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Wan S, Wang S, He X, Song C, Wang J. Noninvasive diagnosis of interstitial fibrosis in chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2024; 46:2367021. [PMID: 38938187 PMCID: PMC11216256 DOI: 10.1080/0886022x.2024.2367021] [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: 05/01/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024] Open
Abstract
RATIONALE AND OBJECTIVES Researchers have delved into noninvasive diagnostic methods of renal fibrosis (RF) in chronic kidney disease, including ultrasound (US), magnetic resonance imaging (MRI), and radiomics. However, the value of these diagnostic methods in the noninvasive diagnosis of RF remains contentious. Consequently, the present study aimed to systematically delineate the accuracy of the noninvasive diagnosis of RF. MATERIALS AND METHODS A systematic search covering PubMed, Embase, Cochrane Library, and Web of Science databases for all data available up to 28 July 2023 was conducted for eligible studies. RESULTS We included 21 studies covering 4885 participants. Among them, nine studies utilized US as a noninvasive diagnostic method, eight studies used MRI, and four articles employed radiomics. The sensitivity and specificity of US for detecting RF were 0.81 (95% CI: 0.76-0.86) and 0.79 (95% CI: 0.72-0.84). The sensitivity and specificity of MRI were 0.77 (95% CI: 0.70-0.83) and 0.92 (95% CI: 0.85-0.96). The sensitivity and specificity of radiomics were 0.69 (95% CI: 0.59-0.77) and 0.78 (95% CI: 0.68-0.85). CONCLUSIONS The current early noninvasive diagnostic methods for RF include US, MRI, and radiomics. However, this study demonstrates that US has a higher sensitivity for the detection of RF compared to MRI. Compared to US, radiomics studies based on US did not show superior advantages. Therefore, challenges still exist in the current radiomics approaches for diagnosing RF, and further exploration of optimized artificial intelligence (AI) algorithms and technologies is needed.
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Affiliation(s)
- Shanshan Wan
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shiping Wang
- Department of Radiology, The Affiliated Anning First People’s Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xinyu He
- Department of Radiology, The Affiliated Anning First People’s Hospital of Kunming University of Science and Technology, Kunming, China
| | - Chao Song
- Department of Radiology, The Affiliated Anning First People’s Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jiaping Wang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Bibeau-Delisle A, Bouabdallaoui N, Lamarche C, Harel F, Pelletier-Galarneau M. Assessment of renal perfusion with 82-rubidium PET in patients with normal and abnormal renal function. Nucl Med Commun 2024:00006231-990000000-00328. [PMID: 39155795 DOI: 10.1097/mnm.0000000000001890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
BACKGROUND Noninvasive measurement of renal blood flow (RBF) and renal vascular resistance (RVR) is challenging, yet critical in renal pathologies. This study evaluates the correlation between serum renal function markers and RBF/RVR assessed using rubidium PET. METHODS Dynamic images from 53 patients who underwent rubidium PET for nonrenal indications were analyzed. RBF was determined using a one-compartment model, and RVR was calculated by dividing mean arterial pressure by RBF. RESULTS The study included 51 patients (31 females and 20 males). Among them, 35 had normal renal function [estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2], and 16 had abnormal renal function (eGFR <60 ml/min/1.73 m2). Patients with normal renal function had significantly higher RBF [median (interquartile range): 443 (297-722) vs 173 (108-380) ml/min/100 g, P = 0.022] and lower RVR [19.1 (12.4-27.2) vs 49.6 (24.4-85.7) mmHg×min×g/ml, P = 0.0011) compared with those with abnormal renal function. There was a moderate correlation between RBF and eGFR (r = 0.62, P < 0.0001) and between RVR and eGFR (r = -0.59, P < 0.0001) in both groups. Among patients with normal renal function, RBF was negatively correlated with age (r = -0.51, P = 0.0017) but there was no correlation among patients with abnormal renal function (r = 0.21, P = 0.44). CONCLUSION PET-measured RBF and RVR correlate with renal function markers and differ significantly by renal function status. Further studies are needed to validate rubidium PET's precision and clinical applicability.
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Affiliation(s)
| | | | - Caroline Lamarche
- Department of Medicine, Hôpital Maisonneuve-Rosemont Research Center, Université de Montréal, Montreal, Quebec, Canada
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Xie S, Chen M, Chen C, Zhao Y, Qin J, Qiu C, Zhu J, Nickel MD, Kuehn B, Shen W. T1 mapping combined with arterial spin labeling MRI to identify renal injury in patients with liver cirrhosis. Front Endocrinol (Lausanne) 2024; 15:1363797. [PMID: 39184137 PMCID: PMC11341387 DOI: 10.3389/fendo.2024.1363797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/08/2024] [Indexed: 08/27/2024] Open
Abstract
Purpose We investigated the capability and imaging criteria of T1 mapping and arterial spin labeling (ASL) MRI to identify renal injury in patients with liver cirrhosis. Methods We recruited 27 patients with cirrhosis and normal renal function (cirrhosis-NR), 10 with cirrhosis and renal dysfunction (cirrhosis-RD) and 23 normal controls (NCs). All participants were examined via renal T1 mapping and ASL imaging. Renal blood flow (RBF) derived from ASL was measured from the renal cortex, and T1 values were measured from the renal parenchyma (cortex and medulla). MRI parameters were compared between groups. Diagnostic performances for detecting renal impairment were statistically analyzed. Results Cortical T1 (cT1) and medullary T1 (mT1) were significantly lower in the NCs than in the cirrhosis-NR group. The cortical RBF showed no significant changes between the NCs and cirrhosis-NR group but was markedly decreased in the cirrhosis-RD group. The areas under the curve (AUCs) for discriminating cirrhosis-NR from NCs were 0.883 and 0.826 by cT1 and mT1, respectively. Cortical RBF identified cirrhosis-RD with AUC of 0.978, and correlated with serum creatinine (r = -0.334) and the estimated glomerular filtration rate (r = 0.483). A classification and regression tree based on cortical RBF and cT1 achieved 85% accuracy in detecting renal impairment in the cirrhosis. Conclusion Renal T1 values might be sensitive predictors of early renal impairment in patients with cirrhosis-NR. RBF enabled quantifying renal perfusion impairment in patients with cirrhosis-RD. The diagnostic algorithm based on cortical RBF and T1 values allowed detecting renal injury during cirrhosis.
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Affiliation(s)
- Shuangshuang Xie
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
| | - Mengyao Chen
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
| | - Chiyi Chen
- Liver Surgery Department, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Yumeng Zhao
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
| | - Jiaming Qin
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
| | - Caixin Qiu
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
| | - Jinxia Zhu
- MR Research Collaboration, Siemens Healthineers, Beijing, China
| | | | - Bernd Kuehn
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Wen Shen
- Radiology Department, Tianjin First Central Hospital, Tianjin Institute of Imaging Medicine, School of Medicine, Nankai University, Tianjin, China
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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.
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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.
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Hillaert A, Sanmiguel Serpa LC, Bogaert S, Broeckx BJG, Hesta M, Vandermeulen E, Germonpré J, Stock E, Pullens P, Vanderperren K. Assessment of pharmacologically induced changes in canine kidney function by multiparametric magnetic resonance imaging and contrast enhanced ultrasound. Front Vet Sci 2024; 11:1406343. [PMID: 38966564 PMCID: PMC11223176 DOI: 10.3389/fvets.2024.1406343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024] Open
Abstract
IntroductionDynamic contrast-enhanced (DCE) MRI and arterial spin labeling (ASL) MRI enable non-invasive measurement of renal blood flow (RBF), whereas blood oxygenation level-dependent (BOLD) MRI enables non-invasive measurement of the apparent relaxation rate (R2*), an indicator of oxygenation. This study was conducted to evaluate the potential role of these MRI modalities in assessing RBF and oxygenation in dogs. The correlation between contrast-enhanced ultrasound (CEUS) and the MRI modalities was examined and also the ability of the MRI modalities to detect pharmacologically induced changes.MethodsRBF, using CEUS, ASL- and DCE-MRI, as well as renal oxygenation, using BOLD-MRI of eight adult beagles were assessed at two time-points, 2–3 weeks apart. During each time point, the anesthetized dogs received either a control (0.9% sodium chloride) or a dopamine treatment. For each time point, measurements were carried out over 2 days. An MRI scan at 3 T was performed on day one, followed by CEUS on day two.ResultsUsing the model-free model with caudal placement of the arterial input function (AIF) region of interest (ROI) in the aorta, the DCE results showed a significant correlation with ASL measured RBF and detected significant changes in blood flow during dopamine infusion. Additionally, R2* negatively correlated with ASL measured RBF at the cortex and medulla, as well as with medullary wash-in rate (WiR) and peak intensity (PI). ASL measured RBF, in its turn, showed a positive correlation with cortical WiR, PI, area under the curve (AUC) and fall time (FT), and with medullary WiR and PI, but a negative correlation with medullary rise time (RT). During dopamine infusion, BOLD-MRI observed a significant decrease in R2* at the medulla and entire kidney, while ASL-MRI demonstrated a significant increase in RBF at the cortex, medulla and the entire kidney.ConclusionASL- and BOLD-MRI can measure pharmacologically induced changes in renal blood flow and renal oxygenation in dogs and might allow detection of changes that cannot be observed with CEUS. However, further research is needed to confirm the potential of ASL- and BOLD-MRI in dogs and to clarify which analysis method is most suitable for DCE-MRI in dogs.
