enhanced (DCE) MRI-derived quantitative measures of vascularity in renal masses > 2 cm and to correlate these with microvessel density (MVD) in clear cell renal cell carcinoma (ccRCC). PATIENTS AND METHODS Informed written consent was obtained from all patients before imaging in this Health Insurance Portability and Accountability Act-compliant, institutional review board-approved, prospective study. Thirty-six consecutive patients scheduled for surgery of a known renal mass > 2 cm underwent 3T ASL and DCE MRI. ASL perfusion measures (PASL) of mean, peak, and low perfusion areas within the mass were correlated to DCE-derived volume transfer constant (K(trans)), rate constant (Kep), and fractional volume of the extravascular extracellular space (Ve) in the same locations using a region of interest analysis. MRI data were correlated to MVD measures in the same tumor regions in ccRCC. Spearman correlation was used to evaluate the correlation between PASL and DCE-derived measurements, and MVD. P < .05 was considered statistically significant. RESULTS Histopathologic diagnosis was obtained in 36 patients (25 men; mean age 58 ± 12 years). PASL correlated with K(trans) (ρ = 0.48 and P = .0091 for the entire tumor and ρ = 0.43 and P = .03 for the high flow area, respectively) and Kep (ρ = 0.46 and P = .01 for the entire tumor and ρ = 0.52 and P = .008 for the high flow area, respectively). PASL (ρ = 0.66; P = .0002), K(trans) (ρ = 0.61; P = .001), and Kep (ρ = 0.64; P = .0006) also correlated with MVD in high and low perfusion areas in ccRCC. CONCLUSION PASL correlated with the DCE-derived measures of vascular permeability and flow, K(trans) and Kep, in renal masses > 2 cm in size. Both measures correlated to MVD in clear cell histology.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Payal Kapur
- Department of Urology, UT Southwestern Medical Center, Dallas, TX; Department of Pathology, UT Southwestern Medical Center, Dallas, TX
| | - Qing Yuan
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Yin Xi
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Ingrid Carvo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | | | - Ivan Dimitrov
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX; Philips Medical Systems, Cleveland, OH
| | - Jeffrey A Cadeddu
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Department of Urology, UT Southwestern Medical Center, Dallas, TX
| | - Vitaly Margulis
- Department of Urology, UT Southwestern Medical Center, Dallas, TX
| | | | - James Brugarolas
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX; Developmental Biology, UT Southwestern Medical Center, Dallas, TX
| | - Ananth J Madhuranthakam
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
| | - Ivan Pedrosa
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX.
| |
Collapse
|
31
|
Tan H, Koktzoglou I, Prasad PV. Renal perfusion imaging with two-dimensional navigator gated arterial spin labeling. Magn Reson Med 2016; 71:570-9. [PMID: 23447145 DOI: 10.1002/mrm.24692] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE To develop a navigator technique enabling free-breathing acquisition to afford sufficient signal averaging for quantitative renal perfusion measurement using arterial spin labeling MRI. METHODS A novel two-dimensional (2D) navigator technique was implemented in concert with flow-sensitive alternating inversion recovery (FAIR) preparation and true fast imaging with steady precession (True-FISP) readout. The navigator images were obtained with a low-resolution fast low angle shot readout at end of each arterial spin labeling acquisition. A retrospective algorithm was developed to automatically detect respiratory motion for selective signal averaging. The 2D navigator-gated FAIR True-FISP sequence was performed in ten healthy volunteers and five patients with chronic kidney disease. RESULTS Excellent image quality and comparable cortical perfusion rates (healthy: 276 ± 28 mL/100 g/min, patients: 155 ± 25 mL/100 g/min) to literature values were obtained. An average of 3-fold signal-to-noise ratio improvement was obtained in the 2D navigator-gated approach compared with the breath-hold acquisition in healthy volunteers. Good image quality was achieved in patients while the results from breath-hold acquisition were unusable. The quantitative perfusion rates were significantly lower in chronic kidney disease patients compared with the healthy volunteers. CONCLUSION 2D navigator-gated free breathing arterial spin labeling is feasible and is a noninvasive method to evaluate renal perfusion both in healthy subjects and those with chronic kidney disease.
