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Tasbihi E, Gladytz T, Millward JM, Periquito JS, Starke L, Waiczies S, Cantow K, Seeliger E, Niendorf T. In vivo monitoring of renal tubule volume fraction using dynamic parametric MRI. Magn Reson Med 2024; 91:2532-2545. [PMID: 38321592 DOI: 10.1002/mrm.30023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE The increasing incidence of kidney diseases is a global concern, and current biomarkers and treatments are inadequate. Changes in renal tubule luminal volume fraction (TVF) serve as a rapid biomarker for kidney disease and improve understanding of renal (patho)physiology. This study uses the amplitude of the long T2 component as a surrogate for TVF in rats, by applying multiexponential analysis of the T2-driven signal decay to examine micromorphological changes in renal tissue. METHODS Simulations were conducted to identify a low mean absolute error (MAE) protocol and an accelerated protocol customized for the in vivo study of T2 mapping of the rat kidney at 9.4 T. We then validated our bi-exponential approach in a phantom mimicking the relaxation properties of renal tissue. This was followed by a proof-of-principle demonstration using in vivo data obtained during a transient increase of renal pelvis and tubular pressure. RESULTS Using the low MAE protocol, our approach achieved an accuracy of MAE < 1% on the mechanical phantom. The T2 mapping protocol customized for in vivo study achieved an accuracy of MAE < 3%. Transiently increasing pressure in the renal pelvis and tubules led to significant changes in TVF in renal compartments: ΔTVFcortex = 4.9%, ΔTVFouter_medulla = 4.5%, and ΔTVFinner_medulla = -14.6%. CONCLUSION These results demonstrate that our approach is promising for research into quantitative assessment of renal TVF in in vivo applications. Ultimately, these investigations have the potential to help reveal mechanism in acute renal injury that may lead to chronic kidney disease, which will support research into renal disorders.
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Affiliation(s)
- Ehsan Tasbihi
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Gladytz
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
| | - Joāo S Periquito
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Ludger Starke
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center, a Joint Cooperation Between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
| | - Kathleen Cantow
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center, a Joint Cooperation Between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany
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2
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Klein T, Gladytz T, Millward JM, Cantow K, Hummel L, Seeliger E, Waiczies S, Lippert C, Niendorf T. Dynamic parametric MRI and deep learning: Unveiling renal pathophysiology through accurate kidney size quantification. NMR Biomed 2024; 37:e5075. [PMID: 38043545 DOI: 10.1002/nbm.5075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/22/2023] [Accepted: 10/19/2023] [Indexed: 12/05/2023]
Abstract
Renal pathologies often manifest as alterations in kidney size, providing a valuable avenue for employing dynamic parametric MRI as a means to derive kidney size measurements for the diagnosis, treatment, and monitoring of renal disease. Furthermore, this approach holds significant potential in supporting MRI data-driven preclinical investigations into the intricate mechanisms underlying renal pathophysiology. The integration of deep learning algorithms is crucial in achieving rapid and precise segmentation of the kidney from temporally resolved parametric MRI, facilitating the use of kidney size as a meaningful (pre)clinical biomarker for renal disease. To explore this potential, we employed dynamic parametric T2 mapping of the kidney in rats in conjunction with a custom-tailored deep dilated U-Net (DDU-Net) architecture. The architecture was trained, validated, and tested on manually segmented ground truth kidney data, with benchmarking against an analytical segmentation model and a self-configuring no new U-Net. Subsequently, we applied our approach to in vivo longitudinal MRI data, incorporating interventions that emulate clinically relevant scenarios in rats. Our approach achieved high performance metrics, including a Dice coefficient of 0.98, coefficient of determination of 0.92, and a mean absolute percentage error of 1.1% compared with ground truth. The DDU-Net enabled automated and accurate quantification of acute changes in kidney size, such as aortic occlusion (-8% ± 1%), venous occlusion (5% ± 1%), furosemide administration (2% ± 1%), hypoxemia (-2% ± 1%), and contrast agent-induced acute kidney injury (11% ± 1%). This approach can potentially be instrumental for the development of dynamic parametric MRI-based tools for kidney disorders, offering unparalleled insights into renal pathophysiology.