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Affiliation(s)
- Amber Hillaert
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luis Carlos Sanmiguel Serpa
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stephanie Bogaert
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
| | - Bart J. G. Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Myriam Hesta
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Eva Vandermeulen
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jolien Germonpré
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Emmelie Stock
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Pim Pullens
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, Ghent, Belgium
- Institute of Biomedical Engineering and Technology, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Hillaert A, Sanmiguel Serpa LC, Xu Y, Hesta M, Bogaert S, Vanderperren K, Pullens P. Optimization of Fair Arterial Spin Labeling Magnetic Resonance Imaging (ASL-MRI) for Renal Perfusion Quantification in Dogs: Pilot Study. Animals (Basel) 2024; 14:1810. [PMID: 38929429 PMCID: PMC11201026 DOI: 10.3390/ani14121810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Arterial spin labeling (ASL) MRI allows non-invasive quantification of renal blood flow (RBF) and shows great potential for renal assessment. To our knowledge, renal ASL-MRI has not previously been performed in dogs. The aim of this pilot study was to determine parameters essential for ALS-MRI-based quantification of RBF in dogs: T1, blood (longitudinal relaxation time), λ (blood tissue partition coefficient) and TI (inversion time). A Beagle was scanned at 3T with a multi-TI ASL sequence, with TIs ranging from 250 to 2500 ms, to determine the optimal TI value. The T1 of blood for dogs was determined by scanning a blood sample with a 2D IR TSE sequence. The water content of the dog's kidney was determined by analyzing kidney samples from four dogs with a moisture analyzer and was subsequently used to calculate λ. The optimal TI and the measured values for T1,blood, and λ were 2000 ms, 1463 ms and 0.91 mL/g, respectively. These optimized parameters for dogs resulted in lower RBF values than those obtained from inline generated RBF maps. In conclusion, this study determined preliminary parameters essential for ALS-MRI-based RBF quantification in dogs. Further research is needed to confirm these values, but it may help guide future research.
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Affiliation(s)
- Amber Hillaert
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Luis Carlos Sanmiguel Serpa
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Yangfeng Xu
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Myriam Hesta
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Stephanie Bogaert
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium; (A.H.)
| | - Pim Pullens
- Department of Medical Imaging, Ghent University Hospital, 9000 Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging, Ghent University, 9000 Ghent, Belgium
- Institute of Biomedical Engineering and Technology (IBiTech)—MEDISP, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium
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Andersson J, Meik R, Pravdivtseva MS, Langguth P, Gottschalk H, Sedaghat S, Jüptner M, Koktzoglou I, Edelman RR, Kühn B, Feldkamp T, Jansen O, Both M, Salehi Ravesh M. Non-contrast preoperative MRI for determining renal perfusion and visualizing renal arteries in potential living kidney donors at 1.5 Tesla. Clin Kidney J 2024; 17:sfae101. [PMID: 38915436 PMCID: PMC11194483 DOI: 10.1093/ckj/sfae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Indexed: 06/26/2024] Open
Abstract
Background The aim of this work was to create and evaluate a preoperative non-contrast-enhanced (CE) magnetic resonance imaging (MRI)/angiography (MRA) protocol to assess renal function and visualize renal arteries and any abnormalities in potential living kidney donors. Methods In total, 28 subjects were examined using scintigraphy to determine renal function. In addition, 3D-pseudocontinuous arterial spin labeling (pCASL), a 2D-non-CE electrocardiogram-triggered radial quiescent interval slice-selective (QISS-MRA), and 4D-CE time-resolved angiography with interleaved stochastic trajectories (CE-MRA) were performed to assess renal perfusion, visualize renal arteries and detect any abnormalities. Two glomerular filtration rates [described by Gates (GFRG) and according to the Chronic Kidney Disease Epidemiology Collaboration formula (GFRCKD-EPI)]. The renal volumes were determined using both MRA techniques. Results The mean value of regional renal blood flow (rRBF) on the right side was significantly higher than that on the left. The agreements between QISS-MRA and CE-MRA concerning the assessment of absence or presence of an aberrant artery and renal arterial stenosis were perfect. The mean renal volumes measured in the right kidney with QISS-MRA were lower than the corresponding values of CE-MRA. In contrast, the mean renal volumes measured in the left kidney with both MRA techniques were similar. The correlation between the GFRG and rRBF was compared in the same manner as that between GFRCKD-EPI and rRBF. Conclusion The combination of pCASL and QISS-MRA constitute a reliable preoperative protocol with a total measurement time of <10 min without the potential side effects of gadolinium-based contrast agents or radiation exposure.
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Affiliation(s)
- Julian Andersson
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Rosalie Meik
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Mariya S Pravdivtseva
- Department of Radiology and Neuroradiology, Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), University Medical Center Schleswig-Holstein (UKSH), University of Kiel, Kiel, Germany
| | - Patrick Langguth
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Hannes Gottschalk
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Sam Sedaghat
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Jüptner
- Department of Nuclear Medicine, Molecular Imaging, Diagnostics and Therapy, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA
- University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bernd Kühn
- Siemens Healthineers AG, Erlangen, Germany
| | - Thorsten Feldkamp
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Mona Salehi Ravesh
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
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Peng J, Gao J, Hong Y, Wu Z, Chen G, Lu G. The value of functional magnetic resonance imaging in evaluating renal allograft function. Asian J Surg 2024; 47:1740-1745. [PMID: 38176978 DOI: 10.1016/j.asjsur.2023.12.121] [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: 08/30/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To explore the value of arterial spin labeled (ASL) and blood oxygen level dependent (BOLD) imaging in evaluating allogeneic kidney function after renal transplantation. METHODS One hundred and thirty-five renal transplant patients were included. Demographic and imaging data were collected. Transplanted renal function, pathology, ASL and BOLD parameters were obtained. The patients were divided into normal, mild and severe injury group. The correlation between BOLD/ASL parameters and clinical data were evaluated. The prediction models were based on ASL and BOLD parameters using multivariate logistic analysis. Cox proportional hazards regression model was used to analyze the effects of gender, age, ASL and BOLD on the survival of renal transplant patients. RESULTS ASL and BOLD parameters were independently associated with renal function injury and renal allograft positive pathology. The AUC of prediction model for renal allograft function based on ASL and BOLD parameters was 0.85, while the AUC based on BOLD parameters was 0.70. Renal transplantation time showed a positive correlation with age, BOLD parameters and SCr,while a negative correlation with ASL parameters and eGFR. ASL parameter was positively correlated with eGFR and negatively correlated with Scr. BOLD parameter was negatively correlated with eGFR, ASL and positively correlated with Scr. Cox proportional hazards regression model showed that the increase of age could reduce the risk of renal function injury and positive pathology. CONCLUSIONS ASL and BOLD were associated with renal function injury and renal allograft positive pathology. ASL and BOLD had some value in predicting renal allograft function.
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Affiliation(s)
- Jin Peng
- Department of Tumor and Vascular Intervention, Chenggong Hospital, Xiamen University, Xiamen, Fujian, 361003, China
| | - Juan Gao
- Department of Radiology, Jinling Hospital, Nanjing University, Nanjing, Jiangsu, 210006, China
| | - Yajun Hong
- Department of Medical Record Statistics, Zhongshan Hospital, Fudan University (Xiamen Branch), Fujian, 361015, China
| | - Zhengcan Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, China
| | - Guozhong Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210006, China.
| | - Guangming Lu
- Department of Radiology, Jinling Hospital, Nanjing University, Nanjing, Jiangsu, 210006, China.
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Liu J, Wang R, Qiu J, Su T. Investigation of renal perfusion and pathological changes in patients with acute kidney disease and tubulointerstitial nephritis using intravoxel incoherent motion and arterial spin labelling MRI: a prospective, observational study protocol. BMJ Open 2024; 14:e076488. [PMID: 38531564 DOI: 10.1136/bmjopen-2023-076488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Acute kidney injury (AKI) is a critical condition with a complex aetiology and different outcomes, where haemodynamic dysfunction, renal hypoperfusion and inflammation serve as key contributors to its development and progression. Early and accurate diagnosis is vital for initiating targeted treatments like fluid resuscitation, vasoactive agents or steroid therapy, which are essential for improving patient outcomes. Intravoxel incoherent motion (IVIM) MRI assesses both capillary perfusion and tissue water diffusion, while arterial spin labelling (ASL) MRI measures renal blood flow without the need for contrast. Research on combined use of IVIM and ASL MRI in patients with AKI is rare. This study aims to investigate the MRI characteristics of IVIM and ASL in patients with tubulointerstitial nephritis (TIN) and to explore their relationship with pathological findings and renal recovery. METHODS AND ANALYSIS Single-centre, prospective, observational cohort study of 30 patients with biopsy-proven TIN. Participants will undergo renal IVIM and ASL MRI within 7 days post-biopsy. The pathological assessments of active and chronic tubulointerstitial injuries will be semiscored using modified Banff criteria. The estimated glomerular filtration rate (eGFR) during follow-up and prevalence of chronic kidney disease at 3 and 6 months will be reported. An eGFR below 45 mL/min is considered a poor renal outcome. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Ethics Committee of Peking University First Hospital and written informed consent will be obtained from all participants (2022Y503). The study results will be disseminated through publication in a relevant peer-reviewed journal and presentation at academic meetings to increase awareness and share findings with the scientific community.
