1
|
El-Ksas M, El-Metwally D, Fahmy D, Shebel H. Early and late assessment of renal allograft dysfunction using intravoxel incoherent motion (IVIM) and diffusion-weighted imaging (DWI): a prospective study. Abdom Radiol (NY) 2024:10.1007/s00261-024-04470-x. [PMID: 38976056 DOI: 10.1007/s00261-024-04470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE To evaluate the ability of the Intravoxel Incoherent Motion (IVIM) and monoexponentially ADC in renal allograft function in the early and late phases of transplantation, and to predict their effectiveness in discrimination of the graft pathology. METHODS This is a prospective study included participants scanned with quantitative diffusion and perfusion sequences on a 3-T MR scanner (Philips, Ingenia); the ADC and IVIM parameters; were calculated. Correlations and regression analysis with the eGFR, transplantation periods, and pathology were assessed. RESULTS This study included 105 renal allograft recipients (85 males, and 20 females with mean age = 32.4 ± 11.9 years and age range = 22-61 years). There was a significant positive correlation between the whole parameters of the ADC and IVIM with eGFR however, the cortical parameters showed higher significant correlation coefficients (p < 0.001). Regression analysis revealed the most significant model can predict eGFR groups included cortical pseudo diffusion (D*) and cortical ADC (p < 0.001). In graft dysfunction eGFR was 61.5 ml/min and normal graft was 64 ml/min. This model demonstrates a high performance of an AUC 96% [0.93-0.97]. In the late transplantation, there is a higher correlation with D* compared to ADC, p-values = 0.001. CONCLUSION IVIM and ADC Values are significant biomarkers for renal allograft function assessment, cortical ADC, and D* had the highest performance even in situations with mild impairment that is not affect the eGFR yet as cases of proteinuria with normal eGFR. Furthermore, D* is superior to ADC in the late assessment of the renal transplant.
Collapse
Affiliation(s)
- Mostafa El-Ksas
- Radiology Department, Urology and Nephrology Center, Mansoura University, El Gomhoureya St, Mansoura, Egypt
| | | | - Dalia Fahmy
- Radiology Department, Mansoura University, Mansoura, Egypt
| | - Haytham Shebel
- Radiology Department, Urology and Nephrology Center, Mansoura University, El Gomhoureya St, Mansoura, Egypt.
| |
Collapse
|
2
|
Bane O, Seeliger E, Cox E, Stabinska J, Bechler E, Lewis S, Hickson LJ, Francis S, Sigmund E, Niendorf T. Renal MRI: From Nephron to NMR Signal. J Magn Reson Imaging 2023; 58:1660-1679. [PMID: 37243378 PMCID: PMC11025392 DOI: 10.1002/jmri.28828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Renal diseases pose a significant socio-economic burden on healthcare systems. The development of better diagnostics and prognostics is well-recognized as a key strategy to resolve these challenges. Central to these developments are MRI biomarkers, due to their potential for monitoring of early pathophysiological changes, renal disease progression or treatment effects. The surge in renal MRI involves major cross-domain initiatives, large clinical studies, and educational programs. In parallel with these translational efforts, the need for greater (patho)physiological specificity remains, to enable engagement with clinical nephrologists and increase the associated health impact. The ISMRM 2022 Member Initiated Symposium (MIS) on renal MRI spotlighted this issue with the goal of inspiring more solutions from the ISMRM community. This work is a summary of the MIS presentations devoted to: 1) educating imaging scientists and clinicians on renal (patho)physiology and demands from clinical nephrologists, 2) elucidating the connection of MRI parameters with renal physiology, 3) presenting the current state of leading MR surrogates in assessing renal structure and functions as well as their next generation of innovation, and 4) describing the potential of these imaging markers for providing clinically meaningful renal characterization to guide or supplement clinical decision making. We hope to continue momentum of recent years and introduce new entrants to the development process, connecting (patho)physiology with (bio)physics, and conceiving new clinical applications. We envision this process to benefit from cross-disciplinary collaboration and analogous efforts in other body organs, but also to maximally leverage the unique opportunities of renal physiology. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 2.
Collapse
Affiliation(s)
- Octavia Bane
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute, New York City, New York, USA
| | - Erdmann Seeliger
- Institute of Translational Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Eleanor Cox
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Julia Stabinska
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eric Bechler
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sara Lewis
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - LaTonya J Hickson
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida, USA
| | - Sue Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Eric Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging Center for Advanced Imaging Innovation and Research (CAI2R), New York University Langone Health, New York City, New York, USA
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| |
Collapse
|
3
|
Stabinska J, Zöllner HJ, Thiel TA, Wittsack HJ, Ljimani A. Image downsampling expedited adaptive least-squares (IDEAL) fitting improves intravoxel incoherent motion (IVIM) analysis in the human kidney. Magn Reson Med 2023; 89:1055-1067. [PMID: 36416075 DOI: 10.1002/mrm.29517] [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: 06/09/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To improve the reliability of intravoxel incoherent motion (IVIM) model parameter estimation for the DWI in the kidney using a novel image downsampling expedited adaptive least-squares (IDEAL) approach. METHODS The robustness of IDEAL was investigated using simulated DW-MRI data corrupted with different levels of Rician noise. Subsequently, the performance of the proposed method was tested by fitting bi- and triexponential IVIM model to in vivo renal DWI data acquired on a clinical 3 Tesla MRI scanner and compared to conventional approaches (fixed D* and segmented fitting). RESULTS The numerical simulations demonstrated that the IDEAL algorithm provides robust estimates of the IVIM parameters in the presence of noise (SNR of 20) as indicated by relatively low absolute percentage bias (maximal sMdPB <20%) and normalized RMSE (maximal RMSE <28%). The analysis of the in vivo data showed that the IDEAL-based IVIM parameter maps were less noisy and more visually appealing than those obtained using the fixed D* and segmented methods. Further, coefficients of variation for nearly all IVIM parameters were significantly reduced in cortex and medulla for IDEAL-based biexponential (coefficients of variation: 4%-50%) and triexponential (coefficients of variation: 7.5%-75%) IVIM modelling compared to the segmented (coefficients of variation: 4%-120%) and fixed D* (coefficients of variation: 17%-174%) methods, reflecting greater accuracy of this method. CONCLUSION The proposed fitting algorithm yields more robust IVIM parameter estimates and is less susceptible to poor SNR than the conventional fitting approaches. Thus, the IDEAL approach has the potential to improve the reliability of renal DW-MRI analysis for clinical applications.
Collapse
Affiliation(s)
- Julia Stabinska
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Dusseldorf, Düsseldorf, Germany
| | - Helge J Zöllner
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Thomas A Thiel
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Dusseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Dusseldorf, Düsseldorf, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Dusseldorf, Düsseldorf, Germany
| |
Collapse
|
4
|
Mei Y, Yang G, Guo Y, Zhao K, Wu S, Xu Z, Zhou S, Yan C, Seeliger E, Niendorf T, Xu Y, Feng Y. Parametric MRI Detects Aristolochic Acid Induced Acute Kidney Injury. Tomography 2022; 8:2902-2914. [PMID: 36548535 PMCID: PMC9786286 DOI: 10.3390/tomography8060243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Exposure to aristolochic acid (AA) is of increased concern due to carcinogenic and nephrotoxic effects, and incidence of aristolochic acid nephropathy (AAN) is increasing. This study characterizes renal alterations during the acute phase of AAN using parametric magnetic resonance imaging (MRI). An AAN and a control group of male Wistar rats received administration of aristolochic acid I (AAI) and polyethylene glycol (PEG), respectively, for six days. Both groups underwent MRI before and 2, 4 and 6 days after AAI or PEG administration. T2 relaxation times and apparent diffusion coefficients (ADCs) were determined for four renal layers. Serum creatinine levels (sCr) and blood urea nitrogen (BUN) were measured. Tubular injury scores (TIS) were evaluated based on histologic findings. Increased T2 values were detected since day 2 in the AAN group, but decreased ADCs and increased sCr levels and BUN were not detected until day 4. Significant linear correlations were observed between T2 of the cortex and the outer stripe of outer medulla and TIS. Our results demonstrate that parametric MRI facilitates early detection of renal injury induced by AAI in a rat model. T2 mapping may be a valuable tool for assessing kidney injury during the acute phase of AAN.
Collapse
Affiliation(s)
- Yingjie Mei
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Guixiang Yang
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yihao Guo
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou 570311, China
| | - Kaixuan Zhao
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Shuyu Wu
- Radiotherapy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou 510095, China
| | - Zhongbiao Xu
- Radiotherapy Center, Guangdong General Hospital, Guangzhou 510080, China
| | - Shan Zhou
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Chenggong Yan
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Erdmann Seeliger
- Institute of Translational Physiology, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Medical Image Processing & Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou 510515, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou 510515, China
- Department of Radiology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan 528399, China
- Correspondence:
| |
Collapse
|
5
|
Gao F, Zhao W, Zheng Y, Duan Y, Ji M, Lin G, Zhu Z. Intravoxel Incoherent Motion Magnetic Resonance Imaging Used in Preoperative Screening of High-Risk Patients With Moyamoya Disease Who May Develop Postoperative Cerebral Hyperperfusion Syndrome. Front Neurosci 2022; 16:826021. [PMID: 35310102 PMCID: PMC8924456 DOI: 10.3389/fnins.2022.826021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to investigate the feasibility of preoperative intravoxel incoherent motion (IVIM) MRI for the screening of high-risk patients with moyamoya disease (MMD) who may develop postoperative cerebral hyperperfusion syndrome (CHS). Methods This study composed of two parts. In the first part 24 MMD patients and 24 control volunteers were enrolled. IVIM-MRI was performed. The relative pseudo-diffusion coefficient, perfusion fraction, apparent diffusion coefficient, and diffusion coefficient (rD*, rf, rADC, and rD) values of the IVIM sequence were compared according to hemispheres between MMD patient and healthy control groups. In the second part, 98 adult patients (124 operated hemispheres) with MMD who underwent surgery were included. Preoperative IVIM-MRI was performed. The rD*, rf, rADC, rD, and rfD* values of the IVIM sequence were calculated and analyzed. Operated hemispheres were divided into CHS and non-CHS groups. Patients’ age, sex, Matsushima type, Suzuki stage, and IVIM-MRI examination results were compared between CHS and non-CHS groups. Results Only the rf value was significantly higher in the healthy control group than in the MMD group (P < 0.05). Out of 124 operated hemispheres, 27 were assigned to the CHS group. Patients with clinical presentation of Matsushima types I–V were more likely to develop CHS after surgery (P < 0.05). The rf values of the ipsilateral hemisphere were significantly higher in the CHS group than in the non-CHS group (P < 0.05). The rfD* values of the ACA and MCA supply areas of the ipsilateral hemisphere were significantly higher in the CHS group than in the non-CHS group (P < 0.05). Only the rf value of the anterior cerebral artery supply area in the contralateral hemisphere was higher in the CHS group than in the non-CHS group (P < 0.05). The rf values of the middle and posterior cerebral artery supply areas and the rD, rD*, and rADC values of the both hemispheres were not significantly different between the CHS and non-CHS groups (P > 0.05). Conclusion Preoperative non-invasive IVIM-MRI analysis, particularly the f-value of the ipsilateral hemisphere, may be helpful in predicting CHS in adult patients with MMD after surgery. MMD patients with ischemic onset symptoms are more likely to develop CHS after surgery.