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Affiliation(s)
- Tobias Klein
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Digital Health - Machine Learning Research Group, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
| | - Thomas Gladytz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Kathleen Cantow
- Institute of Translational Physiology, Charité - Universitätsmedizin, Berlin, Germany
| | - Luis Hummel
- Institute of Translational Physiology, Charité - Universitätsmedizin, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Translational Physiology, Charité - Universitätsmedizin, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Christoph Lippert
- Digital Health - Machine Learning Research Group, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany
- Hasso Plattner Institute for Digital Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine, Berlin, Germany
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3
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Cantow K, Gladytz T, Millward JM, Waiczies S, Niendorf T, Seeliger E. Monitoring kidney size to interpret MRI-based assessment of renal oxygenation in acute pathophysiological scenarios. Acta Physiol (Oxf) 2023; 237:e13868. [PMID: 35993768 DOI: 10.1111/apha.13868] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 01/18/2023]
Abstract
AIM Tissue hypoxia is an early key feature of acute kidney injury. Assessment of renal oxygenation using magnetic resonance imaging (MRI) markers T2 and T2 * enables insights into renal pathophysiology. This assessment can be confounded by changes in the blood and tubular volume fractions, occurring upon pathological insults. These changes are mirrored by changes in kidney size (KS). Here, we used dynamic MRI to monitor KS for physiological interpretation of T2 * and T2 changes in acute pathophysiological scenarios. METHODS KS was determined from T2 *, T2 mapping in rats. Six interventions that acutely alter renal tissue oxygenation were performed directly within the scanner, including interventions that change the blood and/or tubular volume. A biophysical model was used to estimate changes in O2 saturation of hemoglobin from changes in T2 * and KS. RESULTS Upon aortic occlusion KS decreased; this correlated with a decrease in T2 *, T2 . Upon renal vein occlusion KS increased; this negatively correlated with a decrease in T2 *, T2 . Upon simultaneous occlusion of both vessels KS remained unchanged; there was no correlation with decreased T2 *, T2 . Hypoxemia induced mild reductions in KS and T2 *, T2 . Administration of an X-ray contrast medium induced sustained KS increase, with an initial increase in T2 *, T2 followed by a decrease. Furosemide caused T2 *, T2 elevation and a minor increase in KS. Model calculations yielded physiologically plausible calibration ratios for T2 *. CONCLUSION Monitoring KS allows physiological interpretation of acute renal oxygenation changes obtained by T2 *, T2 . KS monitoring should accompany MRI-oximetry, for new insights into renal pathophysiology and swift translation into human studies.
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Affiliation(s)
- Kathleen Cantow
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Gladytz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Gladytz T, Millward JM, Cantow K, Hummel L, Zhao K, Flemming B, Periquito JS, Pohlmann A, Waiczies S, Seeliger E, Niendorf T. Reliable kidney size determination by magnetic resonance imaging in pathophysiological settings. Acta Physiol (Oxf) 2021; 233:e13701. [PMID: 34089569 DOI: 10.1111/apha.13701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/05/2021] [Accepted: 06/01/2021] [Indexed: 12/24/2022]
Abstract
AIM Kidney diseases constitute a major health challenge, which requires noninvasive imaging to complement conventional approaches to diagnosis and monitoring. Several renal pathologies are associated with changes in kidney size, offering an opportunity for magnetic resonance imaging (MRI) biomarkers of disease. This work uses dynamic MRI and an automated bean-shaped model (ABSM) for longitudinal quantification of pathophysiologically relevant changes in kidney size. METHODS A geometry-based ABSM was developed for kidney size measurements in rats using parametric MRI (T2 , T2 * mapping). The ABSM approach was applied to longitudinal renal size quantification using occlusion of the (a) suprarenal aorta or (b) the renal vein, (c) increase in renal pelvis and intratubular pressure and (d) injection of an X-ray contrast medium into the thoracic aorta to induce pathophysiologically relevant changes in kidney size. RESULTS The ABSM yielded renal size measurements with accuracy and precision equivalent to the manual segmentation, with >70-fold time savings. The automated method could detect a ~7% reduction (aortic occlusion) and a ~5%, a ~2% and a ~6% increase in kidney size (venous occlusion, pelvis and intratubular pressure increase and injection of X-ray contrast medium, respectively). These measurements were not affected by reduced image quality following administration of ferumoxytol. CONCLUSION Dynamic MRI in conjunction with renal segmentation using an ABSM supports longitudinal quantification of changes in kidney size in pathophysiologically relevant experimental setups mimicking realistic clinical scenarios. This can potentially be instrumental for developing MRI-based diagnostic tools for various kidney disorders and for gaining new insight into mechanisms of renal pathophysiology.