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Affiliation(s)
- Jiajia Liu
- Peking University First Hospital, Beijing, China
- Department of Nephrology, Peking University First Hospital, Beijing, China
| | - Rui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Jianxing Qiu
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Tao Su
- Peking University First Hospital, Beijing, China
- Department of Nephrology, Peking University First Hospital, Beijing, China
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10
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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: 4] [Impact Index Per Article: 4.0] [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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11
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Wei L, Wahyulaksana G, Te Lintel Hekkert M, Beurskens R, Boni E, Ramalli A, Noothout E, Duncker DJ, Tortoli P, van der Steen AFW, de Jong N, Verweij M, Vos HJ. High-Frame-Rate Volumetric Porcine Renal Vasculature Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2476-2482. [PMID: 37704558 DOI: 10.1016/j.ultrasmedbio.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE The aim of this study was to assess the feasibility and imaging options of contrast-enhanced volumetric ultrasound kidney vasculature imaging in a porcine model using a prototype sparse spiral array. METHODS Transcutaneous freehand in vivo imaging of two healthy porcine kidneys was performed according to three protocols with different microbubble concentrations and transmission sequences. Combining high-frame-rate transmission sequences with our previously described spatial coherence beamformer, we determined the ability to produce detailed volumetric images of the vasculature. We also determined power, color and spectral Doppler, as well as super-resolved microvasculature in a volume. The results were compared against a clinical 2-D ultrasound machine. RESULTS Three-dimensional visualization of the kidney vasculature structure and blood flow was possible with our method. Good structural agreement was found between the visualized vasculature structure and the 2-D reference. Microvasculature patterns in the kidney cortex were visible with super-resolution processing. Blood flow velocity estimations were within a physiological range and pattern, also in agreement with the 2-D reference results. CONCLUSION Volumetric imaging of the kidney vasculature was possible using a prototype sparse spiral array. Reliable structural and temporal information could be extracted from these imaging results.
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Affiliation(s)
- Luxi Wei
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Geraldi Wahyulaksana
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Robert Beurskens
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Enrico Boni
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Alessandro Ramalli
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Emile Noothout
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Dirk J Duncker
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Piero Tortoli
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Antonius F W van der Steen
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Nico de Jong
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Martin Verweij
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Hendrik J Vos
- Department of Cardiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
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12
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Wentland AL. Chronic kidney disease: a chronic challenge for imaging? Eur Radiol 2023; 33:5209-5210. [PMID: 37231072 PMCID: PMC10826735 DOI: 10.1007/s00330-023-09749-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 03/26/2023] [Accepted: 04/14/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Andrew L Wentland
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.
- Department of Medical Physics, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
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13
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Gilani N, Mikheev A, Brinkmann IM, Basukala D, Benkert T, Kumbella M, Babb JS, Chandarana H, Sigmund EE. Characterization of motion dependent magnetic field inhomogeneity for DWI in the kidneys. Magn Reson Imaging 2023; 100:93-101. [PMID: 36924807 PMCID: PMC10108090 DOI: 10.1016/j.mri.2023.03.008] [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: 01/26/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023]
Abstract
PURPOSE Diffusion-weighted imaging (DWI) of the abdomen has increased dramatically for both research and clinical purposes. Motion and static field inhomogeneity related challenges limit image quality of abdominopelvic imaging with the most conventional echo-planar imaging (EPI) pulse sequence. While reversed phase encoded imaging is increasingly used to facilitate distortion correction, it typically assumes one motion independent magnetic field distribution. In this study, we describe a more generalized workflow for the case of kidney DWI in which the field inhomogeneity at multiple respiratory phases is mapped and used to correct all images in a multi-contrast DWI series. METHODS In this HIPAA-compliant and IRB-approved prospective study, 8 volunteers (6 M, ages 28-51) had abdominal imaging performed in a 3 T MRI system (MAGNETOM Prisma; Siemens Healthcare, Erlangen, Germany) with ECG gating. Coronal oblique T2-weighted HASTE images were collected for anatomical reference. Sagittal phase-contrast (PC) MRI images through the left renal artery were collected to determine systolic and diastolic phases. Cardiac triggered oblique coronal DWI were collected at 10 b-values between 0 and 800 s/mm2 and 12 directions. DWI series were distortion corrected using field maps generated by forward and reversed phase encoded b = 0 images collected over the full respiratory cycle and matched by respiratory phase. Morphologic accuracy, intraseries spatial variability, and diffusion tensor imaging (DTI) metrics mean diffusivity (MD) and fractional anisotropy (FA) were compared for results generated with no distortion correction, correction with only one respiratory bin, and correction with multiple respiratory bins across the breathing cycle. RESULTS Computed field maps showed significant variation in static field with kidney laterality, region, and respiratory phase. Distortion corrected images showed significantly better registration to morphologic images than uncorrected images; for the left kidney, the multiple bin correction outperformed one bin correction. Line profile analysis showed significantly reduced spatial variation with multiple bins than one bin correction. DTI metrics were mostly similar between correction methods, with some differences observed in MD between uncorrected and corrected datasets. CONCLUSIONS Our results indicate improved morphology of kidney DWI and derived parametric maps as well as reduced variability over the full image series using the motion-resolved distortion correction. This work highlights some morphologic and quantitative metric improvements can be obtained for kidney DWI when distortion correction is performed in a respiratory-resolved manner.
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Affiliation(s)
- Nima Gilani
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA.
| | - Artem Mikheev
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA
| | | | - Dibash Basukala
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA
| | | | - Malika Kumbella
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA
| | - James S Babb
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA
| | - Hersh Chandarana
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA
| | - Eric E Sigmund
- Center for Advanced Imaging and Innovation (CAI(2)R), Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, New York, USA.
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Ulpiano Trillig A, Damianaki A, Hendriks-Balk M, Brito W, Garessus J, Burnier M, Wuerzner G, Pruijm M. Determinants of Renal Micro-Perfusion as Assessed with Contrast-Enhanced Ultrasound in Healthy Males and Females. J Clin Med 2023; 12:4141. [PMID: 37373834 DOI: 10.3390/jcm12124141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: The renal microcirculation is essential to maintain the renal function, but its determinants in humans have been poorly studied. Contrast-enhanced ultrasound (CEUS) allows the non-invasive quantification of the cortical micro-perfusion at the bedside using the perfusion index (PI). The aims of this study were to assess whether differences exist in PI between healthy males and females and to identify clinical determinants associated with cortical micro-perfusion. (2) Methods: Healthy, normotensive volunteers (eGFR > 60 mL/min/1.73 m2, no albuminuria) underwent CEUS under standardized conditions with the destruction-reperfusion (DR) technique. The mean PI of four DR sequences was reported as the primary outcome measure (3) Results: A total of 115 subjects (77 females and 38 males) completed the study; the mean ± SD age was, respectively, 37.1 ± 12.2 and 37.1 ± 12.7 years in females and males, and the mean eGFR was 105.9 ± 15.1 and 91.0 ± 17.4 mL/min/1.73 m2. The PI (median) was higher in females than in males, i.e., 2705 (IQR 1641-3777) vs. 1965 (IQR 1294-3346) arbitrary units (a.u), p = 0.02). A correlation analysis showed positive associations between PI and eGFR, female sex, heart rate, plasma renin activity (PRA) and plasma aldosterone concentrations (PAC), negative associations with potassium, bicarbonate and systolic blood pressure, and no associations with age, body mass index and renal resistive index (RRI). In a multivariate linear regression analysis, only PRA remained significantly associated with PI. (4) Conclusions: Although the PI was higher among females, this association was no longer significant after adjustment for covariates. There was no difference in females tested during the follicular or the luteal phases. In conclusion, the PI was only weakly influenced by classic clinical variables, but was positively associated with PRA, suggesting that the renin-angiotensin system plays a role in the regulation of the cortical micro-perfusion in humans. Identifying which other factors contribute to the large variations in micro-perfusion across individuals needs further study.