Collapse
Affiliation(s)
- Feng Gao
- Department of Radiology, Huadong Hospital Fudan University, Shanghai, China
- *Correspondence: Feng Gao,
| | - Wei Zhao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yu Zheng
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu, China
| | - Yu Duan
- Department of Neurosurgery, Huadong Hospital Fudan University, Shanghai, China
| | - Ming Ji
- Department of Radiology, Huadong Hospital Fudan University, Shanghai, China
| | - Guangwu Lin
- Department of Radiology, Huadong Hospital Fudan University, Shanghai, China
| | - Zhenfang Zhu
- Department of Radiology, Huadong Hospital Fudan University, Shanghai, China
- Zhenfang Zhu,
| |
Collapse
|
6
|
El Atta HMA, Sakrana AA, Shebel H. Restricted diffusion MRI as a functional biomarker for the assessment of acute calcular upper urinary tract obstruction: initial experience. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00620-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Acute renal obstruction due to stone is a prevalent scenario. The diffusion-weighted magnetic resonance imaging (DWI) of the kidneys provides a noninvasive information on renal function. Our objective is to prospectively assess the potential role of DWI to predict the signal changes of a kidney with acute calcular obstruction.
Results
Chi-square and Fissure exact tests were used to assess the association of diffusion signal changes among patients and control groups. Cohen's Kappa test was run to determine the degree of agreement between the two radiologists. An independent sample t-test was performed to assess the significant difference among ADC values between the two groups. Restricted signals of the obstructed kidneys showed a statistically significant difference when compared with contralateral unobstructed kidney and control group with p value (0.001) and (0.01), respectively. Furthermore, there is a moderate agreement between the two radiologists K = 0.7, p = 0. 001. There is no statistically significant difference in ADC values when comparing the obstructed kidney and the contralateral unobstructed kidney of the patient group or with the control group p value (0.06) and (0.05), respectively.
Conclusion
Restricted signals of the obstructed kidney by DWI may be a helpful tool in diagnosing acute unilateral renal obstruction and can affect its management; however, it needs further validation by more studies.
Collapse
|
7
|
Diffusion Weighted Imaging and T2 Mapping Detect Inflammatory Response in the Renal Tissue during Ischemia Induced Acute Kidney Injury in Different Mouse Strains and Predict Renal Outcome. Biomedicines 2021; 9:biomedicines9081071. [PMID: 34440275 PMCID: PMC8393575 DOI: 10.3390/biomedicines9081071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/15/2021] [Accepted: 08/18/2021] [Indexed: 12/18/2022] Open
Abstract
To characterize ischemia reperfusion injury (IRI)-induced acute kidney injury (AKI) in C57BL/6 (B6) and CD1-mice by longitudinal functional MRI-measurement of edema formation (T2-mapping) and inflammation (diffusion weighted imaging (DWI)). IRI was induced with unilateral right renal pedicle clamping for 35min. 7T-MRI was performed 1 and 14 days after surgery. DWI (7 b-values) and multiecho TSE sequences (7 TE) were acquired. Parameters were quantified in relation to the contralateral kidney on day 1 (d1). Renal MCP-1 and IL-6-levels were measured by qPCR and serum-CXCL13 by ELISA. Immunohistochemistry for fibronectin and collagen-4 was performed. T2-increase on d1 was higher in the renal cortex (127 ± 5% vs. 94 ± 6%, p < 0.01) and the outer stripe of the outer medulla (141 ± 9% vs. 111 ± 9%, p < 0.05) in CD1, indicating tissue edema. Medullary diffusivity was more restricted in CD1 than B6 (d1: 73 ± 3% vs. 90 ± 2%, p < 0.01 and d14: 77 ± 5% vs. 98 ± 3%, p < 0.01). Renal MCP-1 and IL-6-expression as well as systemic CXCL13-release were pronounced in CD1 on d1 after IRI. Renal fibrosis was detected in CD1 on d14. T2-increase and ADC-reduction on d1 correlated with kidney volume loss on d14 (r = 0.7, p < 0.05; r = 0.6, p < 0.05) and could serve as predictive markers. T2-mapping and DWI evidenced higher susceptibility to ischemic AKI in CD1 compared to B6.
Collapse
|
8
|
Perspectives on the Role of Magnetic Resonance Imaging (MRI) for Noninvasive Evaluation of Diabetic Kidney Disease. J Clin Med 2021; 10:jcm10112461. [PMID: 34199385 PMCID: PMC8199575 DOI: 10.3390/jcm10112461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/09/2023] Open
Abstract
Renal magnetic resonance imaging (MRI) techniques are currently in vogue, as they provide in vivo information on renal volume, function, metabolism, perfusion, oxygenation, and microstructural alterations, without the need for exogenous contrast media. New imaging biomarkers can be identified using these tools, which represent a major advance in the understanding and study of the different pathologies affecting the kidney. Diabetic kidney disease (DKD) is one of the most important diseases worldwide due to its high prevalence and impact on public health. However, its multifactorial etiology poses a challenge for both basic and clinical research. Therefore, the use of novel renal MRI techniques is an attractive step forward in the comprehension of DKD, both in its pathogenesis and in its detection and surveillance in the clinical practice. This review article outlines the most promising MRI techniques in the study of DKD, with the purpose of stimulating their clinical translation as possible tools for the diagnosis, follow-up, and monitoring of the clinical impacts of new DKD treatments.
Collapse
|
9
|
Coll-Font J, Afacan O, Hoge S, Garg H, Shashi K, Marami B, Gholipour A, Chow J, Warfield S, Kurugol S. Retrospective Distortion and Motion Correction for Free-Breathing DW-MRI of the Kidneys Using Dual-Echo EPI and Slice-to-Volume Registration. J Magn Reson Imaging 2021; 53:1432-1443. [PMID: 33382173 DOI: 10.1002/jmri.27473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Diffusion-weighted MRI (DW-MRI) of the kidneys is a technique that provides information about the microstructure of renal tissue without requiring exogenous contrasts such as gadolinium, and it can be used for diagnosis in cases of renal disease and assessing response-to-therapy. However, physiological motion and large geometric distortions due to main B0 field inhomogeneities degrade the image quality, reduce the accuracy of quantitative imaging markers, and impede their subsequent clinical applicability. PURPOSE To retrospectively correct for geometric distortion for free-breathing DW-MRI of the kidneys at 3T, in the presence of a nonstatic distortion field due to breathing and bulk motion. STUDY TYPE Prospective. SUBJECTS Ten healthy volunteers (ages 29-38, four females). FIELD STRENGTH/SEQUENCE 3T; DW-MR dual-echo echo-planar imaging (EPI) sequence (10 b-values and 17 directions) and a T2 volume. ASSESSMENT The distortion correction was evaluated subjectively (Likert scale 0-5) and numerically with cross-correlation between the DW images at b = 0 s/mm2 and a T2 volume. The intravoxel incoherent motion (IVIM) and diffusion tensor (DTI) model-fitting performance was evaluated using the root-mean-squared error (nRMSE) and the coefficient of variation (CV%) of their parameters. STATISTICAL TESTS Statistical comparisons were done using Wilcoxon tests. RESULTS The proposed method improved the Likert scores by 1.1 ± 0.8 (P < 0.05), the cross-correlation with the T2 reference image by 0.13 ± 0.05 (P < 0.05), and reduced the nRMSE by 0.13 ± 0.03 (P < 0.05) and 0.23 ± 0.06 (P < 0.05) for IVIM and DTI, respectively. The CV% of the IVIM parameters (slow and fast diffusion, and diffusion fraction for IVIM and mean diffusivity, and fractional anisotropy for DTI) was reduced by 2.26 ± 3.98% (P = 6.971 × 10-2 ), 11.24 ± 26.26% (P = 6.971 × 10-2 ), 4.12 ± 12.91% (P = 0.101), 3.22 ± 0.55% (P < 0.05), and 2.42 ± 1.15% (P < 0.05). DATA CONCLUSION The results indicate that the proposed Di + MoCo method can effectively correct for time-varying geometric distortions and for misalignments due to breathing motion. Consequently, the image quality and precision of the DW-MRI model parameters improved. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 1.
Collapse
Affiliation(s)
- Jaume Coll-Font
- Cardiovascular Research Center, Cardiology, Massachusetts General Hospital, 149 13th St, Charlestown, United States, 02129, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Onur Afacan
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Scott Hoge
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Harsha Garg
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kumar Shashi
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Bahram Marami
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ali Gholipour
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jeanne Chow
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Simon Warfield
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sila Kurugol
- Harvard Medical School, Boston, Massachusetts, USA
- Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
10
|
Intravoxel incoherent motion (IVIM) 3 T MRI for orbital lesion characterization. Eur Radiol 2020; 31:14-23. [PMID: 32740820 DOI: 10.1007/s00330-020-07103-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/28/2020] [Accepted: 07/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of MRI intravoxel incoherent motion (IVIM) when characterizing orbital lesions, which is challenging due to a wide range of locations and histologic types. METHODS This IRB-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3-T MRI prior to surgery from December 2015 to July 2019. An IVIM sequence with 15 b values ranging from 0 to 2000 s/mm2 was performed. Two neuroradiologists, blinded to clinical data, individually analyzed morphological MRIs. They drew one region of interest inside each orbital lesion, providing apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) values. T test, Mann-Whitney U test, and receiver operating characteristic curve analyses were performed to discriminate between orbital lesions and to determine the diagnostic accuracy of the IVIM parameters. RESULTS One hundred fifty-six participants (84 women and 72 men, mean age 54.4 ± 17.5 years) with 167 orbital lesions (98/167 [59%] benign lesions including 54 orbital inflammations and 69/167 [41%] malignant lesions including 32 lymphomas) were included in the study. ADC and D were significantly lower in malignant than in benign lesions: 0.8 × 10-3 mm2/s [0.45] versus 1.04 × 10-3 mm2/s [0.33], p < 0.001, and 0.75 × 10-3 mm2/s [0.40] versus 0.98 × 10-3 mm2/s [0.42], p < 0.001, respectively. D* was significantly higher in malignant lesions than in benign ones: 12.8 × 10-3 mm2/s [20.17] versus 7.52 × 10-3 mm2/s [7.57], p = 0.005. Area under curve was of 0.73, 0.74, 0.72, and 0.81 for ADC, D, D*, and a combination of D, f, and D*, respectively. CONCLUSIONS Our study showed that IVIM might help better characterize orbital lesions. KEY POINTS • Intravoxel incoherent motion (IVIM) helps clinicians to assess patients with orbital lesions. • Intravoxel incoherent motion (IVIM) helps clinicians to characterize orbital lymphoma versus orbital inflammation. • Management of patients becomes more appropriate.
