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Blood Oxygen Level-Dependent (BOLD) MRI in Glomerular Disease. TRANSPLANTOLOGY 2021. [DOI: 10.3390/transplantology2020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Renal hypoxia has recently been implicated as a key contributor and indicator of various glomerular diseases. As such, monitoring changes in renal oxygenation in these disorders may provide an early diagnostic advantage that could prevent potential adverse outcomes. Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) is an emerging noninvasive technique for assessing renal oxygenation in glomerular disease. Although BOLD MRI has produced promising initial results for the use in certain renal pathologies, the use of BOLD imaging in glomerular diseases, including primary and secondary nephrotic and nephritic syndromes, is relatively unexplored. Early BOLD studies on primary nephrotic syndrome, nephrotic syndrome secondary to diabetes mellitus, and nephritic syndrome secondary to systemic lupus erythematosus have shown promising results to support its future clinical utility. In this review, we outline the advancements made in understanding the use of BOLD MRI for the assessment, diagnosis, and screening of these pathologies.
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Bane O, Mendichovszky IA, Milani B, Dekkers IA, Deux JF, Eckerbom P, Grenier N, Hall ME, Inoue T, Laustsen C, Lerman LO, Liu C, Morrell G, Pedersen M, Pruijm M, Sadowski EA, Seeliger E, Sharma K, Thoeny H, Vermathen P, Wang ZJ, Serafin Z, Zhang JL, Francis ST, Sourbron S, Pohlmann A, Fain SB, Prasad PV. Consensus-based technical recommendations for clinical translation of renal BOLD MRI. MAGMA (NEW YORK, N.Y.) 2020; 33:199-215. [PMID: 31768797 PMCID: PMC7021747 DOI: 10.1007/s10334-019-00802-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 01/08/2023]
Abstract
Harmonization of acquisition and analysis protocols is an important step in the validation of BOLD MRI as a renal biomarker. This harmonization initiative provides technical recommendations based on a consensus report with the aim to move towards standardized protocols that facilitate clinical translation and comparison of data across sites. We used a recently published systematic review paper, which included a detailed summary of renal BOLD MRI technical parameters and areas of investigation in its supplementary material, as the starting point in developing the survey questionnaires for seeking consensus. Survey data were collected via the Delphi consensus process from 24 researchers on renal BOLD MRI exam preparation, data acquisition, data analysis, and interpretation. Consensus was defined as ≥ 75% unanimity in response. Among 31 survey questions, 14 achieved consensus resolution, 12 showed clear respondent preference (65-74% agreement), and 5 showed equal (50/50%) split in opinion among respondents. Recommendations for subject preparation, data acquisition, processing and reporting are given based on the survey results and review of the literature. These technical recommendations are aimed towards increased inter-site harmonization, a first step towards standardization of renal BOLD MRI protocols across sites. We expect this to be an iterative process updated dynamically based on progress in the field.
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Affiliation(s)
- Octavia Bane
- BioMedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iosif A Mendichovszky
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Bastien Milani
- Center for BioMedical Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Francois Deux
- Department of Radiology, Groupe Hospitalier Henri Mondor, Créteil, France
| | - Per Eckerbom
- Department of Radiology, Institution for Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Nicolas Grenier
- Department of Radiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tsutomu Inoue
- Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Christoffer Laustsen
- The MR Research Center Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunlei Liu
- Electrical Engineering and Computer Science, and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Glen Morrell
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael Pedersen
- Department of Clinical Medicine-Comparative Medicine Lab, Aarhus University Hospital, Aarhus, Denmark
| | - Menno Pruijm
- Nephrology and Hypertension Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elizabeth A Sadowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erdmann Seeliger
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Harriet Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois, University of Fribourg, Fribourg, Switzerland
| | - Peter Vermathen
- Departments for BioMedical Research and Radiology, Inselspital, Universitaetspital Bern, Bern, Switzerland
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Zbigniew Serafin
- Department of Radiology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jeff L Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan T Francis
- Sir Peter Mansfield Centre, University of Notthingham, Notthingham, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sean B Fain
- Departments of Biomedical Engineering, Radiology, and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA.