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Affiliation(s)
- Antonio Ulpiano Trillig
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Aikaterini Damianaki
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Mariëlle Hendriks-Balk
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Wendy Brito
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Jonas Garessus
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Michel Burnier
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Grégoire Wuerzner
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Menno Pruijm
- Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
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Mao W, Ding Y, Ding X, Fu C, Cao B, Kuehn B, Benkert T, Grimm R, Zhou J, Zeng M. Capability of arterial spin labeling and intravoxel incoherent motion diffusion-weighted imaging to detect early kidney injury in chronic kidney disease. Eur Radiol 2023; 33:3286-3294. [PMID: 36512040 DOI: 10.1007/s00330-022-09331-z] [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: 08/02/2022] [Revised: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To prospectively investigate the capability of arterial spin labeling (ASL) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for the identification of early kidney injury in chronic kidney disease (CKD) patients with normal estimated glomerular filtration rate (eGFR). METHODS Fifty-four CKD patients confirmed by renal biopsy (normal eGFR group [eGFR ≥ 90 mL/min/1.73 m2]: n = 26; abnormal eGFR group [eGFR < 90 mL/min/1.73 m2]: n = 28) and 20 healthy volunteers (HV) were recruited. All subjects were examined by IVIM-DWI and ASL imaging. Renal blood flow (RBF) derived from ASL, true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) derived from IVIM-DWI were measured from the renal cortex. One-way analysis of variance was used to compare MRI parameters among the three groups. The correlation between eGFR and MRI parameters was evaluated by Spearman correlation analysis. Diagnostic performances of MRI parameters for detecting kidney injury were assessed by receiver operating characteristic (ROC) curves. RESULTS The renal cortical D, D*, f, and RBF values showed statistically significant differences among the three groups. eGFR was positively correlated with MRI parameters (D: r = 0.299, D*: r = 0.569, f: r = 0.733, RBF: r = 0.586). The areas under the curve (AUCs) for discriminating CKD patients from HV were 0.725, 0.752, 0.947, and 0.884 by D, D*, f, and RBF, respectively. D, D*, f, RBF, and eGFR identified CKD patients with normal eGFR with AUCs of 0.735, 0.612, 0.917, 0.827, and 0.733, respectively, and AUC of f value was significantly larger than that of eGFR. CONCLUSION IVIM-DWI and ASL were useful for detecting underlying pathologic injury in early CKD patients with normal eGFR. KEY POINTS • The renal cortical f and RBF values in the control group were significantly higher than those in the normal eGFR group. • A negative correlation was observed between the renal cortical D, D*, f, and RBF values and SCr and 24 h-UPRO, while eGFR was significantly positively correlated with renal cortical D, D*, f, and RBF values. • The AUC of renal cortical f values was statistically larger than that of eGFR for the discrimination between the CKD with normal eGFR group and the control group.
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Affiliation(s)
- Wei Mao
- Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Yuqin Ding
- Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Caixia Fu
- MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, People's Republic of China
| | - Bohong Cao
- Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China
| | - Bernd Kuehn
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Jianjun Zhou
- Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
- Department of Radiology, Zhongshan Hospital, Xiamen Branch, Fudan University, Xiamen, People's Republic of China.
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
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16
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Intravoxel incoherent motion diffusion-weighted MRI of renal parenchyma and its clinical significance in patients with untreated acute leukemia: a pilot study. ABDOMINAL RADIOLOGY (NEW YORK) 2023; 48:1363-1371. [PMID: 36763120 DOI: 10.1007/s00261-023-03829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To evaluate quantitative parameters derived from intravoxel incoherent motion diffusion-weighted MRI (IVIM) of renal parenchyma in patients with untreated acute leukemia (AL) and analyze its prognostic significance and probable pathological mechanism. METHODS From March 2019 to November 2021, 67 newly diagnosed AL patients and 67 healthy controls matched in age and sex were recruited. All participants underwent IVIM in the kidneys, and D, D*, f, standard ADC values were measured. The differences of all parameters between AL and controls were analyzed. The relationship between imaging parameters and estimated glomerular filtration rate (eGFR) was studied. Univariable and multivariable analyses were performed to investigate prognostic significance of possible indicators. RESULTS The f and D value of renal medulla and D value of renal cortex in AL patients were lower than those in the healthy control group (t = - 2.173, t = - 3.463, t = - 2.030, respectively, all P < 0.05). The cortical f, cortical standard ADC, medullary f, and medullary standard ADC were correlated with the eGFR (r = 0.524, r = 0.401, r = 0.415, r = 0.325, respectively, all P < 0.05) in patients with AL. A medullary f value ≤ 9.51% (hazard ratio: 0.282; 95% confidence interval: 0.110, 0.719; P = 0.008) was associated with overall survival in a multivariable analysis. CONCLUSION The f and standard ADC values in renal parenchyma were the probable imaging markers of renal function in patients with newly diagnosed de novo AL. Lower renal medullary f value was a potential independent predictor for overall survival.
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Liang P, Yuan G, Li S, He K, Peng Y, Hu D, Li Z, Ma Z, Xu C. Non-invasive evaluation of the pathological and functional characteristics of chronic kidney disease by diffusion kurtosis imaging and intravoxel incoherent motion imaging: comparison with conventional DWI. Br J Radiol 2023; 96:20220644. [PMID: 36400040 PMCID: PMC10997028 DOI: 10.1259/bjr.20220644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/26/2022] [Accepted: 11/06/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore the diagnostic performance of diffusion kurtosis imaging (DKI) and incoherent intravoxel movement (IVIM) in evaluating the clinical and pathological characteristics in chronic kidney disease (CKD) compared to conventional diffusion-weighted imaging (DWI). METHODS Forty-nine CKD patients and 24 healthy volunteers were included in this retrospective study from September 2020 to September 2021. All participants underwent MRI examinations before percutaneous renal biopsy. Coronal T2WI, axial T1WI and T2WI, and DWI (including IVIM and DKI) sequences obtained in one scan. We measured the apparent diffusion coefficient (ADC), true diffusion coefficient (Dt), pseudo-diffusion coefficient (Dp), perfusion fraction (fp), mean kurtosis (MK), and mean diffusivity (MD) values. One-way analysis of variance, correlation analysis, and receiver operating characteristic curve analysis were used in our study. RESULTS Cortex and medulla ADC, MK, Dt, fp were significantly different between the healthy volunteers and CKD stages 1-2 (all p < 0.05). All diffusion parameters showed significant differences between CKD stages 1-2 and CKD stages 3-5 (all p < 0.05). Except for the uncorrelation between MDMedulla and vascular lesion score, all other diffusion parameters were low-to-moderately related to clinical and pathological indicators. fpMedulla was the best parameter to differentiate healthy volunteers from CKD stages 1-2. MKCortex was the best parameter to differentiate CKD stages 1-2 from that CKD stages 3-5. CONCLUSION Renal cortex and medulla fp, Dt, and MK can provide more valuable information than ADC values for the evaluation of clinical and pathological characteristics of CKD patients, and thus can provide auxiliary diagnosis for fibrosis assessment and clinical management of CKD patients. ADVANCES IN KNOWLEDGE IVIM and DKI can provide more diagnostic valuable information for CKD patients than conventional DWI.
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Affiliation(s)
- Ping Liang
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Guanjie Yuan
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Shichao Li
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Kangwen He
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Yang Peng
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Daoyu Hu
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Zufu Ma
- Department of Nephrology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Chuou Xu
- Department of Radiology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
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Brumer I, Bauer DF, Schad LR, Zöllner FG. Synthetic Arterial Spin Labeling MRI of the Kidneys for Evaluation of Data Processing Pipeline. Diagnostics (Basel) 2022; 12:1854. [PMID: 36010205 PMCID: PMC9406826 DOI: 10.3390/diagnostics12081854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
Accurate quantification of perfusion is crucial for diagnosis and monitoring of kidney function. Arterial spin labeling (ASL), a completely non-invasive magnetic resonance imaging technique, is a promising method for this application. However, differences in acquisition (e.g., ASL parameters, readout) and processing (e.g., registration, segmentation) between studies impede the comparison of results. To alleviate challenges arising solely from differences in processing pipelines, synthetic data are of great value. In this work, synthetic renal ASL data were generated using body models from the XCAT phantom and perfusion was added using the general kinetic model. Our in-house developed processing pipeline was then evaluated in terms of registration, quantification, and segmentation using the synthetic data. Registration performance was evaluated qualitatively with line profiles and quantitatively with mean structural similarity index measures (MSSIMs). Perfusion values obtained from the pipeline were compared to the values assumed when generating the synthetic data. Segmentation masks obtained by semi-automated procedure of the processing pipeline were compared to the original XCAT organ masks using the Dice index. Overall, the pipeline evaluation yielded good results. After registration, line profiles were smoother and, on average, MSSIMs increased by 25%. Mean perfusion values for cortex and medulla were close to the assumed perfusion of 250 mL/100 g/min and 50 mL/100 g/min, respectively. Dice indices ranged 0.80-0.93, 0.78-0.89, and 0.64-0.84 for whole kidney, cortex, and medulla, respectively. The generation of synthetic ASL data allows flexible choice of parameters and the generated data are well suited for evaluation of processing pipelines.
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Affiliation(s)
- Irène Brumer
- Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (D.F.B.); (L.R.S.); (F.G.Z.)