Collapse
|
11
|
Mrđanin T, Nikolić O, Molnar U, Mitrović M, Till V. Diffusion-weighted imaging in the assessment of renal function in patients with diabetes mellitus type 2. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:273-283. [DOI: 10.1007/s10334-020-00869-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/15/2022]
|
12
|
Validity of diffusion-weighted magnetic resonance imaging in the evaluation of acute pyelonephritis in comparison with contrast-enhanced computed tomography. Pol J Radiol 2020; 85:e137-e143. [PMID: 32322320 PMCID: PMC7172225 DOI: 10.5114/pjr.2020.93669] [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: 11/06/2019] [Accepted: 01/27/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose Applications of diffusion-weighted magnetic resonance imaging outside the brain have gained increasing importance in recent years, and recent studies have shown the usage of diffusion-weighted (DW) imaging in diagnosing pyelonephritis based on renal cortical and medullary apparent diffusion coefficient (ADC) values. The aim of this study was to assess the validity of DW magnetic resonance (MR) imaging in comparison with contrast-enhanced computed tomography (CECT) in diagnosing pyelonephritis. Material and methods A cross-sectional observational study was conducted for a period of six months in a tertiary hospital in Coimbatore. All patients with clinical and laboratory diagnosis of acute pyelonephritis, who were referred for radiological imaging (CECT), were taken into the study. Out of 112 patients with a clinical and laboratorial diagnosis of acute pyelonephritis (APN), who underwent both DW MR and CECT, diagnosis of APN was made in 100 patients based on CECT, while in 12 cases the investigation (CECT) was negative. Finally, these 100 patients were included in the study. The validity of DW MR imaging in diagnosing APN was assessed by deriving sensitivity, specificity, and positive and negative predictive value in comparison with CECT findings. Results The validity report of DW MR imaging in the detection of APN showed a very high sensitivity (96-100%) and specificity (86-90%) and very low false positives (6-10%) and negatives (< 5%), and it also showed that in the areas of affected renal parenchyma ADC values were consistently lower compared to unaffected renal parenchyma. Conclusion Based on the generated hypothesis, DW MR imaging of the kidneys seems to be highly sensitive and specific for the detection of focal or diffuse infections within the kidney in comparison with CECT.
Collapse
|
13
|
Ljimani A, Caroli A, Laustsen C, Francis S, Mendichovszky IA, Bane O, Nery F, Sharma K, Pohlmann A, Dekkers IA, Vallee JP, Derlin K, Notohamiprodjo M, Lim RP, Palmucci S, Serai SD, Periquito J, Wang ZJ, Froeling M, Thoeny HC, Prasad P, Schneider M, Niendorf T, Pullens P, Sourbron S, Sigmund EE. Consensus-based technical recommendations for clinical translation of renal diffusion-weighted MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:177-195. [PMID: 31676990 PMCID: PMC7021760 DOI: 10.1007/s10334-019-00790-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 12/13/2022]
Abstract
Objectives Standardization is an important milestone in the validation of DWI-based parameters as imaging biomarkers for renal disease. Here, we propose technical recommendations on three variants of renal DWI, monoexponential DWI, IVIM and DTI, as well as associated MRI biomarkers (ADC, D, D*, f, FA and MD) to aid ongoing international efforts on methodological harmonization. Materials and methods Reported DWI biomarkers from 194 prior renal DWI studies were extracted and Pearson correlations between diffusion biomarkers and protocol parameters were computed. Based on the literature review, surveys were designed for the consensus building. Survey data were collected via Delphi consensus process on renal DWI preparation, acquisition, analysis, and reporting. Consensus was defined as ≥ 75% agreement. Results Correlations were observed between reported diffusion biomarkers and protocol parameters. Out of 87 survey questions, 57 achieved consensus resolution, while many of the remaining questions were resolved by preference (65–74% agreement). Summary of the literature and survey data as well as recommendations for the preparation, acquisition, processing and reporting of renal DWI were provided. Discussion The consensus-based technical recommendations for renal DWI aim to facilitate inter-site harmonization and increase clinical impact of the technique on a larger scale by setting a framework for acquisition protocols for future renal DWI studies. We anticipate an iterative process with continuous updating of the recommendations according to progress in the field. Electronic supplementary material The online version of this article (10.1007/s10334-019-00790-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Anna Caroli
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Susan Francis
- Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Octavia Bane
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fabio Nery
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Paul Vallee
- Department of Diagnostic, Geneva University Hospital and University of Geneva, 1211, Geneva-14, Switzerland
| | - Katja Derlin
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Mike Notohamiprodjo
- Die Radiologie, Munich, Germany.,Department of Radiology, University Hospital Tuebingen, Tübingen, Germany
| | - Ruth P Lim
- Department of Radiology, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Stefano Palmucci
- Department of Medical Surgical Sciences and Advanced Technologies, Radiology I Unit, University Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Suraj D Serai
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Joao Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Zhen Jane Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harriet C Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois (HFR), University of Fribourg, 1708, Fribourg, Switzerland
| | - Pottumarthi Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA
| | - Moritz Schneider
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center, German Center for Lung Research, Munich, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, 13125, Berlin, Germany
| | - Pim Pullens
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium.,Department of Radiology, University Hospital Ghent, Ghent, Belgium
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Eric E Sigmund
- Department of Radiology, Center for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation and Research (CAI2R), NYU Langone Health, New York, NY, USA
| |
Collapse
|
14
|
Chen L, Ren T, Zuo P, Fu Y, Xia S, Shen W. Detecting impaired function of renal allografts at the early stage after transplantation using intravoxel incoherent motion imaging. Acta Radiol 2019; 60:1039-1047. [PMID: 30450922 DOI: 10.1177/0284185118810979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Detecting renal allografts with impaired function early after renal transplantation and timely intervention are important to ensure a successful outcome. Purpose To detect impaired function of renal allografts at the early stage after renal transplantation using intravoxel incoherent motion imaging (IVIM). Material and Methods Forty-six recipients with good allograft function and 32 recipients with impaired function were included in this study. All participants were scanned with IVIM using 11 b-values on a 3-T magnetic resonance (MR) scanner; the apparent diffusion coefficient (ADC), ADC of slow diffusion (ADCslow), pseudo-diffusion (ADCfast), and perfusion fraction (f) values were calculated using a full bi-exponential model. Correlations between estimated glomerular filtration rate (eGFR) and the IVIM parameters were assessed by using Spearman correlation analysis. Receiver operating characteristics were used to assess the diagnostic utilities for detecting allografts with impaired function. Results The ADC, ADCslow, ADCfast, and f values of the renal cortex and the ADC and ADCslow values of the renal medulla were significantly higher in allografts with good function compared to those with impaired function (all P < 0.05). There was a significant corticomedullary difference in ADCslow, ADC, and f in all allografts. ADCfast values were higher in the cortex than in the medulla for allografts with good function but no differences were seen in allografts with impaired function ( P > 0.05). Combined use of all cortical IVIM parameters has higher efficacy in detecting renal allograft dysfunction than any single parameter (sensitivity = 90.62%; specificity = 78.26%). Conclusion IVIM technique may be useful for detecting renal allograft dysfunction, especially combined use of cortical parameters.
Collapse
Affiliation(s)
- Lihua Chen
- Department of Radiology, Tianjin Clinical Research Center for Organ Transplantation, Tianjin First Centre Hospital, Tianjin, PR China
| | - Tao Ren
- Department of Radiology, Tianjin Clinical Research Center for Organ Transplantation, Tianjin First Centre Hospital, Tianjin, PR China
| | - Panli Zuo
- MR Collaborations NE Asia, Siemens Healthcare China, Beijing, PR China
| | - Yingxin Fu
- Department of Kidney Transplantation, Tianjin Clinical Research Center for Organ Transplantation, Tianjin First Centre Hospital, Tianjin, PR China
| | - Shuang Xia
- Department of Radiology, Tianjin Clinical Research Center for Organ Transplantation, Tianjin First Centre Hospital, Tianjin, PR China
| | - Wen Shen
- Department of Radiology, Tianjin Clinical Research Center for Organ Transplantation, Tianjin First Centre Hospital, Tianjin, PR China
| |
Collapse
|
15
|
Wu D, Zhang J. Evidence of the diffusion time dependence of intravoxel incoherent motion in the brain. Magn Reson Med 2019; 82:2225-2235. [PMID: 31267578 DOI: 10.1002/mrm.27879] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate the diffusion time (TD ) dependence of intravoxel incoherent motion (IVIM) signals in the brain. METHODS A 3-compartment IVIM model was proposed to characterize 2 types of microcirculatory flows in addition to tissue water in the brain: flows that cross multiple vascular segments (pseudo-diffusive) and flows that stay in 1 segment (ballistic) within TD . The model was first evaluated using simulated flow signals. Experimentally, flow-compensated (FC) pulsed-gradient spin-echo (PGSE) and oscillating-gradient spin-echo (OGSE) sequences were tested using a flow phantom and then used to examine IVIM signals in the mouse brain with TD ranging from ~2.5 ms to 40 ms on an 11.7T scanner. RESULTS By fitting the model to simulated flow signals, we demonstrated the TD dependency of the estimated fraction of pseudo-diffusive flow and the pseudo-diffusion coefficient (D*), which were dictated by the characteristic timescale of microcirculatory flow (τ). Flow phantom experiments validated that the OGSE and FC-PGSE sequences were not susceptible to the change in flow velocity. In vivo mouse brain data showed that both the estimated fraction of pseudo-diffusive flow and D* increased significantly as TD increased. CONCLUSION We demonstrated that IVIM signals measured in the brain are TD -dependent, potentially because more microcirculatory flows approach the pseudo-diffusive limit as TD increases with respect to τ. Measuring the TD dependency of IVIM signals may provide additional information on microvascular flows in the brain.