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Bane O, Mendichovszky IA, Milani B, Dekkers IA, Deux JF, Eckerbom P, Grenier N, Hall ME, Inoue T, Laustsen C, Lerman LO, Liu C, Morrell G, Pedersen M, Pruijm M, Sadowski EA, Seeliger E, Sharma K, Thoeny H, Vermathen P, Wang ZJ, Serafin Z, Zhang JL, Francis ST, Sourbron S, Pohlmann A, Fain SB, Prasad PV. Consensus-based technical recommendations for clinical translation of renal BOLD MRI. MAGMA (NEW YORK, N.Y.) 2019. [PMID: 31768797 DOI: 10.1007/s10334‐019‐00802‐x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Harmonization of acquisition and analysis protocols is an important step in the validation of BOLD MRI as a renal biomarker. This harmonization initiative provides technical recommendations based on a consensus report with the aim to move towards standardized protocols that facilitate clinical translation and comparison of data across sites. We used a recently published systematic review paper, which included a detailed summary of renal BOLD MRI technical parameters and areas of investigation in its supplementary material, as the starting point in developing the survey questionnaires for seeking consensus. Survey data were collected via the Delphi consensus process from 24 researchers on renal BOLD MRI exam preparation, data acquisition, data analysis, and interpretation. Consensus was defined as ≥ 75% unanimity in response. Among 31 survey questions, 14 achieved consensus resolution, 12 showed clear respondent preference (65-74% agreement), and 5 showed equal (50/50%) split in opinion among respondents. Recommendations for subject preparation, data acquisition, processing and reporting are given based on the survey results and review of the literature. These technical recommendations are aimed towards increased inter-site harmonization, a first step towards standardization of renal BOLD MRI protocols across sites. We expect this to be an iterative process updated dynamically based on progress in the field.
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Affiliation(s)
- Octavia Bane
- BioMedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iosif A Mendichovszky
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Bastien Milani
- Center for BioMedical Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean-Francois Deux
- Department of Radiology, Groupe Hospitalier Henri Mondor, Créteil, France
| | - Per Eckerbom
- Department of Radiology, Institution for Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Nicolas Grenier
- Department of Radiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Tsutomu Inoue
- Department of Nephrology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Christoffer Laustsen
- The MR Research Center Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunlei Liu
- Electrical Engineering and Computer Science, and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Glen Morrell
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael Pedersen
- Department of Clinical Medicine-Comparative Medicine Lab, Aarhus University Hospital, Aarhus, Denmark
| | - Menno Pruijm
- Nephrology and Hypertension Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elizabeth A Sadowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erdmann Seeliger
- Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Kanishka Sharma
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Harriet Thoeny
- Department of Radiology, Hôpital Cantonal Fribourgois, University of Fribourg, Fribourg, Switzerland
| | - Peter Vermathen
- Departments for BioMedical Research and Radiology, Inselspital, Universitaetspital Bern, Bern, Switzerland
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California San Francisco Medical Center, San Francisco, CA, USA
| | - Zbigniew Serafin
- Department of Radiology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jeff L Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan T Francis
- Sir Peter Mansfield Centre, University of Notthingham, Notthingham, UK
| | - Steven Sourbron
- Imaging Biomarkers Group, Department of Biomedical Imaging Sciences, University of Leeds, Leeds, UK
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sean B Fain
- Departments of Biomedical Engineering, Radiology, and Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Pottumarthi V Prasad
- Department of Radiology, Center for Advanced Imaging, NorthShore University Health System, Evanston, IL, USA.
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Chen F, Li S, Sun D. Methods of Blood Oxygen Level-Dependent Magnetic Resonance Imaging Analysis for Evaluating Renal Oxygenation. Kidney Blood Press Res 2018. [PMID: 29539614 DOI: 10.1159/000488072] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently been utilized as a noninvasive tool for evaluating renal oxygenation. Several methods have been proposed for analyzing BOLD images. Regional ROI selection is the earliest and most widely used method for BOLD analysis. In the last 20 years, many investigators have used this method to evaluate cortical and medullary oxygenation in patients with ischemic nephropathy, hypertensive nephropathy, diabetic nephropathy, chronic kidney disease (CKD), acute kidney injury and renal allograft rejection. However, clinical trials of BOLD MRI using regional ROI selection revealed that it was difficult to distinguish the renal cortico-medullary zones with this method, and that it was susceptible to observer variability. To overcome these deficiencies, several new methods were proposed for analyzing BOLD images, including the compartmental approach, fractional hypoxia method, concentric objects (CO) method and twelve-layer concentric objects (TLCO) method. The compartmental approach provides an algorithm to judge whether the pixel belongs to the cortex or medulla. Fractional kidney hypoxia, measured by using BOLD MRI, was negatively correlated with renal blood flow, tissue perfusion and glomerular filtration rate (GFR) in patients with atherosclerotic renal artery stenosis. The CO method divides the renal parenchyma into six or twelve layers of thickness in each coronal slice of BOLD images and provides a R2* radial profile curve. The slope of the R2* curve associated positively with eGFR in CKD patients. Indeed, each method invariably has advantages and disadvantages, and there is generally no consensus method so far. Undoubtedly, analytic approaches for BOLD MRI with better reproducibility would assist clinicians in monitoring the degree of kidney hypoxia and thus facilitating timely reversal of tissue hypoxia.
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Affiliation(s)
- Fen Chen
- Department of Nephrology, Xuzhou Medical University, Xuzhou, China
| | - Shulin Li
- Department of Nephrology, Xuzhou Medical University, Xuzhou, China.,Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Dong Sun
- Department of Nephrology, Xuzhou Medical University, Xuzhou, China.,Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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