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Hof S, Marcus C, Kuebart A, Schulz J, Truse R, Raupach A, Bauer I, Flögel U, Picker O, Herminghaus A, Temme S. A Toolbox to Investigate the Impact of Impaired Oxygen Delivery in Experimental Disease Models. Front Med (Lausanne) 2022; 9:869372. [PMID: 35652064 PMCID: PMC9149176 DOI: 10.3389/fmed.2022.869372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022] Open
Abstract
Impaired oxygen utilization is the underlying pathophysiological process in different shock states. Clinically most important are septic and hemorrhagic shock, which comprise more than 75% of all clinical cases of shock. Both forms lead to severe dysfunction of the microcirculation and the mitochondria that can cause or further aggravate tissue damage and inflammation. However, the detailed mechanisms of acute and long-term effects of impaired oxygen utilization are still elusive. Importantly, a defective oxygen exploitation can impact multiple organs simultaneously and organ damage can be aggravated due to intense organ cross-talk or the presence of a systemic inflammatory response. Complexity is further increased through a large heterogeneity in the human population, differences in genetics, age and gender, comorbidities or disease history. To gain a deeper understanding of the principles, mechanisms, interconnections and consequences of impaired oxygen delivery and utilization, interdisciplinary preclinical as well as clinical research is required. In this review, we provide a "tool-box" that covers widely used animal disease models for septic and hemorrhagic shock and methods to determine the structure and function of the microcirculation as well as mitochondrial function. Furthermore, we suggest magnetic resonance imaging as a multimodal imaging platform to noninvasively assess the consequences of impaired oxygen delivery on organ function, cell metabolism, alterations in tissue textures or inflammation. Combining structural and functional analyses of oxygen delivery and utilization in animal models with additional data obtained by multiparametric MRI-based techniques can help to unravel mechanisms underlying immediate effects as well as long-term consequences of impaired oxygen delivery on multiple organs and may narrow the gap between experimental preclinical research and the human patient.
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Affiliation(s)
- Stefan Hof
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Carsten Marcus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anne Kuebart
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Jan Schulz
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Richard Truse
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Annika Raupach
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Inge Bauer
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ulrich Flögel
- Experimental Cardiovascular Imaging, Department of Molecular Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Olaf Picker
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anna Herminghaus
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sebastian Temme
- Department of Anaesthesiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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20
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Ning Z, Chen S, Chen Z, Han H, Qiao H, Zhang N, Wang R, Shen R, Zhao X. Saturated multi-delay renal arterial spin labeling technique for simultaneous perfusion and T 1 quantification in kidneys. Magn Reson Med 2022; 88:1055-1067. [PMID: 35506512 DOI: 10.1002/mrm.29268] [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: 12/28/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To propose a free-breathing simultaneous multi-delay arterial spin labeling (ASL) and T1 mapping technique with a stepwise kinetic model for renal assessment in a single 4-min scan at 3 T. METHODS The proposed saturated multi-delay renal arterial spin labeling (SAMURAI) sequence used flow-sensitive alternating inversion recovery (FAIR) preparation, followed by acquisition of 9 images with Look-Locker spoiled gradient recalled echo (SPGR). Pre-saturation at the imaging slice was used to achieve saturation-based T1 mapping. A 4-step 2-compartment kinetic model was proposed to characterize water transition through artery- and tissue-compartment. The impact of the Look-Locker sampling scheme on the ASL signal was corrected in this model. T1 estimation with dictionary searching method and perfusion quantification based on the proposed kinetic model fitting were conducted after groupwise registration of the acquired images. The feasibility and repeatability of SAMURAI were validated in healthy subjects (n = 11) and patients with different renal diseases (n = 4). RESULTS The proposed SAMURAI technique can provide accurate T1 map with strong correlation (R2 = 0.98) with inversion recovery spin echo (IR-SE) on phantom. SAMURAI provided equally reliable whole kidney and cortical ASL and T1 quantification results compared with multi-TI FAIR (intraclass correlation coefficient [ICC], 0.880-0.958) and IR-SPGR (ICC, 0.875-0.912), respectively. Low renal blood flow and increased T1 were detected by SAMURAI in the affected kidneys of the patients. SAMURAI had excellent scan-rescan repeatability (ICC, 0.905-0.992) and significantly reduced scan time (4 min 6 s vs. 45 min for 9 TIs) compared to multi-TI FAIR. CONCLUSION The proposed SAMURAI technique is feasible and repeatable for simultaneously quantifying T1 and perfusion of kidneys with high time-efficiency.
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Affiliation(s)
- Zihan Ning
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Hualu Han
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Huiyu Qiao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Beijing, China
| | - Rui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Rui Shen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China
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21
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Chhabra J, Karwarker GV, Rajamanuri M, Maligireddy AR, Dai E, Chahal M, Mannava SM, Alfonso M. The Role of Arterial Spin Labeling Functional MRI in Assessing Perfusion Impairment of Renal Allografts: A Systematic Review. Cureus 2022; 14:e25428. [PMID: 35769679 PMCID: PMC9236280 DOI: 10.7759/cureus.25428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/28/2022] [Indexed: 11/05/2022] Open
Abstract
Arterial spin labeling (ASL) is a functional magnetic resonance imaging (fMRI) technique that uses water in arterial blood as a tracer to map an area of interest where the intravascular and extravascular compartments exchange. Our review article focuses primarily on the role of ASL fMRI in assessing perfusion impairment in renal allografts in order to take appropriate steps to eliminate the cause of perfusion impairment at an early stage, thereby extending graft life. The study also highlights various other fMRI techniques that are used to analyze other parameters that affect kidney transplants both acutely and chronically. We gathered our data in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and our search strategy included exclusion/inclusion criteria. Several databases were used in the search strategy, including PubMed, Cochrane, and Science Direct, and the Medical Subject Headings (MeSH) strategy was specifically used for PubMed, and two people scrutinized those papers to conclude that a total of 10 research papers are included in our study. This review article includes papers involving 20 to 98 subjects who had renal allografts within the previous six months and had renal cortical perfusion values measured by ASL fMRI ranging from 35 to 304 ml/100 g/min. Furthermore, when compared to healthy kidney transplant patients, renal ASL perfusion values were significantly lower in subjects with the functional imbalance of kidney transplants. It had a positive correlation with the estimated glomerular filtration rate (eGFR). To summarize, ASL fMRI is critical in detecting renal allograft perfusion impairment.
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Affiliation(s)
- Jayksh Chhabra
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Medha Rajamanuri
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anand Reddy Maligireddy
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Eiman Dai
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meher Chahal
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sai Mahitha Mannava
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Michael Alfonso
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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22
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Multiparametric Functional MRI of the Kidney: Current State and Future Trends with Deep Learning Approaches. ROFO-FORTSCHR RONTG 2022; 194:983-992. [PMID: 35272360 DOI: 10.1055/a-1775-8633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Until today, assessment of renal function has remained a challenge for modern medicine. In many cases, kidney diseases accompanied by a decrease in renal function remain undetected and unsolved, since neither laboratory tests nor imaging diagnostics provide adequate information on kidney status. In recent years, developments in the field of functional magnetic resonance imaging with application to abdominal organs have opened new possibilities combining anatomic imaging with multiparametric functional information. The multiparametric approach enables the measurement of perfusion, diffusion, oxygenation, and tissue characterization in one examination, thus providing more comprehensive insight into pathophysiological processes of diseases as well as effects of therapeutic interventions. However, application of multiparametric fMRI in the kidneys is still restricted mainly to research areas and transfer to the clinical routine is still outstanding. One of the major challenges is the lack of a standardized protocol for acquisition and postprocessing including efficient strategies for data analysis. This article provides an overview of the most common fMRI techniques with application to the kidney together with new approaches regarding data analysis with deep learning. METHODS This article implies a selective literature review using the literature database PubMed in May 2021 supplemented by our own experiences in this field. RESULTS AND CONCLUSION Functional multiparametric MRI is a promising technique for assessing renal function in a more comprehensive approach by combining multiple parameters such as perfusion, diffusion, and BOLD imaging. New approaches with the application of deep learning techniques could substantially contribute to overcoming the challenge of handling the quantity of data and developing more efficient data postprocessing and analysis protocols. Thus, it can be hoped that multiparametric fMRI protocols can be sufficiently optimized to be used for routine renal examination and to assist clinicians in the diagnostics, monitoring, and treatment of kidney diseases in the future. KEY POINTS · Multiparametric fMRI is a technique performed without the use of radiation, contrast media, and invasive methods.. · Multiparametric fMRI provides more comprehensive insight into pathophysiological processes of kidney diseases by combining functional and structural parameters.. · For broader acceptance of fMRI biomarkers, there is a need for standardization of acquisition, postprocessing, and analysis protocols as well as more prospective studies.. · Deep learning techniques could significantly contribute to an optimization of data acquisition and the postprocessing and interpretation of larger quantities of data.. CITATION FORMAT · Zhang C, Schwartz M, Küstner T et al. Multiparametric Functional MRI of the Kidney: Current State and Future Trends with Deep Learning Approaches. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1775-8633.