Collapse
Affiliation(s)
- Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Jiangyang Zhang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| |
Collapse
|
16
|
Caroli A, Schneider M, Friedli I, Ljimani A, De Seigneux S, Boor P, Gullapudi L, Kazmi I, Mendichovszky IA, Notohamiprodjo M, Selby NM, Thoeny HC, Grenier N, Vallée JP. Diffusion-weighted magnetic resonance imaging to assess diffuse renal pathology: a systematic review and statement paper. Nephrol Dial Transplant 2018; 33:ii29-ii40. [PMID: 30137580 PMCID: PMC6106641 DOI: 10.1093/ndt/gfy163] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 12/26/2022] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) is a non-invasive method sensitive to local water motion in the tissue. As a tool to probe the microstructure, including the presence and potentially the degree of renal fibrosis, DWI has the potential to become an effective imaging biomarker. The aim of this review is to discuss the current status of renal DWI in diffuse renal diseases. DWI biomarkers can be classified in the following three main categories: (i) the apparent diffusion coefficient-an overall measure of water diffusion and microcirculation in the tissue; (ii) true diffusion, pseudodiffusion and flowing fraction-providing separate information on diffusion and perfusion or tubular flow; and (iii) fractional anisotropy-measuring the microstructural orientation. An overview of human studies applying renal DWI in diffuse pathologies is given, demonstrating not only the feasibility and intra-study reproducibility of DWI but also highlighting the need for standardization of methods, additional validation and qualification. The current and future role of renal DWI in clinical practice is reviewed, emphasizing its potential as a surrogate and monitoring biomarker for interstitial fibrosis in chronic kidney disease, as well as a surrogate biomarker for the inflammation in acute kidney diseases that may impact patient selection for renal biopsy in acute graft rejection. As part of the international COST (European Cooperation in Science and Technology) action PARENCHIMA (Magnetic Resonance Imaging Biomarkers for Chronic Kidney Disease), aimed at eliminating the barriers to the clinical use of functional renal magnetic resonance imaging, this article provides practical recommendations for future design of clinical studies and the use of renal DWI in clinical practice.
Collapse
Affiliation(s)
- Anna Caroli
- Medical Imaging Unit, Bioengineering Department, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Bergamo, Italy
| | - Moritz Schneider
- Department of Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany
- Comprehensive Pneumology Center, German Center for Lung Research, Munich, Germany
| | - Iris Friedli
- Division of Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Sophie De Seigneux
- Service and Laboratory of Nephrology, Department of Internal Medicine Specialties and Department of Physiology and Metabolism, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Peter Boor
- Institute of Pathology and Division of Nephrology, RWTH University of Aachen, Aachen, Germany
| | - Latha Gullapudi
- Centre for Kidney Research and Innovation, University of Nottingham, Nottingham, UK
| | - Isma Kazmi
- Centre for Kidney Research and Innovation, University of Nottingham, Nottingham, UK
| | - Iosif A Mendichovszky
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, UK
| | | | - Nicholas M Selby
- Centre for Kidney Research and Innovation, University of Nottingham, Nottingham, UK
| | - Harriet C Thoeny
- Department of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Bern, Switzerland
| | - Nicolas Grenier
- Service d'Imagerie Diagnostique et Interventionnelle de l'Adulte, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Jean-Paul Vallée
- Division of Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| |
Collapse
|
17
|
Intravoxel incoherent motion MRI-derived parameters and T2* relaxation time for noninvasive assessment of renal fibrosis: An experimental study in a rabbit model of unilateral ureter obstruction. Magn Reson Imaging 2018; 51:104-112. [DOI: 10.1016/j.mri.2018.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/29/2018] [Accepted: 04/29/2018] [Indexed: 12/20/2022]
|
18
|
Milani B, Ledoux JB, Rotzinger DC, Kanemitsu M, Vallée JP, Burnier M, Pruijm M. Image acquisition for intravoxel incoherent motion imaging of kidneys should be triggered at the instant of maximum blood velocity: evidence obtained with simulations and in vivo experiments. Magn Reson Med 2018; 81:583-593. [DOI: 10.1002/mrm.27393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Bastien Milani
- Département de Medecine, Service de Néphrologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
- Département de Radiologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
- Center for Biomedical Imaging; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| | - Jean-Baptiste Ledoux
- Département de Radiologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
- Center for Biomedical Imaging; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| | - David C. Rotzinger
- Département de Radiologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| | - Michiko Kanemitsu
- Département de Medecine, Service de Néphrologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| | - Jean-Paul Vallée
- Département d'Imagerie et des Sciences de l'information Médicale; Hôpitaux Universitaires de Genève; Genève Switzerland
| | - Michel Burnier
- Département de Medecine, Service de Néphrologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| | - Menno Pruijm
- Département de Medecine, Service de Néphrologie; Centre Hospitalier Universitaire Vaudois; Vaud Switzerland
| |
Collapse
|
19
|
Lecler A, Savatovsky J, Balvay D, Zmuda M, Sadik JC, Galatoire O, Charbonneau F, Bergès O, Picard H, Fournier L. Repeatability of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0 Tesla in orbital lesions. Eur Radiol 2017; 27:5094-5103. [PMID: 28677061 PMCID: PMC5674133 DOI: 10.1007/s00330-017-4933-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate repeatability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters in the orbit. METHODS From December 2015 to March 2016, 22 patients were scanned twice using an IVIM sequence with 15b values (0-2,000 s/mm2) at 3.0T. Two readers independently delineated regions of interest in an orbital mass and in different intra-orbital and extra-orbital structures. Short-term test-retest repeatability and inter-observer agreement were assessed using the intra-class correlation coefficient (ICC), the coefficient of variation (CV) and Bland-Altman limits of agreements (BA-LA). RESULTS Test-retest repeatability of IVIM parameters in the orbital mass was satisfactory for ADC and D (mean CV 12% and 14%, ICC 95% and 93%), poor for f and D*(means CV 43% and 110%, ICC 90% and 65%). Inter-observer repeatability agreement was almost perfect in the orbital mass for all the IVIM parameters (ICC = 95%, 93%, 94% and 90% for ADC, D, f and D*, respectively). CONCLUSIONS IVIM appeared to be a robust tool to measure D in orbital lesions with good repeatability, but this approach showed a poor repeatability of f and D*. KEY POINTS • IVIM technique is feasible in the orbit. • IVIM has a good-acceptable repeatability of D (CV range 12-25 %). • IVIM interobserver repeatability agreement is excellent (ICC range 90-95 %). • f or D* provide higher test-retest and interobserver variabilities.
Collapse
Affiliation(s)
- Augustin Lecler
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France.
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France.
| | - Julien Savatovsky
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Daniel Balvay
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
| | - Mathieu Zmuda
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Jean-Claude Sadik
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Galatoire
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Frédérique Charbonneau
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Bergès
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Hervé Picard
- Clinical Research Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Laure Fournier
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Radiology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| |
Collapse
|
20
|
Poynton CB, Lee MM, Li Y, Laszik Z, Worters PW, Mackenzie JD, Courtier J. Intravoxel incoherent motion analysis of renal allograft diffusion with clinical and histopathological correlation in pediatric kidney transplant patients: A preliminary cross-sectional observational study. Pediatr Transplant 2017; 21. [PMID: 28653457 DOI: 10.1111/petr.12996] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to compare IVIM values in pediatric renal transplants with histopathology and clinical management change. Fifteen pediatric renal transplant recipients (mean 15.7±2.9 years) were prospectively scanned on a 3T MR scanner with multi-b DTI, prior to same-day transplant biopsy. IVIM maps from 14 subjects were analyzed (one excluded due to motion). Mean values were computed from cortical ROIs and medullary ROIs corresponding to the biopsy site. Subjects were also grouped according to whether or not the biopsy resulted in a change in clinical management. Cortico-medullary IVIM estimates and histopathologic Banff scores were correlated with KT. Cortico-medullary IVIM differences between the "change" and "no change" groups was compared with Mann-Whitney U test. Cortical Dp showed significant moderate negative correlation with Banff t and ci scores (KT=-0.497, P=.035 and KT=-0.46, P=.046) and moderate positive correlation with Banff i score (KT=0.527, P=.028). Cortical Pf showed significant moderate correlation with ci and ct scores (KT=0.489, P=.035 and KT=0.457, P=.043). Tissue diffusivity, Dt , estimated with IVIM was significantly different between the "change" and "no change" groups in medullary ROIs (U=6, P=.021). IVIM analysis has potential as a noninvasive biomarker in assessment of pediatric renal allograft pathology.
Collapse
Affiliation(s)
- Clare B Poynton
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Marsha M Lee
- Department of Pediatrics, Division of Pediatric Nephrology, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Yi Li
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Zoltan Laszik
- Department of Pathology, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Pauline W Worters
- Global Applied Science Laboratory, GE Healthcare, Menlo Park, CA, USA
| | - John D Mackenzie
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Jesse Courtier
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| |
Collapse
|
21
|
Park HJ, Sung YS, Lee SS, Lee Y, Cheong H, Kim YJ, Lee MG. Intravoxel incoherent motion diffusion-weighted MRI of the abdomen: The effect of fitting algorithms on the accuracy and reliability of the parameters. J Magn Reson Imaging 2016; 45:1637-1647. [PMID: 27865032 DOI: 10.1002/jmri.25535] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/13/2016] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To evaluate the influence of fitting methods on the accuracy and reliability of intravoxel incoherent motion (IVIM) parameters, with a particular emphasis on the constraint function. MATERIALS AND METHODS Diffusion-weighted (DW) imaging data were analyzed using IVIM-based full-fitting (simultaneous fit of all parameters) and segmented-fitting (step-by-step fit of each parameter), each with and without the constraint function, to estimate the molecular diffusion coefficient (Dslow ), perfusion fraction (f), and flow-related diffusion coefficient (Dfast ). Computational simulations were performed at variable signal-to-noise ratios to evaluate the relative error (RE) and coefficient of variation (CV) of the estimated IVIM parameters. DW imaging of the abdomen was performed twice at 1.5 Tesla using nine b-values (0-900 s/mm2 ) in 12 health volunteers (6 men and 6 women; mean age: 30 years). The measurement repeatability of IVIM parameters in the liver and the pancreas was evaluated using the within-subject coefficient of variation (w CV). RESULTS In simulations, full-fitting without the constraint function yielded the largest RE (P < 0.001 for Dslow and f; P ≤ 0.044 for Dfast ) and CV (P ≤ 0.033 for Dslow and f; P ≤ 0.473 for Dfast ) for IVIM parameters among all four algorithms. In volunteer imaging, full-fitting without the constraint function also resulted in the poorest repeatability for Dslow (w CV, 17.12%-65.45%) and f (w CV, 19.35%-42.84%) in the liver and pancreas, while the other algorithms had similar repeatability values (w CV, 4.05%-11.99% for Dslow and 9.65%-18.66% for f). Measurement repeatability of Dfast (w CV, 29.52%-85.01%) was the poorest among the IVIM parameters. CONCLUSION For accurate and reliable measurement of IVIM parameters, segmented fitting or full-fitting with the constraint function should be used for IVIM-based analysis of DW imaging. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1637-1647.