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Affiliation(s)
- Thomas Gladytz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Kathleen Cantow
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Luis Hummel
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Kaixuan Zhao
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Bert Flemming
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Joāo S Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- 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, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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5
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Periquito JS, Gladytz T, Millward JM, Delgado PR, Cantow K, Grosenick D, Hummel L, Anger A, Zhao K, Seeliger E, Pohlmann A, Waiczies S, Niendorf T. Continuous diffusion spectrum computation for diffusion-weighted magnetic resonance imaging of the kidney tubule system. Quant Imaging Med Surg 2021; 11:3098-3119. [PMID: 34249638 DOI: 10.21037/qims-20-1360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/08/2021] [Indexed: 12/24/2022]
Abstract
Background The use of rigid multi-exponential models (with a priori predefined numbers of components) is common practice for diffusion-weighted MRI (DWI) analysis of the kidney. This approach may not accurately reflect renal microstructure, as the data are forced to conform to the a priori assumptions of simplified models. This work examines the feasibility of less constrained, data-driven non-negative least squares (NNLS) continuum modelling for DWI of the kidney tubule system in simulations that include emulations of pathophysiological conditions. Methods Non-linear least squares (LS) fitting was used as reference for the simulations. For performance assessment, a threshold of 5% or 10% for the mean absolute percentage error (MAPE) of NNLS and LS results was used. As ground truth, a tri-exponential model using defined volume fractions and diffusion coefficients for each renal compartment (tubule system: Dtubules , ftubules ; renal tissue: Dtissue , ftissue ; renal blood: Dblood , fblood ;) was applied. The impact of: (I) signal-to-noise ratio (SNR) =40-1,000, (II) number of b-values (n=10-50), (III) diffusion weighting (b-rangesmall =0-800 up to b-rangelarge =0-2,180 s/mm2), and (IV) fixation of the diffusion coefficients Dtissue and Dblood was examined. NNLS was evaluated for baseline and pathophysiological conditions, namely increased tubular volume fraction (ITV) and renal fibrosis (10%: grade I, mild) and 30% (grade II, moderate). Results NNLS showed the same high degree of reliability as the non-linear LS. MAPE of the tubular volume fraction (ftubules ) decreased with increasing SNR. Increasing the number of b-values was beneficial for ftubules precision. Using the b-rangelarge led to a decrease in MAPE ftubules compared to b-rangesmall. The use of a medium b-value range of b=0-1,380 s/mm2 improved ftubules precision, and further bmax increases beyond this range yielded diminishing improvements. Fixing Dblood and Dtissue significantly reduced MAPE ftubules and provided near perfect distinction between baseline and ITV conditions. Without constraining the number of renal compartments in advance, NNLS was able to detect the (fourth) fibrotic compartment, to differentiate it from the other three diffusion components, and to distinguish between 10% vs. 30% fibrosis. Conclusions This work demonstrates the feasibility of NNLS modelling for DWI of the kidney tubule system and shows its potential for examining diffusion compartments associated with renal pathophysiology including ITV fraction and different degrees of fibrosis.