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23
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Chen J, Chen Q, Zhang J, Pan L, Zha T, Zhang Y, Chen J. Value of T2 Mapping in the Dynamic Evaluation of Renal Ischemia-Reperfusion Injury. Acad Radiol 2022; 29:376-381. [PMID: 33836945 DOI: 10.1016/j.acra.2021.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/01/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore the value of T2 mapping in the dynamic quantitative evaluation of renal ischemia- reperfusion injury (IRI). MATERIALS AND METHODS Forty-eight healthy New Zealand rabbits were randomly divided into IRI group (n = 40) and control group (n = 8). Rabbits in the IRI group underwent left renal artery clamping for 60 minutes. Rabbits underwent MRI examinations (T2WI and T2 mapping) before and 1, 12, 24, and 48 hours after IRI. The inter-observer and intra-observer reproducibility of the T2 values were assessed using the intraclass correlation coefficient (ICC) with 95% confidence interval (CI). Correlations between the T2 value of the renal outer medulla and injury scores were assessed by Spearman correlation analysis. The repeated measures analysis of variance was used to compare the differences in T2 values of the IRI and control group across the different time points. RESULTS Both of the intra-observer (ICC = 0.97, 95% CI 0.95-0.99) and inter-observer reproducibility (ICC = 0.92, 95% CI 0.86-0.96) were excellent for T2 values. The T2 value of the renal outer medulla was moderately positive correlated with tubular epithelial edema (ρ = 0.686, p < 0.001). In IRI group, T2 values of the renal outer medulla were increase at 1 h after IRI (p = 0.001) and were decrease from 1 h to 12 h (p = 0.002). At 1 h after IRI, the T2 values of the renal outer medulla for the IRI group were higher than those for the control group (p < 0.001). CONCLUSION T2 mapping can reflect the dynamic changes of renal parenchyma in an animal model of IRI and be used to assess the early renal IRI.
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Affiliation(s)
- Jing Chen
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Qin Chen
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Jinggang Zhang
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Liang Pan
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Tingting Zha
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Yongcheng Zhang
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China
| | - Jie Chen
- Department of Radiology, Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu, China.
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24
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Grattan-Smith JD, Chow J, Kurugol S, Jones RA. Quantitative renal magnetic resonance imaging: magnetic resonance urography. Pediatr Radiol 2022; 52:228-248. [PMID: 35022851 PMCID: PMC9670866 DOI: 10.1007/s00247-021-05264-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/16/2021] [Accepted: 12/10/2021] [Indexed: 02/03/2023]
Abstract
The goal of functional renal imaging is to identify and quantitate irreversible renal damage and nephron loss, as well as potentially reversible hemodynamic changes. MR urography has evolved into a comprehensive evaluation of the urinary tract that combines anatomical imaging with functional evaluation in a single test without ionizing radiation. Quantitative functional MR imaging is based on dynamic contrast-enhanced MR acquisitions that provide progressive, visible enhancement of the renal parenchyma and urinary tract. The signal changes related to perfusion, concentration and excretion of the contrast agent can be evaluated using both quantitative and qualitative measures. Functional evaluation with MR has continued to improve as a result of significant technical advances allowing for faster image acquisition as well as the development of new tracer kinetic models of renal function. The most common indications for MR urography in children are the evaluation of congenital anomalies of the kidney and urinary tract including hydronephrosis and renal malformations, and the identification of ectopic ureters in children with incontinence. In this paper, we review the underlying acquisition schemes and techniques used to generate quantitative functional parameters including the differential renal function (DRF), asymmetry index, mean transit time (MTT), signal intensity versus time curves as well as the calculation of individual kidney glomerular filtration rate (GFR). Visual inspection and semi-quantitative assessment using the renal transit time (RTT) and calyceal transit times (CTT) are fundamental to accurate diagnosis and are used as a basis for the interpretation of the quantitative data. The importance of visual assessment of the images cannot be overstated when analyzing the quantitative measures of renal function.
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Affiliation(s)
| | - Jeanne Chow
- Department of Radiology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Sila Kurugol
- Department of Radiology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Richard A Jones
- Department of Radiology, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
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25
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Radovic T, Jankovic MM, Stevic R, Spasojevic B, Cvetkovic M, Pavicevic P, Gojkovic I, Kostic M. Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI). Sci Rep 2022; 12:828. [PMID: 35039571 PMCID: PMC8764097 DOI: 10.1038/s41598-022-04794-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/31/2021] [Indexed: 12/11/2022] Open
Abstract
The study aimed to discriminate renal allografts with impaired function by measuring cortical renal blood flow (cRBF) using magnetic resonance imaging arterial spin labelling (ASL-MRI) in paediatric and young adult patients. We included 18 subjects and performed ASL-MRI on 1.5 T MRI to calculate cRBF on parameter maps. cRBF was correlated to calculated glomerular filtration rate (GFR) and compared between patient groups with good (GFR ≥ 60 mL/min/1.73 m2) and impaired allograft function (GFR < 60 mL/min/1.73 m2). Mean cRBF in patients with good allograft function was significantly higher than in patients with impaired allograft function (219.89 ± 57.24 mL/min/100 g vs. 146.22 ± 41.84 mL/min/100 g, p < 0.008), showing a highly significant correlation with GFR in all subjects (r = 0.75, p < 0.0001). Also, the diffusion-weighted imaging (DWI-MRI) apparent diffusion coefficient (ADC) and Doppler measurements of peak-systolic and end-diastolic velocities and the resistive index (PS, ED, RI) were performed and both methods showed no significant difference between groups. ADC implied no correlation with GFR (r = 0.198, p = 0.464), while PS indicated moderate correlation to GFR (r = 0.48, p < 0.05), and PS and ED moderate correlation to cRBF (r = 0.58, p < 0.05, r = 0.56, p < 0.05, respectively). Cortical perfusion as non-invasively measured by ASL-MRI differs between patients with good and impaired allograft function and correlates significantly with its function.
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Affiliation(s)
- Tijana Radovic
- Department of Radiology, University Children's Hospital, Belgrade, Serbia.
| | - Milica M Jankovic
- Department of Signals and Systems, School of Electrical Engineering, University of Belgrade, Belgrade, Serbia
| | - Ruza Stevic
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Radiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Brankica Spasojevic
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Nephrology, Dialysis and Transplantation, University Children's Hospital, Belgrade, Serbia
| | - Mirjana Cvetkovic
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Nephrology, Dialysis and Transplantation, University Children's Hospital, Belgrade, Serbia
| | - Polina Pavicevic
- Department of Radiology, University Children's Hospital, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Gojkovic
- Department of Nephrology, Dialysis and Transplantation, University Children's Hospital, Belgrade, Serbia
| | - Mirjana Kostic
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Nephrology, Dialysis and Transplantation, University Children's Hospital, Belgrade, Serbia
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26
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Zhang H, Wang P, Shi D, Yao X, Li Y, Liu X, Sun Y, Ding J, Wang S, Wang G, Ren K. Capability of intravoxel incoherent motion and diffusion tensor imaging to detect early kidney injury in type 2 diabetes. Eur Radiol 2022; 32:2988-2997. [PMID: 35031840 DOI: 10.1007/s00330-021-08415-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To prospectively investigate the capability of intravoxel incoherent motion (IVIM) and conventional diffusion tensor imaging (DTI) to identify early kidney function injury in type 2 diabetes. METHODS Forty-one diabetes patients (normoalbuminuria: n = 27; microalbuminuria: n = 14) and 28 volunteers were recruited. All participants were examined using DTI and IVIM with 3.0-T MRI. DTI parameters (mean diffusivity [MD], fractional anisotropy [FA]), and IVIM parameters (true diffusion coefficient [D], pseudo-diffusion coefficient [D*], and pseudo-diffusion component fraction [f]) were measured in the renal parenchyma (cortex and medulla) by two experienced radiologists independently. Image features were compared among the groups using separate one-way analyses of variance. Diagnostic performances of various diffusion parameters for predicting diabetic renal damage were compared. RESULTS The medullary D and FA values were significantly different among the microalbuminuria subgroup, normoalbuminuria subgroup, and control group (all p < 0.001). In medulla, area under the curve (AUC) values for combined FA and D were significantly higher than single FA (AUC = 0.938, 0.769, respectively; p = 0.003), and the combined AUC of FA and D was numerically higher than that of single D (0.938 vs 0.878, p > 0.05). AUC of combined FA and D was 0.985, not significantly different from individual AUC for FA and D (AUC = 0.909 and 0.952, respectively; all p > 0.05) in differentiating the microalbuminuria subgroup from the control group. CONCLUSION IVIM-derived D and DTI-derived FA values were better than other parameters for evaluating early kidney impairment of diabetes. The single indicator FA and D performed as well as the combined diagnostic indicator in the medulla for differentiating the microalbuminuria subgroup from the control group. KEY POINTS • We speculated that early renal progression in type 2 diabetes result from restricted tubular flow and kidney tubule dysregulation may precede or at least accompany abnormal glomerular changes. • In medulla, the AUC values of FA and D and the combination of FA and D obtained by comparing the microalbuminuria subgroup with the control group were 0.909, 0.952, and 0.985, respectively. • IVIM-derived D and DTI-derived FA are effective MR biomarkers to evaluate early alterations of the renal function in patients with diabetes.
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Affiliation(s)
- Haoran Zhang
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Peng Wang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Dafa Shi
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Xiang Yao
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Yanfei Li
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Xuedan Liu
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Yang Sun
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Jie Ding
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Siyuan Wang
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Guangsong Wang
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China
| | - Ke Ren
- Department of Radiology, Xiang'an Hospital of Xiamen University, Xiamen, 361005, China. .,Xiamen Key Laboratory of Endocrine-Related Cancer Precision Medicine, Xiamen, China.