Collapse
Affiliation(s)
- Huan Tan
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, USA
| | | | | |
Collapse
|
32
|
Takakura K, Kido A, Fujimoto K, Kiguchi K, Fushimi Y, Sakashita N, Kimura T, Togashi K. [Evaluation of Appropriate Readout Sequence for Renal MRI Perfusion Using ASTAR (ASL) Technique]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2016; 72:1105-1112. [PMID: 27867170 DOI: 10.6009/jjrt.2016_jsrt_72.11.1105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of this study was to compare true-steady state free precession (True-SSFP) with fast field echo (FFE) as readout imaging sequences for renal arterial spin labeling (ASL), and to optimize the imaging condition. Renal ASL perfusion images were acquired using signal targeting with alternated radio frequency using asymmetric inversion slab (ASTAR) technique with respiratory triggering at 3T MRI system, using either 3D True-SSFP or FFE as the readout sequence. Inversion time (TI) varied from 800 to 2400 ms. Appropriate flip angles were estimated for each sequence by simulating signal intensity (SI). The SI of the renal cortex, vertebral body, and intestinal tract were measured, and the contrast ratio of the cortex (CRcortex) or intestine (CRintestine) related to vertebra was calculated. The image quality of the kidneys, background signal suppression, and misregistration were evaluated by four-point scales. As a result, in quantitative evaluation, the average of CRcortex of each TI (800, 1200, 1600, 2000, and 2400 msec) were 0.49, 0.57, 0.63, 0.63, and 0.56 in FFE, and 0.59, 0.71, 0.73, 0.73, and 0.68 in True-SSFP, respectively. IN qualitative evaluation, ASL images with True-SSFP readout were significantly better than those with FFE readout. In conclusion, True-SSFP sequences will be recommended as read out imaging sequence for obtaining ASL image compared with FFE image.
Collapse
Affiliation(s)
- Kyoko Takakura
- Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Kyoto University
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Lanzman RS, Notohamiprodjo M, Wittsack HJ. [Functional magnetic resonance imaging of the kidneys]. Radiologe 2015; 55:1077-87. [PMID: 26628260 DOI: 10.1007/s00117-015-0044-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Interest in functional renal magnetic resonance imaging (MRI) has significantly increased in recent years. This review article provides an overview of the most important functional imaging techniques and their potential clinical applications for assessment of native and transplanted kidneys, with special emphasis on the clarification of renal tumors.
Collapse
|
34
|
Odudu A, Vassallo D, Kalra PA. From anatomy to function: diagnosis of atherosclerotic renal artery stenosis. Expert Rev Cardiovasc Ther 2015; 13:1357-75. [DOI: 10.1586/14779072.2015.1100077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
35
|
Maier FC, Keller MD, Bukala D, Bender B, Mannheim JG, Brereton IM, Galloway GJ, Pichler BJ. Quantification of β-Amyloidosis and rCBF with Dedicated PET, 7 T MR Imaging, and High-Resolution Microscopic MR Imaging at 16.4 T in APP23 Mice. J Nucl Med 2015; 56:1593-9. [DOI: 10.2967/jnumed.115.159350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/21/2015] [Indexed: 12/15/2022] Open
|
36
|
Rapacchi S, Smith RX, Wang Y, Yan L, Sigalov V, Krasileva KE, Karpouzas G, Plotnik A, Sayre J, Hernandez E, Verma A, Burkly L, Wisniacki N, Torrington J, He X, Hu P, Chiao PC, Wang DJJ. Towards the identification of multi-parametric quantitative MRI biomarkers in lupus nephritis. Magn Reson Imaging 2015; 33:1066-1074. [PMID: 26119419 DOI: 10.1016/j.mri.2015.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/16/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To identify potential biomarkers of the renal impairment in lupus nephritis using a multi-parametric renal quantitative MRI (qMRI) protocol including diffusion weighted imaging (DWI), blood oxygen level dependent (BOLD), arterial spin labeling (ASL) and T1rho MRI between a cohort of healthy volunteers and lupus nephritis (LN) patients. MATERIALS AND METHODS The renal qMRI protocol was performed twice with repositioning in between on 10 LN patients and 10 matched controls at 1.5 T. Navigator-gated and breath-hold acquisitions followed by non-rigid image registration were used to control respiratory motion. The repeatability of the 4 MRI modalities was evaluated with the intra-class correlation coefficient (ICC) and within-subject coefficient of variation (wsCV). Unpaired t-test and stepwise logistic regression were carried out to evaluate qMRI parameters between the LN and control groups. RESULTS The reproducibility of the 4 qMRI modalities ranged from moderate to good (ICC=0.4-0.91, wsCV≤12%) with a few exceptions. T1rho MRI and ASL renal blood flow (RBF) demonstrated significant differences between the LN and control groups. Stepwise logistic regression yielded only one significant parameter (medullar T1rho) in differentiating LN from control groups with 95% accuracy. CONCLUSION A reasonable degree of test-retest repeatability and accuracy of a multi-parametric renal qMRI protocol has been demonstrated in healthy volunteers and LN subjects. T1rho and ASL RBF are promising imaging biomarkers of LN.