Collapse
Affiliation(s)
- Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yu Sub Sung
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Seung Soo Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yedaun Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hyunhee Cheong
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Yeong Jae Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, Korea
| |
Collapse
|
22
|
Düzenli K, Öztürk M, Yıldırım İO, Erdem G. The utility of diffusion-weighted imaging to assess acute renal parenchymal changes due to unilateral ureteral stone obstruction. Urolithiasis 2016; 45:401-405. [DOI: 10.1007/s00240-016-0924-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/27/2016] [Indexed: 01/19/2023]
|
23
|
Karan B, Erbay G, Koc Z, Pourbagher A, Yildirim S, Agildere AM. Utility of Diffusion-Weighted MRI to Detect Changes in Liver Diffusion in Benign and Malignant Distal Bile Duct Obstruction: The Influence of Choice of b-Values. Can Assoc Radiol J 2016; 67:395-401. [PMID: 27592163 DOI: 10.1016/j.carj.2016.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/19/2016] [Accepted: 03/24/2016] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The study sought to evaluate the potential of diffusion-weighted magnetic resonance imaging to detect changes in liver diffusion in benign and malignant distal bile duct obstruction and to investigate the effect of the choice of b-values on apparent diffusion coefficient (ADC). METHODS Diffusion-weighted imaging was acquired with b-values of 200, 600, 800, and 1000 s/mm2. ADC values were obtained in 4 segments of the liver. The mean ADC values of 16 patients with malignant distal bile duct obstruction, 14 patients with benign distal bile duct obstruction, and a control group of 16 healthy patients were compared. RESULTS Mean ADC values for 4 liver segments were lower in the malignant obstruction group than in the benign obstruction and control groups using b = 200 s/mm2 (P < .05). Mean ADC values of the left lobe medial and lateral segments were lower in the malignant obstruction group than in the benign obstructive and control groups using b = 600 s/mm2 (P < .05). Mean ADC values of the right lobe posterior segment were lower in the malignant and benign obstruction groups than in the control group using b = 1000 s/mm2 (P < .05). Using b = 800 s/mm2, ADC values of all 4 liver segments in each group were not significantly different (P > .05). There were no correlations between the ADC values of liver segments and liver function tests. CONCLUSION Measurement of ADC shows good potential for detecting changes in liver diffusion in patients with distal bile duct obstruction. Calculated ADC values were affected by the choice of b-values.
Collapse
Affiliation(s)
- Belgin Karan
- Department of Radiology, Baskent University School of Medicine, Adana, Turkey; Department of Radiology, Medipol University School of Medicine, Istanbul, Turkey.
| | - Gurcan Erbay
- Department of Radiology, Baskent University School of Medicine, Adana, Turkey
| | - Zafer Koc
- Department of Radiology, Baskent University School of Medicine, Adana, Turkey
| | - Aysin Pourbagher
- Department of Radiology, Baskent University School of Medicine, Adana, Turkey
| | - Sedat Yildirim
- Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey
| | | |
Collapse
|
24
|
Perfusion Assessment Using Intravoxel Incoherent Motion-Based Analysis of Diffusion-Weighted Magnetic Resonance Imaging. Invest Radiol 2016; 51:520-8. [DOI: 10.1097/rli.0000000000000262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
25
|
Dunn DP, Kelsey NR, Lee KS, Smith MP, Mortele KJ. Non-oncologic applications of diffusion-weighted imaging (DWI) in the genitourinary system. ACTA ACUST UNITED AC 2016; 40:1645-54. [PMID: 26109511 DOI: 10.1007/s00261-015-0471-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Diffusion-weighted imaging (DWI) has become an increasingly used tool in abdominal and pelvic magnetic resonance imaging (MRI), primarily in the oncologic setting. DWI sequences are being added to routine MRI protocols at many institutions, and as its use has spread, more non-oncologic applications have been explored. The purpose of this article is to provide a review of DWI applications in inflammatory, infectious, autoimmune-mediated, and ischemic processes affecting the genitourinary system.
Collapse
Affiliation(s)
- Dell P Dunn
- Department of Radiology, David Grant Medical Center, 101 Bodin Cir, Travis AFB, CA, 94535, USA,
| | | | | | | | | |
Collapse
|
26
|
Cai XR, Yu J, Zhou QC, Du B, Feng YZ, Liu XL. Use of intravoxel incoherent motion MRI to assess renal fibrosis in a rat model of unilateral ureteral obstruction. J Magn Reson Imaging 2016; 44:698-706. [PMID: 26841951 DOI: 10.1002/jmri.25172] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 01/19/2016] [Indexed: 02/01/2023] Open
Affiliation(s)
- Xiang-Ran Cai
- Medical Imaging Center, First Affiliated Hospital; Jinan University; Guangzhou Guangdong China
| | - Juan Yu
- Department of Medical Imaging, Shenzhen Second People's Hospital; Shenzhen University; Shenzhen Guangdong China
| | - Qing-Chun Zhou
- Department of Urology, Nanhua Affiliated Hospital; Nanhua University; Hengyang Hunan China
| | - Bin Du
- Department of Pathology, First Affiliated Hospital; Jinan University; Guangzhou Guangdong China
| | - You-Zhen Feng
- Medical Imaging Center, First Affiliated Hospital; Jinan University; Guangzhou Guangdong China
| | - Xiao-ling Liu
- Medical Imaging Center, First Affiliated Hospital; Jinan University; Guangzhou Guangdong China
| |
Collapse
|
27
|
Valerio M, Zini C, Fierro D, Giura F, Colarieti A, Giuliani A, Laghi A, Catalano C, Panebianco V. 3T multiparametric MRI of the prostate: Does intravoxel incoherent motion diffusion imaging have a role in the detection and stratification of prostate cancer in the peripheral zone? Eur J Radiol 2016; 85:790-4. [PMID: 26971425 DOI: 10.1016/j.ejrad.2016.01.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/13/2016] [Accepted: 01/16/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the potential added value of the intravoxel incoherent motion model to conventional multiparametric magnetic resonance protocol in order to differentiate between healthy and neoplastic prostate tissue in the peripheral zone. MATERIAL AND METHODS Mono-exponential and bi-exponential fits were used to calculate ADC and IVIM parameters in 53 patients with peripheral zone biopsy proved tumor. Inferential statistics analysis was performed on T2, ADC and IVIM parameters (D, D*, f) comparing healthy and neoplastic tissues. Linear discriminant analysis was performed for the conventional parameters (T2 and ADC), the IVIM parameters (molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (f) and the combined T2-weighted imaging/DWI and IVIM parameters (T2, ADC, D, D* and f). A correlation with Gleason scores was achieved. RESULTS The values of T2, ADC and D were significantly lower in cancerous tissues (2749.82 ± 1324.67 ms, 0.76 ± 0.27 × 10(-3)mm(2)/s and 0.99 ± 0.38 × 10(-3)mm(2)/s respectively) compared to those found in the healthy tissues (3750.70 ± 1735.37 ms, 1.39 ± 0.48 × 10(-3)mm(2)/s and 1.77 ± 0.36 × 10(-3)mm(2)/s respectively); D* parameter was significantly increased in neoplastic compared to healthy tissue (15.56 ± 12.91 × 10(-3)mm(2)/s and 10.25 ± 10.52 × 10(-3)mm(2)/s respectively). The specificity, sensitivity and accuracy of the T2-weighted imaging/DWI and IVIM parameters were 100, 96 and 98%, respectively, compare to 88, 92 and 90% and 96, 92 and 94 for T2-weighted imaging/ADC and IVIM alone. CONCLUSIONS IVIM parameters increase the specificity and sensitivity in the evaluation of peripheral zone prostate cancer. A statistical difference between low grade tumors and high grade tumors has been demostrated in that ADC, D and D* dataset; in particular, D has been found to have the highest significativity.
Collapse
Affiliation(s)
- Mariacristina Valerio
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Chiara Zini
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Davide Fierro
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Francesca Giura
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Anna Colarieti
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Alessandro Giuliani
- Environment and Health Dept., Istituto Superiore di Sanità, Rome, V.le Regina Elena, 299, 00161 Roma, Italy
| | - Andrea Laghi
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Carlo Catalano
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy
| | - Valeria Panebianco
- Dept. of Radiological Sciences, Oncology & Pathology-Sapienza University of Rome, V.le Regina Elena, 324, 00161 Roma, Italy.
| |
Collapse
|
28
|
Rona G, Pasaoglu L, Ozkayar N, Ciliz D, Toprak U, Kaya T, Abat G. Functional evaluation of secondary renal amyloidosis with diffusion-weighted MR imaging. Ren Fail 2016; 38:249-55. [PMID: 26727603 DOI: 10.3109/0886022x.2015.1128252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study evaluated whether diffusion-weighted magnetic resonance imaging (DW-MRI) can be used to diagnose secondary renal amyloidosis looking specifically at the diagnostic efficacy of two apparent diffusion coefficient (ADC) measurement methods as they were used with DW-MRI. METHODS The study included 24 amyloid nephropathy (AN) patients, 20 chronic kidney disease (CKD) patients, and 20 healthy volunteers (HV). ADC values were measured using two different methods: 1) the method of the region of interest indicators (ROIs) and 2) the method of drawing whole renal parenchyma (WP). The correlation between the two methods was evaluated. RESULTS ROIs could differentiate AN-CKD (p = 0.007). ROIs and WP could differentiate AN-HV (p < 0.05). However, none of the methods could differentiate CKD-HV (p > 0.05). The sensitivity and specificity of the ROIs method in differentiating AN from CKD patients for 1.8 × 10(-3) cutoff ADC values were 79% and 60% and for AN-HV patients 79% and 70%. ADC values of AN patients with GFR > 60 mL/min were lower than that of HV (p < 0.01). CONCLUSION DW-MRI is a useful and non-invasive diagnostic tool in diagnosing secondary renal amyloidosis and differentiating renal amyloidosis from other CKDs. ROIs had the highest sensitivity and specificity for assessing the involvement of renal amyloidosis. MRI diagnosis of AN may obviate a renal biopsy for diagnosis.
