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Kline TL, Edwards ME, Garg I, Irazabal MV, Korfiatis P, Harris PC, King BF, Torres VE, Venkatesh SK, Erickson BJ. Quantitative MRI of kidneys in renal disease. Abdom Radiol (NY) 2018; 43:629-638. [PMID: 28660330 DOI: 10.1007/s00261-017-1236-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the reproducibility and utility of quantitative magnetic resonance imaging (MRI) sequences for the assessment of kidneys in young adults with normal renal function (eGFR ranged from 90 to 130 mL/min/1.73 m2) and patients with early renal disease (autosomal dominant polycystic kidney disease). MATERIALS AND METHODS This prospective case-control study was performed on ten normal young adults (18-30 years old) and ten age- and sex-matched patients with early renal parenchymal disease (autosomal dominant polycystic kidney disease). All subjects underwent a comprehensive kidney MRI protocol, including qualitative imaging: T1w, T2w, FIESTA, and quantitative imaging: 2D cine phase contrast of the renal arteries, and parenchymal diffusion weighted imaging (DWI), magnetization transfer imaging (MTI), blood oxygen level dependent (BOLD) imaging, and magnetic resonance elastography (MRE). The normal controls were imaged on two separate occasions ≥24 h apart (range 24-210 h) to assess reproducibility of the measurements. RESULTS Quantitative MR imaging sequences were found to be reproducible. The mean ± SD absolute percent difference between quantitative parameters measured ≥24 h apart were: MTI-derived ratio = 4.5 ± 3.6%, DWI-derived apparent diffusion coefficient (ADC) = 6.5 ± 3.4%, BOLD-derived R2* = 7.4 ± 5.9%, and MRE-derived tissue stiffness = 7.6 ± 3.3%. Compared with controls, the ADPKD patient's non-cystic renal parenchyma (NCRP) had statistically significant differences with regard to quantitative parenchymal measures: lower MTI percent ratios (16.3 ± 4.4 vs. 23.8 ± 1.2, p < 0.05), higher ADCs (2.46 ± 0.20 vs. 2.18 ± 0.10 × 10-3 mm2/s, p < 0.05), lower R2*s (14.9 ± 1.7 vs. 18.1 ± 1.6 s-1, p < 0.05), and lower tissue stiffness (3.2 ± 0.3 vs. 3.8 ± 0.5 kPa, p < 0.05). CONCLUSION Excellent reproducibility of the quantitative measurements was obtained in all cases. Significantly different quantitative MR parenchymal measurement parameters between ADPKD patients and normal controls were obtained by MT, DWI, BOLD, and MRE indicating the potential for detecting and following renal disease at an earlier stage than the conventional qualitative imaging techniques.
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Affiliation(s)
- Timothy L Kline
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA.
| | - Marie E Edwards
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Ishan Garg
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA
| | - Maria V Irazabal
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Panagiotis Korfiatis
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA
| | - Peter C Harris
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Bernard F King
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA
| | - Vicente E Torres
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sudhakar K Venkatesh
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA
| | - Bradley J Erickson
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, 55905, MN, USA
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Kline TL, Korfiatis P, Edwards ME, Bae KT, Yu A, Chapman AB, Mrug M, Grantham JJ, Landsittel D, Bennett WM, King BF, Harris PC, Torres VE, Erickson BJ. Image texture features predict renal function decline in patients with autosomal dominant polycystic kidney disease. Kidney Int 2017; 92:1206-1216. [PMID: 28532709 DOI: 10.1016/j.kint.2017.03.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 03/10/2017] [Accepted: 03/16/2017] [Indexed: 12/14/2022]
Abstract
Magnetic resonance imaging (MRI) examinations provide high-resolution information about the anatomic structure of the kidneys and are used to measure total kidney volume (TKV) in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Height-adjusted TKV (HtTKV) has become the gold-standard imaging biomarker for ADPKD progression at early stages of the disease when estimated glomerular filtration rate (eGFR) is still normal. However, HtTKV does not take advantage of the wealth of information provided by MRI. Here we tested whether image texture features provide additional insights into the ADPKD kidney that may be used as complementary information to existing biomarkers. A retrospective cohort of 122 patients from the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) study was identified who had T2-weighted MRIs and eGFR values over 70 mL/min/1.73m2 at the time of their baseline scan. We computed nine distinct image texture features for each patient. The ability of each feature to predict subsequent progression to CKD stage 3A, 3B, and 30% reduction in eGFR at eight-year follow-up was assessed. A multiple linear regression model was developed incorporating age, baseline eGFR, HtTKV, and three image texture features identified by stability feature selection (Entropy, Correlation, and Energy). Including texture in a multiple linear regression model (predicting percent change in eGFR) improved Pearson correlation coefficient from -0.51 (using age, eGFR, and HtTKV) to -0.70 (adding texture). Thus, texture analysis offers an approach to refine ADPKD prognosis and should be further explored for its utility in individualized clinical decision making and outcome prediction.