Collapse
Affiliation(s)
- Stanislas Rapacchi
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert X Smith
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Yi Wang
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Lirong Yan
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Victor Sigalov
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Kate E Krasileva
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - George Karpouzas
- Department of Rheumatology, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Adam Plotnik
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - James Sayre
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Elizabeth Hernandez
- Department of Rheumatology, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | | | | | | | | | - Xiang He
- Department of Radiology, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Peng Hu
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Danny J J Wang
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA; Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA.
| |
Collapse
|
37
|
Hueper K, Gueler F, Bräsen JH, Gutberlet M, Jang MS, Lehner F, Richter N, Hanke N, Peperhove M, Martirosian P, Tewes S, Vo Chieu VD, Großhennig A, Haller H, Wacker F, Gwinner W, Hartung D. Functional MRI detects perfusion impairment in renal allografts with delayed graft function. Am J Physiol Renal Physiol 2015; 308:F1444-51. [DOI: 10.1152/ajprenal.00064.2015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/28/2015] [Indexed: 11/22/2022] Open
Abstract
Delayed graft function (DGF) after kidney transplantation is not uncommon, and it is associated with long-term allograft impairment. Our aim was to compare renal perfusion changes measured with noninvasive functional MRI in patients early after kidney transplantation to renal function and allograft histology in biopsy samples. Forty-six patients underwent MRI 4–11 days after transplantation. Contrast-free MRI renal perfusion images were acquired using an arterial spin labeling technique. Renal function was assessed by estimated glomerular filtration rate (eGFR), and renal biopsies were performed when indicated within 5 days of MRI. Twenty-six of 46 patients had DGF. Of these, nine patients had acute rejection (including borderline), and eight had other changes (e.g., tubular injury or glomerulosclerosis). Renal perfusion was significantly lower in the DGF group compared with the group with good allograft function (231 ± 15 vs. 331 ± 15 ml·min−1·100 g−1, P < 0.001). Living donor allografts exhibited significantly higher perfusion values compared with deceased donor allografts ( P < 0.001). Renal perfusion significantly correlated with eGFR ( r = 0.64, P < 0.001), resistance index ( r = −0.57, P < 0.001), and cold ischemia time ( r = −0.48, P < 0.01). Furthermore, renal perfusion impairment early after transplantation predicted inferior renal outcome and graft loss. In conclusion, noninvasive functional MRI detects renal perfusion impairment early after kidney transplantation in patients with DGF.
Collapse
Affiliation(s)
- Katja Hueper
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Faikah Gueler
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | | | - Marcel Gutberlet
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Mi-Sun Jang
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Frank Lehner
- Department of General, Abdominal and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Nicolas Richter
- Department of General, Abdominal and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Nils Hanke
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Matti Peperhove
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Petros Martirosian
- Section on Experimental Radiology, University of Tübingen, Tübingen, Germany; and
| | - Susanne Tewes
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Van Dai Vo Chieu
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Anika Großhennig
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Wilfried Gwinner
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Dagmar Hartung
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
38
|
Park SH, Han PK, Choi SH. Physiological and Functional Magnetic Resonance Imaging Using Balanced Steady-state Free Precession. Korean J Radiol 2015; 16:550-9. [PMID: 25995684 PMCID: PMC4435985 DOI: 10.3348/kjr.2015.16.3.550] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 02/05/2015] [Indexed: 12/01/2022] Open
Abstract
Balanced steady-state free precession (bSSFP) is a highly efficient pulse sequence that is known to provide the highest signal-to-noise ratio per unit time. Recently, bSSFP is getting increasingly popular in both the research and clinical communities. This review will be focusing on the application of the bSSFP technique in the context of probing the physiological and functional information. In the first part of this review, the basic principles of bSSFP are briefly covered. Afterwards, recent developments related to the application of bSSFP, in terms of physiological and functional imaging, are introduced and reviewed. Despite its long development history, bSSFP is still a promising technique that has many potential benefits for obtaining high-resolution physiological and functional images.