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27
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Albano D, Bruno F, Agostini A, Angileri SA, Benenati M, Bicchierai G, Cellina M, Chianca V, Cozzi D, Danti G, De Muzio F, Di Meglio L, Gentili F, Giacobbe G, Grazzini G, Grazzini I, Guerriero P, Messina C, Micci G, Palumbo P, Rocco MP, Grassi R, Miele V, Barile A. Dynamic contrast-enhanced (DCE) imaging: state of the art and applications in whole-body imaging. Jpn J Radiol 2021; 40:341-366. [PMID: 34951000 DOI: 10.1007/s11604-021-01223-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/17/2021] [Indexed: 12/18/2022]
Abstract
Dynamic contrast-enhanced (DCE) imaging is a non-invasive technique used for the evaluation of tissue vascularity features through imaging series acquisition after contrast medium administration. Over the years, the study technique and protocols have evolved, seeing a growing application of this method across different imaging modalities for the study of almost all body districts. The main and most consolidated current applications concern MRI imaging for the study of tumors, but an increasing number of studies are evaluating the use of this technique also for inflammatory pathologies and functional studies. Furthermore, the recent advent of artificial intelligence techniques is opening up a vast scenario for the analysis of quantitative information deriving from DCE. The purpose of this article is to provide a comprehensive update on the techniques, protocols, and clinical applications - both established and emerging - of DCE in whole-body imaging.
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Affiliation(s)
- Domenico Albano
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata, Sezione Di Scienze Radiologiche, Università Degli Studi Di Palermo, via Vetoio 1L'Aquila, 67100, Palermo, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Agostini
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Clinical, Special and Dental Sciences, Department of Radiology, University Politecnica delle Marche, University Hospital "Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi", Ancona, Italy
| | - Salvatore Alessio Angileri
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Radiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Benenati
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Dipartimento di Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Oncologia ed Ematologia, RadioterapiaRome, Italy
| | - Giulia Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Michaela Cellina
- Department of Radiology, ASST Fatebenefratelli Sacco, Ospedale Fatebenefratelli, Milan, Italy
| | - Vito Chianca
- Ospedale Evangelico Betania, Naples, Italy
- Clinica Di Radiologia, Istituto Imaging Della Svizzera Italiana - Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Diletta Cozzi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Ginevra Danti
- Department of Emergency Radiology, Careggi University Hospital, Florence, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Letizia Di Meglio
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Giuliana Giacobbe
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giulia Grazzini
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Irene Grazzini
- Department of Radiology, Section of Neuroradiology, San Donato Hospital, Arezzo, Italy
| | - Pasquale Guerriero
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | | | - Giuseppe Micci
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Dipartimento Di Biomedicina, Neuroscienze E Diagnostica Avanzata, Sezione Di Scienze Radiologiche, Università Degli Studi Di Palermo, via Vetoio 1L'Aquila, 67100, Palermo, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Abruzzo Health Unit 1, Department of diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, L'Aquila, Italy
| | - Maria Paola Rocco
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Roberto Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Antonio Barile
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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28
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Deng S, Muir ER. Editorial for "Perfusion Analysis of Kidney Injury in Rats With Cirrhosis Induced by Common Bile Duct Ligation Using Arterial Spin Labeling MRI". J Magn Reson Imaging 2021; 55:1405-1406. [PMID: 34596941 DOI: 10.1002/jmri.27947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shengwen Deng
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Eric R Muir
- Department of Radiology, Stony Brook University, Stony Brook, New York, USA
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29
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Charlton JR, Xu Y, Parvin N, Wu T, Gao F, Baldelomar EJ, Morozov D, Beeman SC, Derakhshan J, Bennett KM. Image analysis techniques to map pyramids, pyramid structure, glomerular distribution, and pathology in the intact human kidney from 3-D MRI. Am J Physiol Renal Physiol 2021; 321:F293-F304. [PMID: 34282957 PMCID: PMC8530750 DOI: 10.1152/ajprenal.00130.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/28/2021] [Accepted: 07/15/2021] [Indexed: 11/22/2022] Open
Abstract
Kidney pathologies are often highly heterogeneous. To comprehensively understand kidney structure and pathology, it is critical to develop tools to map tissue microstructure in the context of the whole, intact organ. Magnetic resonance imaging (MRI) can provide a unique, three-dimensional view of the kidney and allows for measurements of multiple pathological features. Here, we developed a platform to systematically render and map gross and microstructural features of the human kidney based on three-dimensional MRI. These features include pyramid number and morphology as well as the associated medulla and cortex. In a subset of these kidneys, we also mapped individual glomeruli and glomerular volumes using cationic ferritin-enhanced MRI to report intrarenal heterogeneity in glomerular density and size. Finally, we rendered and measured regions of nephron loss due to pathology and individual glomerular volumes in each pyramidal unit. This work provides new tools to comprehensively evaluate the kidney across scales, with potential applications in anatomic and physiological research, transplant allograft evaluation, biomarker development, biopsy guidance, and therapeutic monitoring. These image rendering and analysis tools could eventually impact the field of transplantation medicine to improve longevity matching of donor allografts and recipients and reduce discard rates through the direct assessment of donor kidneys.NEW & NOTEWORTHY We report the application of cutting-edge image analysis approaches to characterize the pyramidal geometry, glomerular microstructure, and heterogeneity of the whole human kidney imaged using MRI. This work establishes a framework to improve the detection of microstructural pathology to potentially facilitate disease monitoring or transplant evaluation in the individual kidney.
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Affiliation(s)
- Jennifer R Charlton
- Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, Virginia
| | - Yanzhe Xu
- School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe, Arizona
- Mayo Center for Innovative Imaging, Arizona State University, Tempe, Arizona
| | - Neda Parvin
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Teresa Wu
- School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe, Arizona
- Mayo Center for Innovative Imaging, Arizona State University, Tempe, Arizona
| | - Fei Gao
- School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe, Arizona
- Mayo Center for Innovative Imaging, Arizona State University, Tempe, Arizona
| | - Edwin J Baldelomar
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Darya Morozov
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Scott C Beeman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona
| | - Jamal Derakhshan
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Kevin M Bennett
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri
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30
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Clarke GD, Li J, Kuo AH, Moody AJ, Nathanielsz PW. Cardiac magnetic resonance imaging: insights into developmental programming and its consequences for aging. J Dev Orig Health Dis 2021; 12:203-219. [PMID: 33349289 PMCID: PMC7987688 DOI: 10.1017/s2040174420001233] [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] [Indexed: 12/16/2022]
Abstract
Cardiovascular diseases (CVD) are important consequences of adverse perinatal conditions such as fetal hypoxia and maternal malnutrition. Cardiac magnetic resonance imaging (CMR) can produce a wealth of physiological information related to the development of the heart. This review outlines the current state of CMR technologies and describes the physiological biomarkers that can be measured. These phenotypes include impaired ventricular and atrial function, maladaptive ventricular remodeling, and the proliferation of myocardial steatosis and fibrosis. The discussion outlines the applications of CMR to understanding the developmental pathways leading to impaired cardiac function. The use of CMR, both in animal models of developmental programming and in human studies, is described. Specific examples are given in a baboon model of intrauterine growth restriction (IUGR). CMR offers great potential as a tool for understanding the sequence of dysfunctional adaptations of developmental origin that can affect the human cardiovascular system.
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Affiliation(s)
- G D Clarke
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - J Li
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - A H Kuo
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - A J Moody
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - P W Nathanielsz
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
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31
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Matsumoto KI, Mitchell JB, Krishna MC. Multimodal Functional Imaging for Cancer/Tumor Microenvironments Based on MRI, EPRI, and PET. Molecules 2021; 26:1614. [PMID: 33799481 PMCID: PMC8002164 DOI: 10.3390/molecules26061614] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
Radiation therapy is one of the main modalities to treat cancer/tumor. The response to radiation therapy, however, can be influenced by physiological and/or pathological conditions in the target tissues, especially by the low partial oxygen pressure and altered redox status in cancer/tumor tissues. Visualizing such cancer/tumor patho-physiological microenvironment would be a useful not only for planning radiotherapy but also to detect cancer/tumor in an earlier stage. Tumor hypoxia could be sensed by positron emission tomography (PET), electron paramagnetic resonance (EPR) oxygen mapping, and in vivo dynamic nuclear polarization (DNP) MRI. Tissue oxygenation could be visualized on a real-time basis by blood oxygen level dependent (BOLD) and/or tissue oxygen level dependent (TOLD) MRI signal. EPR imaging (EPRI) and/or T1-weighted MRI techniques can visualize tissue redox status non-invasively based on paramagnetic and diamagnetic conversions of nitroxyl radical contrast agent. 13C-DNP MRI can visualize glycometabolism of tumor/cancer tissues. Accurate co-registration of those multimodal images could make mechanisms of drug and/or relation of resulted biological effects clear. A multimodal instrument, such as PET-MRI, may have another possibility to link multiple functions. Functional imaging techniques individually developed to date have been converged on the concept of theranostics.
