Is MRI relaxometry parameter T1ρ specific to fibrosis or confounded by concomitant pathological features?

Assessment of Acute Kidney Injury using MRI

There has been growing interest in using quantitative magnetic resonance imaging (MRI) to describe and understand the pathophysiology of acute kidney injury (AKI). The ability to assess kidney blood flow, perfusion, oxygenation, and changes in tissue microstructure at repeated timepoints is hugely appealing, as this offers new possibilities to describe nature and severity of AKI, track the time-course to recovery or progression to chronic kidney disease (CKD), and may ultimately provide a method to noninvasively assess response to new therapies. This could have significant clinical implications considering that AKI is common (affecting more than 13 million people globally every year), harmful (associated with short and long-term morbidity and mortality), and currently lacks specific treatments. However, this is also a challenging area to study. After the kidney has been affected by an initial insult that leads to AKI, complex coexisting processes ensue, which may recover or can progress to CKD. There are various preclinical models of AKI (from which most of our current understanding derives), and these differ from each other but more importantly from clinical AKI. These aspects are fundamental to interpreting the results of the different AKI studies in which renal MRI has been used, which encompass different settings of AKI and a variety of MRI measures acquired at different timepoints. This review aims to provide a comprehensive description and interpretation of current studies (both preclinical and clinical) in which MRI has been used to assess AKI, and discuss future directions in the field. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 3.

Adiabatically prepared spin-lock could reduce the R1ρ dispersion

Background

R_1ρ (or spin-lock) imaging is prone to artifacts arising from field inhomogeneities that may impact the R_1ρ quantification. Previous research has proposed two types of method to manage the artifacts in continuous-wave constant amplitude spin-lock, one is based on the composite block pulses to compensate for the field imperfections, another category uses adiabatic pulses in the R_1ρ pre-pulse to excite and reverse the magnetization (named adiabatic prepared approach). Although both methods have proved their efficiency in alleviating artifacts, we observed that the adiabatic pulse approach could produce much lower R_1ρ dispersion in human knee cartilage than the block pulse method (characterized by the R_1ρ difference ∆R_1ρ =11.4 Hz (from spin-lock field 50 to 500 Hz) for the block pulse method vs. ∆R_1ρ =4.5 Hz for the adiabatic pulse approach). Prompted by this observation, the purpose of this study was to investigate the underlying factors that may affect the R_1ρ dispersion through numerical simulations based on the two-pool exchanging Bloch-McConnell equations.

Methods

The effects of free water pool size P_a (from 0.80 to 0.95), chemical exchange rate k_b (from the bound to free water pool, ranged from 500 to 3,000 Hz), adiabatic pulse duration T_p (from 5.0 to 25 ms), and the chemical shift of the bound pool ppm_b (from 1.0 to 5.0 ppm) were examined on the degree of the R_1ρ dispersion for the two R_1ρ imaging methods.

Results

In general, the greater the ppm_b, k_b, T_p, and the smaller P_a, the more significant difference in R_1ρ dispersion between the block and adiabatic approaches, with the dispersion curve of the adiabatic method becoming flatter.

Conclusions

The adiabatic prepared approach may compromise the R_1ρ dispersion, the effect is determined by the combination of the tissue and radiofrequency (RF) pulse properties. It is suggested that care should be taken when using the adiabatically prepared approach to study R_1ρ dispersion.