Collapse
Affiliation(s)
- Sung-Hong Park
- Magnetic Resonance Imaging Lab, Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon 305-701, Korea
| | - Paul Kyu Han
- Magnetic Resonance Imaging Lab, Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon 305-701, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea
| |
Collapse
|
39
|
Prevost VH, Girard OM, Callot V, Cozzone PJ, Duhamel G. Fast imaging strategies for mouse kidney perfusion measurement with pseudocontinuous arterial spin labeling (pCASL) at ultra high magnetic field (11.75 tesla). J Magn Reson Imaging 2015; 42:999-1008. [DOI: 10.1002/jmri.24874] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/04/2015] [Indexed: 12/28/2022] Open
Affiliation(s)
- Valentin H Prevost
- Aix-Marseille Université, CNRS Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Olivier M Girard
- Aix-Marseille Université, CNRS Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Virginie Callot
- Aix-Marseille Université, CNRS Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Patrick J Cozzone
- Aix-Marseille Université, CNRS Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Guillaume Duhamel
- Aix-Marseille Université, CNRS Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| |
Collapse
|
40
|
Longitudinal PET-MRI reveals β-amyloid deposition and rCBF dynamics and connects vascular amyloidosis to quantitative loss of perfusion. Nat Med 2014; 20:1485-92. [PMID: 25384087 DOI: 10.1038/nm.3734] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 07/10/2014] [Indexed: 01/05/2023]
Abstract
The dynamics of β-amyloid deposition and related second-order physiological effects, such as regional cerebral blood flow (rCBF), are key factors for a deeper understanding of Alzheimer's disease (AD). We present longitudinal in vivo data on the dynamics of β-amyloid deposition and the decline of rCBF in two different amyloid precursor protein (APP) transgenic mouse models of AD. Using a multiparametric positron emission tomography and magnetic resonance imaging approach, we demonstrate that in the presence of cerebral β-amyloid angiopathy (CAA), β-amyloid deposition is accompanied by a decline of rCBF. Loss of perfusion correlates with the growth of β-amyloid plaque burden but is not related to the number of CAA-induced microhemorrhages. However, in a mouse model of parenchymal β-amyloidosis and negligible CAA, rCBF is unchanged. Because synaptically driven spontaneous network activity is similar in both transgenic mouse strains, we conclude that the disease-related decline of rCBF is caused by CAA.
Collapse
|
41
|
Boss A, Martirosian P, Fuchs J, Obermayer F, Tsiflikas I, Schick F, Schäfer JF. Dynamic MR urography in children with uropathic disease with a combined 2D and 3D acquisition protocol--comparison with MAG3 scintigraphy. Br J Radiol 2014; 87:20140426. [PMID: 25270833 DOI: 10.1259/bjr.20140426] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate combined two-dimensional (2D) and three-dimensional (3D) dynamic MR urography with respiratory compensation in children with anomalies of the genitourinary tract, allowing for computation of split renal function and assessment of urinary tract obstruction. METHODS Dynamic MR urography was performed in 53 children (3 months-16 years of age) with anomalies of the urinary tract. A protocol for dynamic MR urography and nephrography was implemented at 1.5 T using a navigator-triggered 2D TurboFLASH sequence. Split renal function and contrast-medium excretion were assessed after the bolus injection of 0.05 mmol kg(-1) body weight of gadolinium dimeglumine. In the excretory phase, a 3D gradient-echo data set with high spatial resolution was acquired. In all patients, mercaptoacetyltriglycine (MAG3) scintigraphy was obtained as a reference standard. RESULTS In all children, dynamic MR nephrography and urography could be performed with excellent compensation of breathing artefacts providing region of interest analysis in nearly identical kidney positions. The assessment of contrast-medium excretion into the ureter allowed for discrimination of functional from non-functional stenosis. Split renal function assessed by MRI showed an excellent agreement with the MAG3 reference standard with a correlation coefficient r = 0.95. Additionally recorded 3D data sets offered good depiction of anatomical anomalies in all patients. CONCLUSION The proposed protocol provides a robust technique for assessment of ureteral obstruction and split renal function with compensation of breathing artefacts, short post-processing time and excellent 3D spatial resolution. ADVANCES IN KNOWLEDGE The combined protocol of 2D and 3D MR urography is an efficient technique for assessment of renal morphology and function.