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Affiliation(s)
- Ken-ichiro Matsumoto
- Quantitative RedOx Sensing Group, Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, Quantum Medical Science Directorate, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - James B. Mitchell
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1002, USA;
| | - Murali C. Krishna
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1002, USA;
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32
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Ran X, Lin L, Yang M, Niu G, Chen L, Shao Y, Zou Y, Wang B. Contrast-Enhanced Ultrasound Evaluation of Renal Blood Perfusion Changes After Percutaneous Transluminal Renal Angioplasty and Stenting for Severe Atherosclerotic Renal Artery Stenosis. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1872-1879. [PMID: 32451193 DOI: 10.1016/j.ultrasmedbio.2020.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/05/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
This study used contrast-enhanced ultrasound (CEUS) to evaluate changes in renal cortical blood perfusion after percutaneous transluminal renal angioplasty and stenting (PTRAS) for severe renal artery stenosis (RAS) (≥70%). CEUS was performed in 21 patients with 24 severe RASs that underwent PTRAS. Renal cortical perfusion was quantitatively evaluated by comparing time intensity curve (TIC) parameters for SonoVue (Bracco, Milan, Italy) contrast enhancement, including peak intensity (PI), time to peak (TTP), mean transmit time (MTT), curve ascending slope (S), area under the curve (AUC), AUC-wash-in and AUC-wash-out. The parameters PI, TTP, MTT and S differed significantly between the pre-intervention and post-intervention TIC analysis (p < 0.05). Of the 24 pre-intervention curve appearances, 58.3% (14/24) improved after operation. The PI difference correlated positively with the estimated glomerular filtration rate difference (r = 0.433, p < 0.05). In conclusion, changes in some ultrasound perfusion parameters on CEUS and the shape of the TIC can be used to quantitatively and intuitively evaluate renal cortical blood perfusion change after PTRAS.
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Affiliation(s)
- Xu Ran
- Department of Ultrasound Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Letao Lin
- Minimally Invasive Interventional Division, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Min Yang
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, P.R. China
| | - Guochen Niu
- Minimally Invasive Interventional Division, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China
| | - Luzeng Chen
- Department of Ultrasound Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Yuhong Shao
- Department of Ultrasound Medicine, Peking University First Hospital, Beijing, P.R. China
| | - Yinghua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, P.R. China.
| | - Bin Wang
- Department of Ultrasound Medicine, Peking University First Hospital, Beijing, P.R. China
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33
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Niendorf T, Seeliger E, Cantow K, Flemming B, Waiczies S, Pohlmann A. Probing renal blood volume with magnetic resonance imaging. Acta Physiol (Oxf) 2020; 228:e13435. [PMID: 31876349 DOI: 10.1111/apha.13435] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023]
Abstract
Damage to the kidney substantially reduces life expectancy. Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. In vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) is sensitive to changes in the effective transversal relaxation time (T2 *) in vivo, and is non-invasive and indicative of renal tissue oxygenation. However, the renal T2 * to tissue pO2 relationship is not governed exclusively by renal blood oxygenation, but is affected by physiological confounders with alterations in renal blood volume fraction (BVf) being of particular relevance. To decipher this interference probing renal BVf is essential for the pursuit of renal MR oximetry. Superparamagnetic iron oxide nanoparticle (USPIO) preparations can be used as MRI visible blood pool markers for detailing alterations in BVf. This review promotes the opportunities of MRI-based assessment of renal BVf. Following an outline on the specifics of renal oxygenation and perfusion, changes in renal BVf upon interventions and their potential impact on renal T2 * are discussed. We also describe the basic principles of renal BVf assessment using ferumoxytol-enhanced MRI in the equilibrium concentration regimen. We demonstrate that ferumoxytol does not alter control of renal haemodynamics and oxygenation. Preclinical applications of ferumoxytol enhanced renal MRI as well as considerations for its clinical implementation for examining renal BVf changes are provided alongside practical considerations. Finally, we explore the future directions of MRI-based assessment of renal BVf.
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Affiliation(s)
- Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Erdmann Seeliger
- Institute of Physiology Charité – Universitätsmedizin Berlin Campus Mitte, and Center for Cardiovascular Research (CCR) Berlin Germany
| | - Kathleen Cantow
- Institute of Physiology Charité – Universitätsmedizin Berlin Campus Mitte, and Center for Cardiovascular Research (CCR) Berlin Germany
| | - Bert Flemming
- Institute of Physiology Charité – Universitätsmedizin Berlin Campus Mitte, and Center for Cardiovascular Research (CCR) Berlin Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
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34
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Li X, Johnson CP, Ellermann J. 7T bone perfusion imaging of the knee using arterial spin labeling MRI. Magn Reson Med 2019; 83:1577-1586. [PMID: 31872919 DOI: 10.1002/mrm.28142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/06/2019] [Accepted: 12/02/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE To evaluate the feasibility of arterial spin labeling (ASL) imaging of epiphyseal bone marrow in the distal femoral condyle of the knee at 7T MRI. METHODS The knees of 7 healthy volunteers were imaged with ASL using a 7T whole body MRI scanner and a 28-channel knee coil. ASL imaging used a flow-sensitive alternating inversion recovery method for labeling and a single-shot fast spin echo sequence for image readout. ASL imaging with a single oblique transverse slice was performed at 2 slice positions in the distal femoral condyle. Blood flow was measured in 2 regions of interest: the epiphyseal bone marrow and the overlying patellofemoral cartilage. To analyze perfusion SNR, 200 noise images were also acquired using the same ASL imaging protocol with RF pulses turned off. RESULTS Knee bone marrow perfusion imaging was successfully performed with all volunteers. The overall mean of blood flow in the knee bone marrow was 32.90 ± 2.41 mL/100 g/min, and the blood flow was higher at the more distal slice position. We observed significant B0 and B 1 + inhomogeneities, which need to be addressed in the future to improve the quality of ASL imaging and increase the reliability of knee bone marrow perfusion measurements. CONCLUSION Bone marrow perfusion imaging of the distal femoral condyle is feasible using ASL at 7T. Further technical development is needed to improve the ASL method to overcome existing challenges.
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Affiliation(s)
- Xiufeng Li
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Casey P Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Jutta Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
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35
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Päivärinta J, Oikonen V, Räisänen-Sokolowski A, Tolvanen T, Löyttyniemi E, Iida H, Nuutila P, Metsärinne K, Koivuviita N. Renal vascular resistance is increased in patients with kidney transplant. BMC Nephrol 2019; 20:437. [PMID: 31775670 PMCID: PMC6882025 DOI: 10.1186/s12882-019-1617-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite improvement in short-term outcome of kidney transplants, the long-term survival of kidney transplants has not changed over past decades. Kidney biopsy is the gold standard of transplant pathology but it's invasive. Quantification of transplant blood flow could provide a novel non-invasive method to evaluate transplant pathology. The aim of this retrospective cross-sectional pilot study was to evaluate positron emission tomography (PET) as a method to measure kidney transplant perfusion and find out if there is correlation between transplant perfusion and histopathology. METHODS Renal cortical perfusion of 19 kidney transplantation patients [average time from transplantation 33 (17-54) months; eGFR 55 (47-69) ml/min] and 10 healthy controls were studied by [15 O]H2O PET. Perfusion and Doppler resistance index (RI) of transplants were compared with histology of one-year protocol transplant biopsy. RESULTS Renal cortical perfusion of healthy control subjects and transplant patients were 2.7 (2.4-4.0) ml min- 1 g- 1 and 2.2 (2.0-3.0) ml min- 1 g- 1, respectively (p = 0.1). Renal vascular resistance (RVR) of the patients was 47.0 (36.7-51.4) mmHg mL- 1min- 1g- 1 and that of the healthy 32.4 (24.6-39.6) mmHg mL- 1min-1g-1 (p = 0.01). There was a statistically significant correlation between Doppler RI and perfusion of transplants (r = - 0.51, p = 0.026). Transplant Doppler RI of the group of mild fibrotic changes [0.73 (0.70-0.76)] and the group of no fibrotic changes [0.66 (0.61-0.72)] differed statistically significantly (p = 0.03). No statistically significant correlation was found between cortical perfusion and fibrosis of transplants (p = 0.56). CONCLUSIONS [15 O]H2O PET showed its capability as a method in measuring perfusion of kidney transplants. RVR of transplant patients with stage 2-3 chronic kidney disease was higher than that of the healthy, although kidney perfusion values didn't differ between the groups. Doppler based RI correlated with perfusion and fibrosis of transplants.
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Affiliation(s)
- Johanna Päivärinta
- Department of Nephrology, Turku University Hospital, PL 52,Kiinanmyllykatu 4-8, 20521, Turku, Finland.
- Department of Medicine, University of Turku, Turku, Finland.
| | - Vesa Oikonen
- Turku PET Centre, University of Turku, Turku, Finland
| | - Anne Räisänen-Sokolowski
- Department of Pathology, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Tuula Tolvanen
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | | | - Hidehiro Iida
- Turku PET Centre, University of Turku, Turku, Finland
| | - Pirjo Nuutila
- Department of Medicine, University of Turku, Turku, Finland
- Turku PET Centre, University of Turku, Turku, Finland
| | - Kaj Metsärinne
- Department of Nephrology, Turku University Hospital, PL 52,Kiinanmyllykatu 4-8, 20521, Turku, Finland
| | - Niina Koivuviita
- Department of Nephrology, Turku University Hospital, PL 52,Kiinanmyllykatu 4-8, 20521, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
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