Collapse
Affiliation(s)
- Gunay Rona
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Lale Pasaoglu
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Nihal Ozkayar
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Deniz Ciliz
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Ugur Toprak
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Tunca Kaya
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| | - Gizem Abat
- a Ankara Numune Egitim Ve Arastirma Hastanesi , Ankara , Turkey
| |
Collapse
|
29
|
Barbieri S, Donati OF, Froehlich JM, Thoeny HC. Comparison of Intravoxel Incoherent Motion Parameters across MR Imagers and Field Strengths: Evaluation in Upper Abdominal Organs. Radiology 2015; 279:784-94. [PMID: 26678455 DOI: 10.1148/radiol.2015151244] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose To determine the reproducibility of intravoxel incoherent motion (IVIM) parameters measured in upper abdominal organs with magnetic resonance (MR) imagers from different vendors and with different field strengths. Materials and Methods This prospective study was approved by the independent ethics committees of Kanton Bern and Kanton Zurich, and signed informed consent was obtained from all participants. Abdominal diffusion-weighted images in 10 healthy men (mean age, 37 years ± 8 [standard deviation]) were acquired by using 1.5- and 3.0-T MR imagers from three different vendors. Two readers independently delineated regions of interest that were used to measure IVIM parameters (diffusion coefficient [Dt], perfusion fraction [Fp], and pseudodiffusion coefficient [Dp]) in the left and right lobes of the liver, and in the pancreas, spleen, renal cortex, and renal medulla. Measurement reproducibility between readers was assessed with intraclass correlation coefficients (ICCs). Variability across MR imagers was analyzed by using between- and within-subject coefficients of variation (CVs) and analysis of variance (ANOVA). Results Between-reader reproducibility was high for Dt (ICC, 94.6%), intermediate for Fp (ICC, 81.7%), and low for Dp (ICC, 69.5%). Between- and within-subject CVs of Dt were relatively high (>20%) in the left lobe of the liver and relatively low (<10%) in the renal cortex and renal medulla. CVs generally exceeded 15% for Fp values and 20% for Dp. ANOVA indicated significant differences (P < .05) between MR imagers. Conclusion IVIM parameters in the upper abdomen may differ substantially across MR imagers. (©) RSNA, 2015 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Sebastiano Barbieri
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Olivio F Donati
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Johannes M Froehlich
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| | - Harriet C Thoeny
- From the Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (S.B., J.M.F., H.C.T.); and Institute of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland (O.F.D.)
| |
Collapse
|
30
|
Ye J, Kumar BS, Li XB, Li HM, Zhou YW, Liu LQ. Clinical applications of diffusion-weighted magnetic resonance imaging in diagnosis of renal lesions - a systematic review. Clin Physiol Funct Imaging 2015; 37:459-473. [PMID: 26648310 DOI: 10.1111/cpf.12313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/21/2015] [Indexed: 01/07/2023]
Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) is an established technique to detect the changes of the diffusion of water in biological tissues and reflect the pathophysiological process on the molecular level. It is a promising non-invasive imaging modality in detection of microstructural and functional changes in pathologies of kidney. To systematically review the research advancement of the DW-MRI in diagnosis of renal lesions, a systematic literature search was performed up to 8 October 2014 using the MEDLINE/PubMed and Embase databases for articles reporting on DW-MRI in diagnosis of renal lesions. Only articles with full data about DW-MRI application with potential implication in solving usually encountered clinical challenges about renal lesions were finally examined. The clinical application of DW-MRI allows a better understanding of some pathologic conditions of the kidney including renal insufficiency, renal artery stenosis, ureteral obstruction, foetal kidney disease, hydronephrosis and pyonephrosis. In addition, DW-MRI can also provide clinicians with the information of function evaluation of renal allograft and curative effect assessment of renal tumour. In summary, performance of renal DW-MRI, presuming that measurements are high quality, will further boost this modality, particularly for early detection of diffusion renal conditions, as well as more accurate characterization of renal lesions.
Collapse
Affiliation(s)
- Jing Ye
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | | | - Xiao-Bo Li
- Department of Neurology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Hong-Mei Li
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Ying-Wen Zhou
- Department of Imaging, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Li-Qin Liu
- Department of Oncology, Northern Jiangsu People's Hospital, Yangzhou, China
| |
Collapse
|
31
|
Villa L, Giusti G, Knoll T, Traxer O. Imaging for Urinary Stones: Update in 2015. Eur Urol Focus 2015; 2:122-129. [PMID: 28723526 DOI: 10.1016/j.euf.2015.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/14/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
Abstract
CONTEXT Imaging is essential for the diagnosis and the clinical decision-making process of patients with urinary stones. OBJECTIVE To assess the benefits and limitations of various imaging techniques by specifically focusing on different phases of stone patients' management. EVIDENCE ACQUISITION PubMed and Web of Science databases were used to identify studies published in the last 10 yr on this argument. Search terms included 'urolithiasis', nephrolithiasis', or 'urinary stones' in combination (AND) with the terms 'imaging', 'computer tomography', 'ultrasonography', 'intravenous pyelogram', or 'radiation exposure'. Study selection was based on an independent peer-review process of all the authors after the structured data search. EVIDENCE SYNTHESIS Noncontrast-enhanced computer tomography (CT) provides the highest value of diagnostic accuracy for urinary stones. Stone composition can be specifically assessed through the use of dual-energy CT. When information about the anatomy of the renal collecting system is required or alternative pathologies are suspected, CT with contrast injection is recommended. Low-dose protocols allowed a drastic reduction of the effective dose administered to the patient, thus limiting the biological risk due to ionising radiations. Other strategies to contain the radiation exposure include the dual-split bolus dual energy CT and the adaptive statistical image reconstruction. Abdomen ultrasound may be a valid alternative as an initial approach since it does not change the outcome of patients compared with CT, and should be the imaging of choice in children and pregnant women. CONCLUSIONS Noncontrast-enhanced CT is the most accurate imaging technique to identify urinary stones. Abdomen ultrasound seems to be a valid alternative in the initial evaluation of urinary colic. New low-dose protocols and strategies have been developed to contain radiation exposure, which is a major issue especially in specific circumstances. PATIENT SUMMARY Noncontrast-enhanced computer tomography has been increasingly used for the diagnosis and management of urinary stones. Low-dose protocols as well as alternative imaging should be considered by clinicians in specific circumstances to minimise radiation exposure.
Collapse
Affiliation(s)
- Luca Villa
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Guido Giusti
- Department of Urology, IRCCS Ospedale San Raffaele Ville Turro, Milan, Italy
| | - Thomas Knoll
- Department of Urology, Klinikum Sindelfingen-Boeblingen, University of Tuebingen, Sindelfingen, Germany
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Pierre et Marie Curie University, Paris, France
| |
Collapse
|
32
|
Panicker JN, Fowler CJ, Kessler TM. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol 2015; 14:720-32. [PMID: 26067125 DOI: 10.1016/s1474-4422(15)00070-8] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/27/2015] [Accepted: 04/27/2015] [Indexed: 12/21/2022]
Abstract
Lower urinary tract (LUT) dysfunction is a common sequela of neurological disease, resulting in symptoms that have a pronounced effect on quality of life. The site and nature of the neurological lesion affect the pattern of dysfunction. The risk of developing upper urinary tract damage and renal failure is much lower in patients with slowly progressive non-traumatic neurological disorders than in those with spinal cord injury or spina bifida; this difference in morbidity is taken into account in the development of appropriate management algorithms. Clinical assessment might include tests such as uroflowmetry, post-void residual volume measurement, renal ultrasound, (video-)urodynamics, neurophysiology, and urethrocystoscopy, depending on the indication. Incomplete bladder emptying is most often managed by intermittent catheterisation, and storage dysfunction by antimuscarinic drugs. Intradetrusor injections of onabotulinumtoxinA have transformed the management of neurogenic detrusor overactivity. Neuromodulation offers promise for managing both storage and voiding dysfunction. An individualised, patient-tailored approach is required for the management of LUT dysfunction associated with neurological disorders.
Collapse
Affiliation(s)
- Jalesh N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK.
| | - Clare J Fowler
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK
| | - Thomas M Kessler
- Neuro-Urology, Spinal Cord Injury Center, University of Zürich, Balgrist University Hospital, Zürich, Switzerland
| |
Collapse
|
33
|
Sulkowska K, Palczewski P, Duda-Zysk A, Szeszkowski W, Wojcik D, Kownacka-Piotrowska D, Gołebiowski M. Diffusion-weighted MRI of kidneys in healthy volunteers and living kidney donors. Clin Radiol 2015; 70:1122-7. [PMID: 26149258 DOI: 10.1016/j.crad.2015.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/09/2015] [Accepted: 05/29/2015] [Indexed: 12/13/2022]
Abstract
AIM To establish the normal apparent diffusion coefficient (ADC) values in healthy kidneys, comparing them with the literature, and assessing the correlation between ADC values, creatinine blood level, and glomerular filtration rate (GFR). MATERIALS AND METHODS Twenty-four healthy volunteers and 26 living kidney donors were examined on a 1.5 T magnetic resonance imaging (MRI) unit. Two diffusion-weighted imaging (DWI) sequences were included in the study protocol (protocol 1 with 16 b-values, protocol 2 with 10 b-values) before the examination blood and urine samples were collected. The GFR was calculated using Cockcroft & Gault and MDRD (Modification of Diet In Renal Disease) formulas and the ADC values were measured separately for the cortex and medulla of each kidney by two independent observers. All statistical analyses were performed using the STATISTICA (version 10.0) software package. Data were analysed using an unpaired t-test; p < 0.05 indicated a statistically significant difference. RESULTS The average ADC value for protocol 1 for the cortex was 2.26 × 10(-3) mm(2)/s, for the medulla 2.21 × 10(-3) mm(2)/s. In protocol 2, the respective values were 2.13 × 10(-3) mm(2)/s and 2.06 × 10(-3) mm(2)/s. Neither statistically significant interobserver differences nor correlation between ADC values, GFR, and creatinine serum level were observed. CONCLUSION The reference ADC values were established. The measurements show high interobserver consistency. The differences in ADC values reported in the literature suggest dependence on the equipment and methodology and point to the necessity of obtaining ADC norms for each MRI unit.
Collapse
Affiliation(s)
- K Sulkowska
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland.
| | - P Palczewski
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland
| | - A Duda-Zysk
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland
| | - W Szeszkowski
- II Department of Clinical Radiology, Warsaw Medical University, Banacha 1a, 02-097 Warsaw, Poland
| | - D Wojcik
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland
| | - D Kownacka-Piotrowska
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland
| | - M Gołebiowski
- I Department of Clinical Radiology, Warsaw Medical University, Chalubinskiego 5, 02-004 Warsaw, Poland
| |
Collapse
|
34
|
Friedli I, Crowe LA, Viallon M, Porter DA, Martin PY, de Seigneux S, Vallée JP. Improvement of renal diffusion-weighted magnetic resonance imaging with readout-segmented echo-planar imaging at 3T. Magn Reson Imaging 2015; 33:701-8. [DOI: 10.1016/j.mri.2015.02.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/20/2015] [Indexed: 01/06/2023]
|
35
|
Barbieri S, Donati OF, Froehlich JM, Thoeny HC. Impact of the calculation algorithm on biexponential fitting of diffusion-weighted MRI in upper abdominal organs. Magn Reson Med 2015; 75:2175-84. [PMID: 26059232 DOI: 10.1002/mrm.25765] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/19/2015] [Accepted: 04/13/2015] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare the variability, precision, and accuracy of six different algorithms (Levenberg-Marquardt, Trust-Region, Fixed-Dp , Segmented-Unconstrained, Segmented-Constrained, and Bayesian-Probability) for computing intravoxel-incoherent-motion-related parameters in upper abdominal organs. METHODS Following the acquisition of abdominal diffusion-weighted magnetic resonance images of 10 healthy men, six distinct algorithms were employed to compute intravoxel-incoherent-motion-related parameters in the left and right liver lobe, pancreas, spleen, renal cortex, and renal medulla. Algorithms were evaluated regarding inter-reader and intersubject variability. Comparability of results was assessed by analyses of variance. The algorithms' precision and accuracy were investigated on simulated data. RESULTS A Bayesian-Probability based approach was associated with very low inter-reader variability (average Intraclass Correlation Coefficients: 96.5-99.6%), the lowest inter-subject variability (Coefficients of Variation [CV] for the pure diffusion coefficient Dt : 3.8% in the renal medulla, 6.6% in the renal cortex, 10.4-12.1% in the left and right liver lobe, 15.3% in the spleen, 15.8% in the pancreas; for the perfusion fraction Fp : 15.5% on average; for the pseudodiffusion coefficient Dp : 25.8% on average), and the highest precision and accuracy. Results differed significantly (P < 0.05) across algorithms in all anatomical regions. CONCLUSION The Bayesian-Probability algorithm should be preferred when computing intravoxel-incoherent-motion-related parameters in upper abdominal organs.