Collapse
Affiliation(s)
- A Boss
- 1 Department of Diagnostic and Interventional Radiology, University Hospital of Zürich, Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|
42
|
Gao Y, Goodnough CL, Erokwu BO, Farr GW, Darrah R, Lu L, Dell KM, Yu X, Flask CA. Arterial spin labeling-fast imaging with steady-state free precession (ASL-FISP): a rapid and quantitative perfusion technique for high-field MRI. NMR IN BIOMEDICINE 2014; 27:996-1004. [PMID: 24891124 PMCID: PMC4110188 DOI: 10.1002/nbm.3143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 04/28/2014] [Accepted: 04/30/2014] [Indexed: 05/03/2023]
Abstract
Arterial spin labeling (ASL) is a valuable non-contrast perfusion MRI technique with numerous clinical applications. Many previous ASL MRI studies have utilized either echo-planar imaging (EPI) or true fast imaging with steady-state free precession (true FISP) readouts, which are prone to off-resonance artifacts on high-field MRI scanners. We have developed a rapid ASL-FISP MRI acquisition for high-field preclinical MRI scanners providing perfusion-weighted images with little or no artifacts in less than 2 s. In this initial implementation, a flow-sensitive alternating inversion recovery (FAIR) ASL preparation was combined with a rapid, centrically encoded FISP readout. Validation studies on healthy C57/BL6 mice provided consistent estimation of in vivo mouse brain perfusion at 7 and 9.4 T (249 ± 38 and 241 ± 17 mL/min/100 g, respectively). The utility of this method was further demonstrated in the detection of significant perfusion deficits in a C57/BL6 mouse model of ischemic stroke. Reasonable kidney perfusion estimates were also obtained for a healthy C57/BL6 mouse exhibiting differential perfusion in the renal cortex and medulla. Overall, the ASL-FISP technique provides a rapid and quantitative in vivo assessment of tissue perfusion for high-field MRI scanners with minimal image artifacts.
Collapse
Affiliation(s)
- Ying Gao
- Department of Radiology, Case Western Reserve University, Cleveland, OH 44106
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106
| | - Candida L. Goodnough
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106
| | | | - George W. Farr
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106
- Aeromics, LLC, Cleveland, OH 44106
| | - Rebecca Darrah
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44106
| | - Lan Lu
- Department of Radiology, Case Western Reserve University, Cleveland, OH 44106
- Department of Urology, Case Western Reserve University, Cleveland, OH 44106
| | - Katherine M. Dell
- CWRU Center for the Study of Kidney Disease and Biology, MetroHealth Campus, Case Western Reserve University, Cleveland, OH 44109
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106
| | - Xin Yu
- Department of Radiology, Case Western Reserve University, Cleveland, OH 44106
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106
| | - Chris A. Flask
- Department of Radiology, Case Western Reserve University, Cleveland, OH 44106
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106
| |
Collapse
|
43
|
Zhang JL, Morrell G, Rusinek H, Sigmund EE, Chandarana H, Lerman LO, Prasad PV, Niles D, Artz N, Fain S, Vivier PH, Cheung AK, Lee VS. New magnetic resonance imaging methods in nephrology. Kidney Int 2014; 85:768-78. [PMID: 24067433 PMCID: PMC3965662 DOI: 10.1038/ki.2013.361] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/16/2013] [Accepted: 07/17/2013] [Indexed: 02/06/2023]
Abstract
Established as a method to study anatomic changes, such as renal tumors or atherosclerotic vascular disease, magnetic resonance imaging (MRI) to interrogate renal function has only recently begun to come of age. In this review, we briefly introduce some of the most important MRI techniques for renal functional imaging, and then review current findings on their use for diagnosis and monitoring of major kidney diseases. Specific applications include renovascular disease, diabetic nephropathy, renal transplants, renal masses, acute kidney injury, and pediatric anomalies. With this review, we hope to encourage more collaboration between nephrologists and radiologists to accelerate the development and application of modern MRI tools in nephrology clinics.
