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Wang B, Wang Y, Wang J, Jin C, Zhou R, Guo J, Zhang H, Wang M. Multiparametric Magnetic Resonance Investigations on Acute and Long-Term Kidney Injury. J Magn Reson Imaging 2024; 59:43-57. [PMID: 37246343 DOI: 10.1002/jmri.28784] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023] Open
Abstract
Acute kidney injury (AKI) is a frequent complication of critical illness and carries a significant risk of short- and long-term mortality. The prediction of the progression of AKI to long-term injury has been difficult for renal disease treatment. Radiologists are keen for the early detection of transition from AKI to long-term kidney injury, which would help in the preventive measures. The lack of established methods for early detection of long-term kidney injury underscores the pressing needs of advanced imaging technology that reveals microscopic tissue alterations during the progression of AKI. Fueled by recent advances in data acquisition and post-processing methods of magnetic resonance imaging (MRI), multiparametric MRI is showing great potential as a diagnostic tool for many kidney diseases. Multiparametric MRI studies offer a precious opportunity for real-time noninvasive monitoring of pathological development and progression of AKI to long-term injury. It provides insight into renal vasculature and function (arterial spin labeling, intravoxel incoherent motion), tissue oxygenation (blood oxygen level-dependent), tissue injury and fibrosis (diffusion tensor imaging, diffusion kurtosis imaging, T1 and T2 mapping, quantitative susceptibility mapping). The multiparametric MRI approach is highly promising but the longitudinal investigation on the transition of AKI to irreversible long-term impairment is largely ignored. Further optimization and implementation of renal MR methods in clinical practice will enhance our comprehension of not only AKI but chronic kidney diseases. Novel imaging biomarkers for microscopic renal tissue alterations could be discovered and benefit the preventative interventions. This review explores recent MRI applications on acute and long-term kidney injury while addressing lingering challenges, with emphasis on the potential value of the development of multiparametric MRI for renal imaging on clinical systems. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Bin Wang
- Department of Medical Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yongfang Wang
- Department of Medical Imaging, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jing Wang
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Jinxia Guo
- GE Healthcare, MR Research China, Beijing, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Min Wang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
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Lorentzian-Corrected Apparent Exchange-Dependent Relaxation (LAREX) Ω-Plot Analysis-An Adaptation for qCEST in a Multi-Pool System: Comprehensive In Silico, In Situ, and In Vivo Studies. Int J Mol Sci 2022; 23:ijms23136920. [PMID: 35805925 PMCID: PMC9266897 DOI: 10.3390/ijms23136920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/05/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022] Open
Abstract
Based on in silico, in situ, and in vivo studies, this study aims to develop a new method for the quantitative chemical exchange saturation transfer (qCEST) technique considering multi-pool systems. To this end, we extended the state-of-the-art apparent exchange-dependent relaxation (AREX) method with a Lorentzian correction (LAREX). We then validated this new method with in situ and in vivo experiments on human intervertebral discs (IVDs) using the Kendall-Tau correlation coefficient. In the in silico experiments, we observed significant deviations of the AREX method as a function of the underlying exchange rate (kba) and fractional concentration (fb) compared to the ground truth due to the influence of other exchange pools. In comparison to AREX, the LAREX-based Ω-plot approach yielded a substantial improvement. In the subsequent in situ and in vivo experiments on human IVDs, no correlation to the histological reference standard or Pfirrmann classification could be found for the fb (in situ: τ = −0.17 p = 0.51; in vivo: τ = 0.13 p = 0.30) and kba (in situ: τ = 0.042 p = 0.87; in vivo: τ = −0.26 p = 0.04) of Glycosaminoglycan (GAG) with AREX. In contrast, the influence of interfering pools could be corrected by LAREX, and a moderate to strong correlation was observed for the fractional concentration of GAG for both in situ (τ = −0.71 p = 0.005) and in vivo (τ = −0.49 p < 0.001) experiments. The study presented here is the first to introduce a new qCEST method that enables qCEST imaging in systems with multiple proton pools.
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Caroli A. Diffusion-Weighted Magnetic Resonance Imaging: Clinical Potential and Applications. J Clin Med 2022; 11:3339. [PMID: 35743409 PMCID: PMC9224775 DOI: 10.3390/jcm11123339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023] Open
Abstract
Since its discovery in the 1980s [...].
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Affiliation(s)
- Anna Caroli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
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Radke KL, Abrar DB, Frenken M, Wilms LM, Kamp B, Boschheidgen M, Liebig P, Ljimani A, Filler TJ, Antoch G, Nebelung S, Wittsack HJ, Müller-Lutz A. Chemical Exchange Saturation Transfer for Lactate-Weighted Imaging at 3 T MRI: Comprehensive In Silico, In Vitro, In Situ, and In Vivo Evaluations. Tomography 2022; 8:1277-1292. [PMID: 35645392 PMCID: PMC9149919 DOI: 10.3390/tomography8030106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 01/22/2023] Open
Abstract
Based on in silico, in vitro, in situ, and in vivo evaluations, this study aims to establish and optimize the chemical exchange saturation transfer (CEST) imaging of lactate (Lactate-CEST—LATEST). To this end, we optimized LATEST sequences using Bloch−McConnell simulations for optimal detection of lactate with a clinical 3 T MRI scanner. The optimized sequences were used to image variable lactate concentrations in vitro (using phantom measurements), in situ (using nine human cadaveric lower leg specimens), and in vivo (using four healthy volunteers after exertional exercise) that were then statistically analyzed using the non-parametric Friedman test and Kendall Tau-b rank correlation. Within the simulated Bloch−McConnell equations framework, the magnetization transfer ratio asymmetry (MTRasym) value was quantified as 0.4% in the lactate-specific range of 0.5−1 ppm, both in vitro and in situ, and served as the imaging surrogate of the lactate level. In situ, significant differences (p < 0.001) and strong correlations (τ = 0.67) were observed between the MTRasym values and standardized intra-muscular lactate concentrations. In vivo, a temporary increase in the MTRasym values was detected after exertional exercise. In this bench-to-bedside comprehensive feasibility study, different lactate concentrations were detected using an optimized LATEST imaging protocol in vitro, in situ, and in vivo at 3 T, which prospectively paves the way towards non-invasive quantification and monitoring of lactate levels across a broad spectrum of diseases.
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Affiliation(s)
- Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Daniel B. Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Lena Marie Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Matthias Boschheidgen
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | | | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Timm Joachim Filler
- Institute of Anatomy I, Heinrich-Heine-University, D-40225 Dusseldorf, Germany;
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, D-52074 Aachen, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (K.L.R.); (M.F.); (L.M.W.); (B.K.); (M.B.); (A.L.); (G.A.); (S.N.); (H.-J.W.); (A.M.-L.)
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