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Affiliation(s)
- Joāo S Periquito
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Institute of Physiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thomas Gladytz
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jason M Millward
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Paula Ramos Delgado
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Kathleen Cantow
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Dirk Grosenick
- Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany
| | - Luis Hummel
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Ariane Anger
- Institute of Physiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Kaixuan Zhao
- 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, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,Experimental and Clinical Research Center, a Joint Cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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6
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Cantow K, Ladwig-Wiegard M, Flemming B, Pohlmann A, Niendorf T, Seeliger E. Monitoring Renal Hemodynamics and Oxygenation by Invasive Probes: Experimental Protocol. Methods Mol Biol 2021; 2216:327-347. [PMID: 33476009 PMCID: PMC9703868 DOI: 10.1007/978-1-0716-0978-1_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Renal tissue hypoperfusion and hypoxia are early key elements in the pathophysiology of acute kidney injury of various origins, and may also promote progression from acute injury to chronic kidney disease. Here we describe methods to study control of renal hemodynamics and tissue oxygenation by means of invasive probes in anesthetized rats. Step-by-step protocols are provided for two setups, one for experiments in laboratories for integrative physiology and the other for experiments within small-animal magnetic resonance scanners.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This experimental protocol chapter is complemented by a separate chapter describing the basic concepts of quantitatively assessing renal perfusion and oxygenation with invasive probes.
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Affiliation(s)
- Kathleen Cantow
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Mechthild Ladwig-Wiegard
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Free University Berlin, Berlin, Germany
| | - Bert Flemming
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
- Siemens Healthcare, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Erdmann Seeliger
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité - University Medicine Berlin, Berlin, Germany.
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Cantow K, Evans RG, Grosenick D, Gladytz T, Niendorf T, Flemming B, Seeliger E. Quantitative Assessment of Renal Perfusion and Oxygenation by Invasive Probes: Basic Concepts. Methods Mol Biol 2021; 2216:89-107. [PMID: 33475996 PMCID: PMC9703258 DOI: 10.1007/978-1-0716-0978-1_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Renal tissue hypoperfusion and hypoxia are early key elements in the pathophysiology of acute kidney injury of various origins, and may also promote progression from acute injury to chronic kidney disease. Here we describe basic principles of methodology to quantify renal hemodynamics and tissue oxygenation by means of invasive probes in experimental animals. Advantages and disadvantages of the various methods are discussed in the context of the heterogeneity of renal tissue perfusion and oxygenation.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by a separate chapter describing the experimental procedure and data analysis.
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Affiliation(s)
- Kathleen Cantow
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
| | - Dirk Grosenick
- Physikalisch-Technische Bundesanstalt (German Federal Metrologic Institute), Berlin, Germany
| | - Thomas Gladytz
- Physikalisch-Technische Bundesanstalt (German Federal Metrologic Institute), Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany
| | - Bert Flemming
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Erdmann Seeliger
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany.
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8
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Cantow K, Ladwig-Wiegard M, Flemming B, Fekete A, Hosszu A, Seeliger E. Reversible (Patho)Physiologically Relevant Test Interventions: Rationale and Examples. Methods Mol Biol 2021; 2216:57-73. [PMID: 33475994 DOI: 10.1007/978-1-0716-0978-1_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Renal tissue hypoperfusion and hypoxia are early key elements in the pathophysiology of acute kidney injury of various origins, and may also promote progression from acute injury to chronic kidney disease. Here we describe test interventions that are used to study the control of renal hemodynamics and oxygenation in experimental animals in the context of kidney-specific control of hemodynamics and oxygenation. The rationale behind the use of the individual tests, the physiological responses of renal hemodynamics and oxygenation, the use in preclinical studies, and the possible application in humans are discussed.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers.
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Affiliation(s)
- Kathleen Cantow
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Mechthild Ladwig-Wiegard
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Free University Berlin, Berlin, Germany
| | - Bert Flemming
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Andrea Fekete
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Adam Hosszu
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Erdmann Seeliger
- Working Group Integrative Kidney Physiology, Institute of Physiology, Charité-University Medicine Berlin, Berlin, Germany.