Collapse
Affiliation(s)
- Jeff L Zhang
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Glen Morrell
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Henry Rusinek
- Department of Radiology, New York University, New York, New York, USA
| | - Eric E Sigmund
- Department of Radiology, New York University, New York, New York, USA
| | - Hersh Chandarana
- Department of Radiology, New York University, New York, New York, USA
| | - Lilach O Lerman
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - David Niles
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nathan Artz
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sean Fain
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Alfred K Cheung
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, Utah, USA
| | - Vivian S Lee
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
44
|
Cutajar M, Thomas DL, Hales PW, Banks T, Clark CA, Gordon I. Comparison of ASL and DCE MRI for the non-invasive measurement of renal blood flow: quantification and reproducibility. Eur Radiol 2014; 24:1300-8. [PMID: 24599625 DOI: 10.1007/s00330-014-3130-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 02/06/2014] [Accepted: 02/13/2014] [Indexed: 12/27/2022]
|
45
|
Gillis KA, McComb C, Foster JE, Taylor AHM, Patel RK, Morris STW, Jardine AG, Schneider MP, Roditi GH, Delles C, Mark PB. Inter-study reproducibility of arterial spin labelling magnetic resonance imaging for measurement of renal perfusion in healthy volunteers at 3 Tesla. BMC Nephrol 2014; 15:23. [PMID: 24484613 PMCID: PMC3909760 DOI: 10.1186/1471-2369-15-23] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 01/28/2014] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Measurement of renal perfusion is a crucial part of measuring kidney function. Arterial spin labelling magnetic resonance imaging (ASL MRI) is a non-invasive method of measuring renal perfusion using magnetised blood as endogenous contrast. We studied the reproducibility of ASL MRI in normal volunteers. METHODS ASL MRI was performed in healthy volunteers on 2 occasions using a 3.0 Tesla MRI scanner with flow-sensitive alternating inversion recovery (FAIR) perfusion preparation with a steady state free precession (True-FISP) pulse sequence. Kidney volume was measured from the scanned images. Routine serum and urine biochemistry were measured prior to MRI scanning. RESULTS 12 volunteers were recruited yielding 24 kidneys, with a mean participant age of 44.1 ± 14.6 years, blood pressure of 136/82 mmHg and chronic kidney disease epidemiology formula estimated glomerular filtration rate (CKD EPI eGFR) of 98.3 ± 15.1 ml/min/1.73 m2. Mean kidney volumes measured using the ellipsoid formula and voxel count method were 123.5 ± 25.5 cm3, and 156.7 ± 28.9 cm3 respectively. Mean kidney perfusion was 229 ± 41 ml/min/100 g and mean cortical perfusion was 327 ± 63 ml/min/100 g, with no significant differences between ASL MRIs. Mean absolute kidney perfusion calculated from kidney volume measured during the scan was 373 ± 71 ml/min. Bland Altman plots were constructed of the cortical and whole kidney perfusion measurements made at ASL MRIs 1 and 2. These showed good agreement between measurements, with a random distribution of means plotted against differences observed. The intra class correlation for cortical perfusion was 0.85, whilst the within subject coefficient of variance was 9.2%. The intra class correlation for whole kidney perfusion was 0.86, whilst the within subject coefficient of variance was 7.1%. CONCLUSIONS ASL MRI at 3.0 Tesla provides a repeatable method of measuring renal perfusion in healthy subjects without the need for administration of exogenous compounds. We have established normal values for renal perfusion using ASL MRI in a cohort of healthy volunteers.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Patrick B Mark
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, UK.