Collapse
Affiliation(s)
- Sebastiano Barbieri
- Department of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Bern, Switzerland
| | - Olivio F Donati
- Department of Diagnostic and Interventional Radiology, University Hospital, Zürich, Switzerland
| | - Johannes M Froehlich
- Department of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Bern, Switzerland
| | - Harriet C Thoeny
- Department of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Bern, Switzerland
| |
Collapse
|
36
|
Boor P, Floege J. Renal allograft fibrosis: biology and therapeutic targets. Am J Transplant 2015; 15:863-86. [PMID: 25691290 DOI: 10.1111/ajt.13180] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 11/30/2014] [Accepted: 12/19/2014] [Indexed: 01/25/2023]
Abstract
Renal tubulointerstitial fibrosis is the final common pathway of progressive renal diseases. In allografts, it is assessed with tubular atrophy as interstitial fibrosis/tubular atrophy (IF/TA). IF/TA occurs in about 40% of kidney allografts at 3-6 months after transplantation, increasing to 65% at 2 years. The origin of renal fibrosis in the allograft is complex and includes donor-related factors, in particular in case of expanded criteria donors, ischemia-reperfusion injury, immune-mediated damage, recurrence of underlying diseases, hypertensive damage, nephrotoxicity of immunosuppressants, recurrent graft infections, postrenal obstruction, etc. Based largely on studies in the non-transplant setting, there is a large body of literature on the role of different cell types, be it intrinsic to the kidney or bone marrow derived, in mediating renal fibrosis, and the number of mediator systems contributing to fibrotic changes is growing steadily. Here we review the most important cellular processes and mediators involved in the progress of renal fibrosis, with a focus on the allograft situation, and discuss some of the challenges in translating experimental insights into clinical trials, in particular fibrosis biomarkers or imaging modalities.
Collapse
Affiliation(s)
- P Boor
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Aachen, Germany; Department of Pathology, RWTH University of Aachen, Aachen, Germany; Institute of Molecular Biomedicine, Bratislava, Slovakia
| | | |
Collapse
|
37
|
Boor P, Perkuhn M, Weibrecht M, Zok S, Martin IV, Gieseke J, Schoth F, Ostendorf T, Kuhl C, Floege J. Diffusion-weighted MRI does not reflect kidney fibrosis in a rat model of fibrosis. J Magn Reson Imaging 2015; 42:990-8. [DOI: 10.1002/jmri.24853] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 01/02/2015] [Indexed: 12/23/2022] Open
Affiliation(s)
- Peter Boor
- Institute of Pathology, RWTH University Aachen; Aachen Germany
- Division of Nephrology, RWTH University Aachen; Aachen Germany
- Electron Microscopic Facility, Medical Faculty RWTH; Aachen Germany
- Institute of Molecular Biomedicine, Comenius University; Bratislava Slovakia
| | - Michael Perkuhn
- Department of Radiology; RWTH University Aachen; Aachen Germany
- Philips Technologie GmbH Innovative Technologies; Research Laboratories; Aachen Germany
| | - Martin Weibrecht
- Department of Radiology; RWTH University Aachen; Aachen Germany
- Philips Technologie GmbH Innovative Technologies; Research Laboratories; Aachen Germany
| | - Stephanie Zok
- Division of Nephrology, RWTH University Aachen; Aachen Germany
| | - Ina V. Martin
- Division of Nephrology, RWTH University Aachen; Aachen Germany
| | | | - Felix Schoth
- Department of Radiology; RWTH University Aachen; Aachen Germany
| | - Tammo Ostendorf
- Division of Nephrology, RWTH University Aachen; Aachen Germany
| | - Christiane Kuhl
- Department of Radiology; RWTH University Aachen; Aachen Germany
| | - Jürgen Floege
- Division of Nephrology, RWTH University Aachen; Aachen Germany
| |
Collapse
|
38
|
Wurnig MC, Donati OF, Ulbrich E, Filli L, Kenkel D, Thoeny HC, Boss A. Systematic analysis of the intravoxel incoherent motion threshold separating perfusion and diffusion effects: Proposal of a standardized algorithm. Magn Reson Med 2014; 74:1414-22. [DOI: 10.1002/mrm.25506] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/02/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Moritz C. Wurnig
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Olivio F. Donati
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Erika Ulbrich
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Lukas Filli
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - David Kenkel
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| | - Harriet C. Thoeny
- Department of Diagnostic and Interventional Radiology; University Hospital Bern; Switzerland
| | - Andreas Boss
- Department of Diagnostic and Interventional Radiology; University Hospital Zurich; Switzerland
| |
Collapse
|
39
|
Giannarini G, Kessler TM, Roth B, Vermathen P, Thoeny HC. Functional Multiparametric Magnetic Resonance Imaging of the Kidneys Using Blood Oxygen Level Dependent and Diffusion-Weighted Sequences. J Urol 2014; 192:434-9. [DOI: 10.1016/j.juro.2014.02.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2014] [Indexed: 12/11/2022]
Affiliation(s)
| | - Thomas M. Kessler
- Neuro-Urology, Spinal Cord Injury Centre and Research, University of Zurich, Balgrist University Hospital, Zurich, Switzerland
| | - Beat Roth
- Department of Urology, University of Bern, Inselspital, Bern, Switzerland
| | - Peter Vermathen
- Department of Radiology, Neuroradiology and Nuclear Medicine, Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Bern, Switzerland
| | - Harriet C. Thoeny
- Department of Radiology, Neuroradiology and Nuclear Medicine, Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Bern, Switzerland
| |
Collapse
|
40
|
Notohamiprodjo M, Chandarana H, Mikheev A, Rusinek H, Grinstead J, Feiweier T, Raya JG, Lee VS, Sigmund EE. Combined intravoxel incoherent motion and diffusion tensor imaging of renal diffusion and flow anisotropy. Magn Reson Med 2014; 73:1526-32. [PMID: 24752998 DOI: 10.1002/mrm.25245] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/19/2014] [Accepted: 03/17/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE We used a combined intravoxel incoherent motion-diffusion tensor imaging (IVIM-DTI) methodology to distinguish structural from flow effects on renal diffusion anisotropy. METHODS Eight volunteers were examined with IVIM-DTI at 3T with 20 diffusion directions and 10 b-values. Mean diffusivity (MD) and fractional anisotropy (FA) from DTI analysis were calculated for low (b ≤ 200 s/mm(2) ), high (b > 200 s/mm(2) ), and full b-value ranges. IVIM-parameters perfusion-fraction fP , pseudo-diffusivity Dp , and tissue-diffusivity Dt were first calculated independently on a voxelwise basis for all directions. After estimating a fixed isotropic fp from these data, global anisotropies of Dt and Dp in the cortex and medulla were determined in a constrained cylindrical description and visualized using polar plots and cosine scatterplots. RESULTS For all b-value ranges, medullary FA was significantly higher than that of the cortex. The corticomedullary difference was smaller for the high b-value range. Significantly higher fp and Dt were determined for the cortex and showed a significantly higher directional variance in the medulla. Polar plot analysis displayed nearly isotropic Dp and Dt in the cortex and anisotropy in the medulla. CONCLUSION Both flow and microstructure apparently contribute to the medullary diffusion anisotropy. The described novel method may be useful in separating decreased tubular flow from irreversible structural tubular damage, for example, in diabetic nephropathy or during allograft rejection.
Collapse
Affiliation(s)
- Mike Notohamiprodjo
- Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, New York, USA; Department of Clinical Radiology, University Hospitals Munich, Munich, Germany; Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Jaimes C, Darge K, Khrichenko D, Carson RH, Berman JI. Diffusion tensor imaging and tractography of the kidney in children: feasibility and preliminary experience. Pediatr Radiol 2014; 44:30-41. [PMID: 24022583 DOI: 10.1007/s00247-013-2774-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/01/2013] [Accepted: 07/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Functional magnetic resonance urography (fMRU) provides morphological and functional information based on perfusion. Diffusion tensor imaging (DTI) complements fMRU by measuring renal microstructure and provides insight into the relationship between renal structure and function. OBJECTIVE To evaluate the feasibility and utility of renal DTI and tractography in the setting of fMRU in children. MATERIALS AND METHODS We prospectively enrolled 9 children (6 boys, 3 girls) with a mean age of 4.3 years (range 6 months to 14.8 years). All children were examined with MRI at 3.0 tesla. DTI was acquired with an echo-planar sequence (TR/TE = 2,300/69 ms, b = 300 s/mm2) with 12 non-collinear directions and 3 signal averages. Functional MRU results were used to group the moieties as normal or abnormal. Regions of interest were placed in the medulla and cortex to measure DTI parameters of microstructure. DTI tractography measures of parenchymal volume were compared to fMRU-derived volumes. RESULTS We analyzed 19 moieties (13 normal; 6 abnormal). Tractography of normal moieties showed numerous tracks with a radial arrangement and convergence into pyramids. Abnormal moieties did not show the radial arrangement or converging architecture and had tracks that were loosely arranged and left hollow spaces. Tractography volume correlated with MRU parenchymal volume (r 2 = 0.93, P < 0.005) and abnormal moieties exhibited greater tractography volume than normal moieties (P < 0.005). Tractography volume also correlated with age of the child (P < 0.001). In normal moieties, the medulla had higher fractional anisotropy (0.401 +/−0.05) than the cortex (0.183 +/− 0.03) (P < 0.001); fractional anisotropy in these regions did not change with age (P > 0.1). There were no differences in apparent diffusion coefficient values between the cortex and medulla (P > 0.5). We observed a trend of increasing apparent diffusion coefficient values with age in the cortex and medulla, which did not reach statistical significance (cortex: r2 = 0.21, P > 0.1; medulla: r2 = 0.135, P > 0.1). CONCLUSION DTI with tractography is feasible in children and can complement the functional information obtained from fMRU.
