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Bhasin-Chhabra B, Patel MD, Koratala A. A CKD Patient with Microcystic Kidneys on Imaging. Kidney360 2023; 4:e1343-e1344. [PMID: 37768812 PMCID: PMC10550001 DOI: 10.34067/kid.0000000000000200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/10/2023] [Indexed: 09/30/2023]
Affiliation(s)
| | | | - Abhilash Koratala
- Division of Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin
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McTavish S, Van AT, Peeters JM, Weiss K, Makowski MR, Braren RF, Karampinos DC. Motion compensated renal diffusion weighted imaging. Magn Reson Med 2022; 89:144-160. [PMID: 36098347 DOI: 10.1002/mrm.29433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To assess the effect of respiratory motion and cardiac driven pulsation in renal DWI and to examine asymmetrical velocity-compensated diffusion encoding waveforms for robust ADC mapping in the kidneys. METHODS The standard monopolar Stejskal-Tanner pulsed gradient spin echo (pgse) and the asymmetric bipolar velocity-compensated (asym-vc) diffusion encoding waveforms were used for coronal renal DWI at 3T. The robustness of the ADC quantification in the kidneys was tested with the aforementioned waveforms in respiratory-triggered and breath-held cardiac-triggered scans at different trigger delays in 10 healthy subjects. RESULTS The pgse waveform showed higher ADC values in the right kidney at short trigger delays in comparison to longer trigger delays in the respiratory triggered scans when the diffusion gradient was applied in the feet-head (FH) direction. The coefficient of variation over all respiratory trigger delays, averaged over all subjects was 0.15 for the pgse waveform in the right kidney when diffusion was measured in the FH direction; the corresponding coefficient of variation for the asym-vc waveform was 0.06. The effect of cardiac driven pulsation was found to be small in comparison to the effect of respiratory motion. CONCLUSION Short trigger delays in respiratory-triggered scans can cause higher ADC values in comparison to longer trigger delays in renal DWI, especially in the right kidney when diffusion is measured in the FH direction. The asym-vc waveform can reduce ADC variation due to respiratory motion in respiratory-triggered scans at the cost of reduced SNR compared to the pgse waveform.
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Affiliation(s)
- Sean McTavish
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Anh T Van
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Rickmer F Braren
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
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Ruiz-Bedoya CA, Ordonez AA, Werner RA, Plyku D, Klunk MH, Leal J, Lesniak WG, Holt DP, Dannals RF, Higuchi T, Rowe SP, Jain SK. 11C-PABA as a PET Radiotracer for Functional Renal Imaging: Preclinical and First-in-Human Study. J Nucl Med 2020; 61:1665-1671. [PMID: 32198314 DOI: 10.2967/jnumed.119.239806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/09/2020] [Indexed: 12/22/2022] Open
Abstract
para-Aminobenzoic acid (PABA) has been previously used as an exogenous marker to verify completion of 24-h urine sampling. Therefore, we hypothesized that PABA radiolabeled with 11C might allow high-quality dynamic PET of the kidneys with less radiation exposure than other agents because of its shorter biologic and physical half-life. We evaluated if 11C-PABA can visualize renal anatomy and quantify function in healthy rats and rabbits and in a first-in-humans study on healthy volunteers. Methods: Healthy rats and rabbits were injected with 11C-PABA intravenously. Subsequently, dynamic PET was performed, followed by postmortem tissue-biodistribution studies. 11C-PABA PET was directly compared with the current standard, 99mTc-mercaptoacetyltriglycin, in rats. Three healthy human subjects also underwent dynamic PET after intravenous injection of 11C-PABA. Results: In healthy rats and rabbits, dynamic PET demonstrated a rapid accumulation of 11C-PABA in the renal cortex, followed by rapid excretion through the pelvicalyceal system. In humans, 11C-PABA PET was safe and well tolerated. There were no adverse or clinically detectable pharmacologic effects in any subject. The cortex was delineated on PET, and the activity gradually transited to the medulla and then pelvis with high spatiotemporal resolution. Conclusion: 11C-PABA demonstrated fast renal excretion with a very low background signal in animals and humans. These results suggest that 11C-PABA might be used as a novel radiotracer for functional renal imaging, providing high-quality spatiotemporal images with low radiation exposure.
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Affiliation(s)
- Camilo A Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rudolf A Werner
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Donika Plyku
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mariah H Klunk
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeff Leal
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Wojciech G Lesniak
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel P Holt
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert F Dannals
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Takahiro Higuchi
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; and.,Department of Nuclear Medicine, University Hospital, University of Würzburg, Würzburg, Germany
| | - Steven P Rowe
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland .,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ozen C, Ertan P, Aras F, Gumuser G, Ozkol M, Horasan Dinc G. Evaluation of abnormal radiological findings in children aged 2 to 36 months followed by recurrent urinary tract infection: a retrospective study. Ren Fail 2017; 39:100-103. [PMID: 27819162 PMCID: PMC6014493 DOI: 10.1080/0886022x.2016.1251460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 10/30/2022] Open
Abstract
Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux.