| |
Collapse
|
46
|
Hueper K, Gutberlet M, Rong S, Hartung D, Mengel M, Lu X, Haller H, Wacker F, Meier M, Gueler F. Acute Kidney Injury: Arterial Spin Labeling to Monitor Renal Perfusion Impairment in Mice—Comparison with Histopathologic Results and Renal Function. Radiology 2014; 270:117-24. [DOI: 10.1148/radiol.13130367] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
47
|
Ferré JC, Bannier E, Raoult H, Mineur G, Carsin-Nicol B, Gauvrit JY. Arterial spin labeling (ASL) perfusion: Techniques and clinical use. Diagn Interv Imaging 2013; 94:1211-23. [DOI: 10.1016/j.diii.2013.06.010] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
48
|
Ferré JC, Bannier E, Raoult H, Mineur G, Carsin-Nicol B, Gauvrit JY. Perfusion par arterial spin labeling (ASL) : technique et mise en œuvre clinique. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jradio.2013.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Rajendran R, Lew SK, Yong CX, Tan J, Wang DJJ, Chuang KH. Quantitative mouse renal perfusion using arterial spin labeling. NMR IN BIOMEDICINE 2013; 26:1225-1232. [PMID: 23592238 DOI: 10.1002/nbm.2939] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 12/30/2012] [Accepted: 02/08/2013] [Indexed: 06/02/2023]
Abstract
Information on renal perfusion is essential for the diagnosis and prognosis of kidney function. Quantification using gadolinium chelates is limited as a result of filtration through renal glomeruli and safety concerns in patients with kidney dysfunction. Arterial spin labeling MRI is a noninvasive technique for perfusion quantification that has been applied to humans and animals. However, because of the low sensitivity and vulnerability to motion and susceptibility artifacts, its application to mice has been challenging. In this article, mouse renal perfusion was studied using flow-sensitive alternating inversion recovery at 7 T. Good perfusion image quality was obtained with spin-echo echo-planar imaging after controlling for respiratory, susceptibility and fat artifacts by triggering, high-order shimming and water excitation, respectively. High perfusion was obtained in the renal cortex relative to the medulla, and signal was absent in scans carried out post mortem. Cortical perfusion increased from 397 ± 36 (mean ± standard deviation) to 476 ± 73 mL/100 g/min after switching from 100% oxygen to carbogen with 95% oxygen and 5% carbon dioxide. The perfusion in the medulla was 2.5 times lower than that in the cortex and changed from 166 ± 41 mL/100 g/min under oxygen to 203 ± 40 mL/100 g/min under carbogen. T1 decreased in both the cortex (from 1570 ± 164 to 1377 ± 72 ms, p < 0.05) and medulla (from 1788 ± 107 to 1573 ± 144 ms, p < 0.05) under carbogen relative to 100% oxygen. The results showed the potential of the use of ASL for perfusion quantification in mice and in models of renal diseases.
Collapse
Affiliation(s)
- Reshmi Rajendran
- Magnetic Resonance Imaging Group, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | | | | | | | | | | |
Collapse
|
50
|
Correlation of biexponential diffusion parameters with arterial spin-labeling perfusion MRI: results in transplanted kidneys. Invest Radiol 2013; 48:140-4. [PMID: 23249648 DOI: 10.1097/rli.0b013e318277bfe3] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of the present study was to explore the correlation between diffusion parameters assessed by biexponential analysis and the tissue perfusion measured by arterial spin labeling (ASL) imaging in renal allografts. MATERIAL AND METHODS Seventeen recipients of renal allograft (11 men and 6 women; mean [SD] age, 53.6 [14.1] years) were included in this study. For diffusion-weighted imaging, a paracoronal echo-planar imaging sequence was acquired with 16 b values (range, b = 0-750 s/mm²) and 6 averages at 1.5 T. For the quantitative assessment of transplanted kidney perfusion, a flow-sensitive alternating inversion recovery true fast imaging with steady precession-ASL technique was applied. No respiratory gating was used. For quantitative analysis, region of interest measurements were performed on parameter maps. The Spearman correlation coefficients were calculated to determine the association between mean serum creatinine levels, estimated glomerular filtration rate, the apparent diffusion coefficient (ADC) of pure diffusion, the ADC of pseudodiffusion, the monoexponential ADC, the fraction of pseudodiffusion, and the tissue perfusion ASL values. RESULTS In the renal cortex, the fraction of pseudodiffusion was 17.4% ± 4.0%, the apparent diffusion coefficient of pure diffusion was 160.7 ± 15.0 × 10⁻⁵ mm²/s, the monoexponential ADC was 193.2 ± 16.7 × 10⁻⁵ mm²/s, and the ADC of pseudodiffusion was 1421.0 ± 237.7 × 10⁻⁵ mm²/s. Mean cortical perfusion of renal allografts, as assessed with ASL imaging, was 247.2 ± 75.0 mL/100 g/min. There was a significant correlation between ASL perfusion and the fraction of pseudodiffusion (r = 0.68; P < 0.005) but not with the other diffusion coefficients. Both ASL perfusion and the fraction of pseudodiffusion exhibited a significant correlation with serum creatinine levels (r = 0.51 and r= 0.53, respectively; P < 0.05) and estimated glomerular filtration rate (r = 0.63 and r = 0.54, respectively; P < 0.05). CONCLUSIONS This is the first study that shows a significant correlation between renal allograft perfusion, as assessed with ASL perfusion measurements, and the fraction of pseudodiffusion derived from biexponential diffusion-weighted imaging measurements.
Collapse
|