Collapse
|
42
|
Value of diffusion-weighted MR imaging for the detection of nephritis. ScientificWorldJournal 2013; 2013:348105. [PMID: 24319359 PMCID: PMC3844243 DOI: 10.1155/2013/348105] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/22/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate diffusion-weighted MR imaging (DWI-MRI) for the detection and assessment of infectious renal disease. Materials and Methods. Twenty-one patients with suspicious increased signal intensity of the kidneys on DWI sequences and corresponding ADC decrease were identified. Sixty patients without clinical signs of renal infection served as a control group. All patients were examined with the following sequences: EPI-DWI (0/400/800 s/mm2), T2w HASTE, and T1w VIBE after intravenous injection of Gd-chelate. Confirmation of renal infection was established on the basis of clinical criteria. T1w and T2w images were assessed and compared to DWI for the presence of altered signal, and the degree of the visibility of pathology was graded on an ordinal three-point scale. Results. In all 21 patients with positive DWI findings a renal infection could be confirmed. T2w imaging and contrast-enhanced T1w imaging displayed obvious pathologic signal in 3/21 (14%) and 11/19 (58%) patients and slightly pathologic signal in 17/21 (81%) and 7/19 (37%), respectively. The median visibility score of 2 for the DWI and the T1w images was significantly higher than the score of 1 for the T2w imaging, P = 0.0001 (DWI versus T2w) and P = 0.078 (T1w versus T2w). Conclusion. DWI of the kidneys seems to be highly sensitive for the detection of infections within the kidney.
Collapse
|
43
|
Hueper K, Rong S, Gutberlet M, Hartung D, Mengel M, Lu X, Haller H, Wacker F, Meier M, Gueler F. T2 Relaxation Time and Apparent Diffusion Coefficient for Noninvasive Assessment of Renal Pathology After Acute Kidney Injury in Mice. Invest Radiol 2013; 48:834-42. [DOI: 10.1097/rli.0b013e31829d0414] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
44
|
Donati OF, Chong D, Nanz D, Boss A, Froehlich JM, Andres E, Seifert B, Thoeny HC. Diffusion-weighted MR imaging of upper abdominal organs: field strength and intervendor variability of apparent diffusion coefficients. Radiology 2013; 270:454-63. [PMID: 24471390 DOI: 10.1148/radiol.13130819] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine the variability of apparent diffusion coefficient (ADC) values in various anatomic regions in the upper abdomen measured with magnetic resonance (MR) systems from different vendors and with different field strengths. MATERIALS AND METHODS Ten healthy men (mean age, 36.6 years ± 7.7 [standard deviation]) gave written informed consent to participate in this prospective ethics committee-approved study. Diffusion-weighted (DW) MR imaging was performed in each subject with 1.5- and 3.0-T MR systems from each of three vendors at two institutions. Two readers independently measured ADC values in seven upper abdominal regions (left and right liver lobe, gallbladder, pancreas, spleen, and renal cortex and medulla). ADC values were tested for interobserver differences, as well as for differences related to field strength and vendor, with repeated-measures analysis of variance; coefficients of variation (CVs) and variance components were calculated. RESULTS Interreader agreement was excellent (intraclass coefficient, 0.876). ADC values were (77.5-88.8) ×10(-5) mm(2)/sec in the spleen and (250.6-278.5) ×10(-5) mm(2)/sec in the gallbladder. There were no significant differences between ADC values measured at 1.5 T and those measured at 3.0 T in any anatomic region (P >.10 for all). In two of seven regions at 1.5 T (left and right liver lobes, P < .023) and in four of seven regions at 3.0 T (left liver lobe, pancreas, and renal cortex and medulla, P < .008), intervendor differences were significant. CVs ranged from 7.0% to 27.1% depending on the anatomic location. CONCLUSION Despite significant intervendor differences in ADC values of various anatomic regions of the upper abdomen, ADC values of the gallbladder, pancreas, spleen, and kidney may be comparable between MR systems from different vendors and between different field strengths.
Collapse
Affiliation(s)
- Olivio F Donati
- From the Institute of Diagnostic and Interventional Radiology (O.F.D., D.N., A.B.) and University School of Medicine (E.A.), University Hospital Zurich, Zurich, Switzerland; Department of Radiology, Neuroradiology and Nuclear Medicine, Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Freiburgstrasse 10, CH-3010 Bern, Switzerland (D.C., J.M.F., H.C.T.); and Division of Biostatistics, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland (B.S.)
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Federau C, O'Brien K, Meuli R, Hagmann P, Maeder P. Measuring brain perfusion with intravoxel incoherent motion (IVIM): Initial clinical experience. J Magn Reson Imaging 2013; 39:624-32. [DOI: 10.1002/jmri.24195] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 04/05/2013] [Indexed: 12/12/2022] Open
Affiliation(s)
- Christian Federau
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | | | - Reto Meuli
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | - Patric Hagmann
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| | - Philippe Maeder
- University Hospital Center and University of Lausanne (CHUV-UNIL); Switzerland
| |
Collapse
|
46
|
WELLS ITP, FREEMAN SJ. Investigation of loin pain. IMAGING 2013. [DOI: 10.1259/imaging.20110059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
47
|
Dewhurst C, Beddy P, Pedrosa I. MRI evaluation of acute appendicitis in pregnancy. J Magn Reson Imaging 2013; 37:566-75. [PMID: 23423797 DOI: 10.1002/jmri.23765] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 06/29/2012] [Indexed: 12/13/2022] Open
|
48
|
Federau C, Maeder P, O’Brien K, Browaeys P, Meuli R, Hagmann P. Quantitative Measurement of Brain Perfusion with Intravoxel Incoherent Motion MR Imaging. Radiology 2012; 265:874-81. [DOI: 10.1148/radiol.12120584] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
49
|
Tshering Vogel DW, Zbaeren P, Geretschlaeger A, Vermathen P, De Keyzer F, Thoeny HC. Diffusion-weighted MR imaging including bi-exponential fitting for the detection of recurrent or residual tumour after (chemo)radiotherapy for laryngeal and hypopharyngeal cancers. Eur Radiol 2012; 23:562-9. [PMID: 22865270 DOI: 10.1007/s00330-012-2596-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/25/2012] [Accepted: 07/02/2012] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To assess whether diffusion-weighted magnetic resonance imaging (DW-MRI) including bi-exponential fitting helps to detect residual/recurrent tumours after (chemo)radiotherapy of laryngeal and hypopharyngeal carcinoma. METHODS Forty-six patients with newly-developed/worsening symptoms after (chemo)radiotherapy for laryngeal/hypopharyngeal cancers were prospectively imaged using conventional MRI and axial DW-MRI. Qualitative (visual assessment) and quantitative analysis (mono-exponentially: total apparent diffusion coefficient [ADC(T)], and bi-exponentially: perfusion fraction [F(P)] and true diffusion coefficient [ADC(D)]) were performed. Diffusion parameters of tumour versus post-therapeutic changes were compared, with final diagnosis based on histopathology and follow-up. Mann-Whitney U test was used for statistical analysis. RESULTS Qualitative DW-MRI combined with morphological images allowed the detection of tumour with a sensitivity of 94% and specificity 100%. ADC(T) and ADC(D) values were lower in tumour with values 120 ± 49 × 10(-5) mm(2)/s and 113 ± 50 × 10(-5) mm(2)/s, respectively, compared with post-therapeutic changes with values 182 ± 41 × 10(-5) mm(2)/s (P < 0.0002) and 160 ± 47 × 10(-5) mm(2)/s (P < 0.003), respectively. F(P) values were significantly lower in tumours than in non-tumours (13 ± 9% versus 31 ± 16%, P < 0.0002), with F(P) being the best quantitative parameter for differentiation between post-therapeutic changes and recurrence. CONCLUSIONS DW-MRI in combination with conventional MRI substantially improves detection and exclusion of tumour in patients with laryngeal and hypopharyngeal cancers after treatment with (chemo)radiotherapy on both qualitative and quantitative analysis, with F(P) being the best quantitative parameter in this context.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Biopsy, Needle
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/therapy
- Chemoradiotherapy/methods
- Cohort Studies
- Diffusion Magnetic Resonance Imaging/methods
- Female
- Head and Neck Neoplasms/diagnosis
- Head and Neck Neoplasms/mortality
- Head and Neck Neoplasms/therapy
- Humans
- Hypopharyngeal Neoplasms/diagnosis
- Hypopharyngeal Neoplasms/mortality
- Hypopharyngeal Neoplasms/therapy
- Immunohistochemistry
- Laryngeal Neoplasms/diagnosis
- Laryngeal Neoplasms/mortality
- Laryngeal Neoplasms/therapy
- Magnetic Resonance Imaging/methods
- Male
- Middle Aged
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/mortality
- Neoplasm, Residual/pathology
- Prognosis
- Prospective Studies
- ROC Curve
- Risk Assessment
- Squamous Cell Carcinoma of Head and Neck
- Statistics, Nonparametric
- Survival Rate
Collapse
Affiliation(s)
- Dechen W Tshering Vogel
- Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
| | | | | | | | | | | |
Collapse
|
50
|
Rheinheimer S, Schneider F, Stieltjes B, Morath C, Zeier M, Kauczor HU, Hallscheidt P. IVIM-DWI of transplanted kidneys: reduced diffusion and perfusion dependent on cold ischemia time. Eur J Radiol 2012; 81:e951-6. [PMID: 22785337 DOI: 10.1016/j.ejrad.2012.06.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/15/2012] [Accepted: 06/17/2012] [Indexed: 12/28/2022]
Abstract
PURPOSE To evaluate the effect of cold ischemia time (CIT) of renal allografts on diffusion and perfusion using intravoxel incoherent motion (IVIM) derived parameters. MATERIAL AND METHODS A total of 37 patients with renal allografts (CIT: 27 <15 h, 10 ≥15 h) and 30 individuals with healthy kidneys were examined at 1.5 T using a single-shot echo-planar diffusion-weighted pulse sequence with nine b-values ranging from 0 to 800 s/mm(2). ADC, perfusion fraction f, and the diffusion coefficient D were calculated using the IVIM model. Parameters of allografts stratified by CIT were compared with healthy kidney groups using the Mann-Whitney U test for unpaired data. We computed the Spearman correlation coefficient for correlation with creatinine values. RESULTS ADC, D, and f of transplanted kidneys were significantly lower than in the healthy controls. The long-CIT group showed significantly lower diffusion parameters compared with the short-CIT group [mean±SD]: ADC: 1.63±0.14 μm(2)/ms, f: 11.90±5.22%, D: 1.55±0.25 μm(2)/ms versus ADC: 1.79±0.13 μm(2)/ms, f: 16.12±3.43%, D: 1.73±0.14 μm(2)/ms, P(ADC), (f), (D)<0.05. CONCLUSION Our results suggest that diffusion parameters, especially the ADC, depend on the CIT of the kidney allograft. Potentially, this stands for functional changes in renal allografts. Diffusion-weighted imaging could be used for follow-up examinations. Thus, diffusion parameters may help guide therapy in patients with delayed graft function.
Collapse
Affiliation(s)
- S Rheinheimer
- Diagnostic and Interventional Radiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | | | | | | | | | | | | |
Collapse
|