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Affiliation(s)
- Cinar Ozen
- Department of Pediatric Nephrology, Celal Bayar University, Manisa, Turkey
| | - Pelin Ertan
- Department of Pediatric Nephrology, Celal Bayar University, Manisa, Turkey
| | - Feray Aras
- Department of Nuclear Medicine, Celal Bayar University, Manisa, Turkey
| | - Gul Gumuser
- Department of Nuclear Medicine, Celal Bayar University, Manisa, Turkey
| | - Mine Ozkol
- Department of Radiology, Celal Bayar University, Manisa, Turkey
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Abstract
Objective To assess the use of urologic investigations among traumatic spinal cord injury (TSCI) patients. Methods This is a retrospective cohort study from Ontario, Canada. We included all adult TSCI patients injured between 2002 and 2012. The primary outcome was the frequency of urodynamic testing, renal imaging, and cystoscopy. Primary exposure was the year of injury. The impact of age, sex, comorbidity, socioeconomic status, and lesion level was assessed with Cox regression models. Results One thousand five hundred and fifty one incident TSCI patients were discharged from a rehabilitation hospital. The median follow-up time of this cohort was 5.0 years (interquartile range =2.9–7.5). At least one urodynamics, renal imaging, or cystoscopy was performed during follow-up for 50%, 80%, and 48% of the cohort, respectively. The overall rate of these tests was 0.22, 0.60, and 0.22 per person-year of follow-up. The proportion of patients who had regular, yearly urodynamics (<2%), renal imaging (6%), or cystoscopy (<2%) was low. There were no significant linear trends in the use of these tests over the 10-year study period. Urodynamics were significantly less likely to be performed in patients over 65 years of age (hazard ratio [HR] =0.63, P<0.01) and those with a higher level of comorbidity (HR =0.72, P<0.01). Patients with quadriplegia were significantly less likely to receive any of the investigations compared to those with paraplegia. Conclusion Renal imaging is done at least once for the majority of patients with TSCI; however, only half undergo urodynamics or cystoscopy. Few patients have regular urologic testing. The reality of urologic testing after TSCI is very different from urologist’s ideals and practice guidelines.
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Affiliation(s)
- Blayne Welk
- Department of Surgery and Epidemiology and Biostatistics, Western University, ON, Canada; Institute for Clinical Evaluative Sciences - Western (ICES Western), London, ON, Canada
| | - Kuan Liu
- Institute for Clinical Evaluative Sciences - Western (ICES Western), London, ON, Canada
| | - Salimah Z Shariff
- Institute for Clinical Evaluative Sciences - Western (ICES Western), London, ON, Canada
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Piccoli GB, Priola AM, Vigotti FN, Guzzo G, Veltri A. Renal infarction versus pyelonephritis in a woman presenting with fever and flank pain. Am J Kidney Dis 2014; 64:311-4. [PMID: 24767880 DOI: 10.1053/j.ajkd.2014.02.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 02/07/2014] [Indexed: 11/11/2022]
Abstract
Patients with fever, flank pain, and dysuria frequently are encountered in the emergency department. Acute pyelonephritis is the most likely diagnosis; however, its clinical and radiologic presentation consistently overlap with that of acute renal infarction. Ultrasound is unable to distinguish early infarction from nonabscessed acute pyelonephritis. Hence, computed tomography or magnetic resonance imaging are needed. We report the case of a 68-year-old woman who presented with fever, flank pain, and dysuria, along with respiratory distress and tachycardia. Elevated values for inflammatory indexes suggested a diagnosis of acute pyelonephritis, and subsequent contrast-enhanced computed tomography showed hypodense wedge-shaped areas in both kidneys. However, the presence of a thin rim of capsular enhancement (cortical rim sign), the absence of perirenal inflammatory changes, and the location of the lesions apart from defined calyces suggested the alternative diagnosis of renal infarction. The underlying cause was not identified until an episode of acute dyspnea revealed paroxysmal arrhythmia. Our case demonstrates that a thorough knowledge of the imaging findings of renal infarction and acute pyelonephritis is essential to correctly making the diagnosis.
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Affiliation(s)
- Giorgina B Piccoli
- SS Nefrologia, Department of Medical and Biological Sciences, ASOU san Luigi Gonzaga, University of Turin, Turin, Italy.
| | - Adriano M Priola
- SCDU Radiologia, Department of Oncology, ASOU san Luigi Gonzaga, University of Turin, Turin, Italy
| | - Federica N Vigotti
- SS Nefrologia, Department of Medical and Biological Sciences, ASOU san Luigi Gonzaga, University of Turin, Turin, Italy
| | - Gabriella Guzzo
- SS Nefrologia, Department of Medical and Biological Sciences, ASOU san Luigi Gonzaga, University of Turin, Turin, Italy
| | - Andrea Veltri
- SCDU Radiologia, Department of Oncology, ASOU san Luigi Gonzaga, University of Turin, Turin, Italy
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Lepor H. Surgical, Pharmacological, and Technological Advances in Adult and Pediatric Urology - State of the Art: Highlights of the 7th Annual NYU Department of Urology Postgraduate Course December 7-9, 2000, New York, NY. Rev Urol 2002; 4:24-33. [PMID: 16985649 PMCID: PMC1475965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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