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Affiliation(s)
- Timothy L Kline
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Panagiotis Korfiatis
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Marie E Edwards
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kyongtae T Bae
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Alan Yu
- The Kidney Institute, Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
| | - Arlene B Chapman
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Michal Mrug
- Division of Nephrology, University of Alabama and Department of Veterans Affairs Medical Center, Birmingham, Alabama, USA
| | - Jared J Grantham
- The Kidney Institute, Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA
| | - Douglas Landsittel
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - William M Bennett
- Legacy Transplant Services, Legacy Good Samaritan Hospital, Portland, Oregon, USA
| | - Bernard F King
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Peter C Harris
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Vicente E Torres
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Bradley J Erickson
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
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Kline TL, Irazabal MV, Ebrahimi B, Hopp K, Udoji KN, Warner JD, Korfiatis P, Mishra PK, Macura SI, Venkatesh SK, Lerman LO, Harris PC, Torres VE, King BF, Erickson BJ. Utilizing magnetization transfer imaging to investigate tissue remodeling in a murine model of autosomal dominant polycystic kidney disease. Magn Reson Med 2015; 75:1466-73. [PMID: 25974140 PMCID: PMC4644111 DOI: 10.1002/mrm.25701] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/06/2015] [Accepted: 03/02/2015] [Indexed: 01/01/2023]
Abstract
Purpose Noninvasive imaging techniques that quantify renal tissue composition are needed to more accurately ascertain prognosis and monitor disease progression in polycystic kidney disease (PKD). Given the success of magnetization transfer (MT) imaging to characterize various tissue remodeling pathologies, it was tested on a murine model of autosomal dominant PKD. Methods C57Bl/6 Pkd1 R3277C mice at 9, 12, and 15 months were imaged with a 16.4T MR imaging system. Images were acquired without and with RF saturation in order to calculate MT ratio (MTR) maps. Following imaging, the mice were euthanized and kidney sections were analyzed for cystic and fibrotic indices, which were compared with statistical parameters of the MTR maps. Results The MTR‐derived mean, median, 25th percentile, skewness, and kurtosis were all closely related to indices of renal pathology, including kidney weight/body weight, cystic index, and percent of remaining parenchyma. The correlation between MTR and histology‐derived cystic and fibrotic changes was R2 = 0.84 and R2 = 0.70, respectively. Conclusion MT imaging provides a new, noninvasive means of measuring tissue remodeling PKD changes and may be better suited for characterizing renal impairment compared with conventional MR techniques. Magn Reson Med 75:1466–1473, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance.
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Affiliation(s)
- Timothy L Kline
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria V Irazabal
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Behzad Ebrahimi
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Katharina Hopp
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Kelly N Udoji
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joshua D Warner
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Prasanna K Mishra
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Slobodan I Macura
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Lilach O Lerman
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Peter C Harris
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Vicente E Torres
- Division of Nephrology and Hypertension Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Bernard F King
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Magnetisation transfer MR imaging of the kidney: evaluation at 3.0 T in association with renal function. Eur Radiol 2013; 23:2315-9. [DOI: 10.1007/s00330-013-2841-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 10/26/2022]
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