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Cantow K, Hummel L, Flemming B, Waiczies S, Niendorf T, Seeliger E. Imagine physiology without imaging. Acta Physiol (Oxf) 2020; 230:e13549. [PMID: 32852085 DOI: 10.1111/apha.13549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Kathleen Cantow
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Luis Hummel
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Bert Flemming
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Sonia Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Erdmann Seeliger
- Institut für vegetative Physiologie Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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10
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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11
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Cantow K, Flemming B, Ladwig-Wiegard M, Persson PB, Seeliger E. Publisher Correction: Low dose nitrite improves reoxygenation following renal ischemia in rats. Sci Rep 2018; 8:1748. [PMID: 29367591 PMCID: PMC5784111 DOI: 10.1038/s41598-018-19651-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kathleen Cantow
- Institut für vegetative Physiologie, Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bert Flemming
- Institut für vegetative Physiologie, Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mechthild Ladwig-Wiegard
- Institut für vegetative Physiologie, Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institut für Tierschutz, Tierverhalten und Versuchstierkunde, Freie Universität Berlin, Berlin, Germany
| | - Pontus B Persson
- Institut für vegetative Physiologie, Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Erdmann Seeliger
- Institut für vegetative Physiologie, Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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12
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Pohlmann A, Cantow K, Huelnhagen T, Grosenick D, Dos Santos Periquito J, Boehmert L, Gladytz T, Waiczies S, Flemming B, Seeliger E, Niendorf T. Experimental MRI Monitoring of Renal Blood Volume Fraction Variations En Route to Renal Magnetic Resonance Oximetry. ACTA ACUST UNITED AC 2017; 3:188-200. [PMID: 30042981 PMCID: PMC6024389 DOI: 10.18383/j.tom.2017.00012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diagnosis of early-stage acute kidney injury (AKI) will benefit from a timely identification of local tissue hypoxia. Renal tissue hypoxia is an early feature in AKI pathophysiology, and renal oxygenation is increasingly being assessed through T2*-weighted magnetic resonance imaging (MRI). However, changes in renal blood volume fraction (BVf) confound renal T2*. The aim of this study was to assess the feasibility of intravascular contrast-enhanced MRI for monitoring renal BVf during physiological interventions that are concomitant with variations in BVf and to explore the possibility of correcting renal T2* for BVf variations. A dose-dependent study of the contrast agent ferumoxytol was performed in rats. BVf was monitored throughout short-term occlusion of the renal vein, which is known to markedly change renal blood partial pressure of O2 and BVf. BVf calculated from MRI measurements was used to estimate oxygen saturation of hemoglobin (SO2). BVf and SO2 were benchmarked against cortical data derived from near-infrared spectroscopy. As estimated from magnetic resonance parametric maps of T2 and T2*, BVf was shown to increase, whereas SO2 was shown to decline during venous occlusion (VO). This observation could be quantitatively reproduced in test–retest scenarios. Changes in BVf and SO2 were in good agreement with data obtained from near-infrared spectroscopy. Our findings provide motivation to advance multiparametric MRI for studying AKIs, with the ultimate goal of translating MRI-based renal BVf mapping into clinical practice en route noninvasive renal magnetic resonance oximetry as a method of assessing AKI and progression to chronic damage.
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Affiliation(s)
- Andreas Pohlmann
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - Kathleen Cantow
- Institute of Physiology and Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Till Huelnhagen
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - Dirk Grosenick
- Physikalisch-Technische-Bundesanstalt (PTB), Berlin, Germany
| | - Joāo Dos Santos Periquito
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - Laura Boehmert
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - Thomas Gladytz
- Physikalisch-Technische-Bundesanstalt (PTB), Berlin, Germany
| | - Sonia Waiczies
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany
| | - Bert Flemming
- Institute of Physiology and Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Physiology and Center for Cardiovascular Research, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Thoralf Niendorf
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin Ultrahigh Field Facility (B.U.F.F.), Berlin, Germany.,Experimental and Clinical Research Center, Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany; and.,Deutsches Zentrum für Herz- Kreislauf-Forschung (DZHK; German Centre for Cardiovascular Research), Berlin, Germany
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Brix S, Cantow K, Flemming B, Pohlmann A, Niendorf T, Seeliger E. Interpretation of functional renal MRI findings: Where physiology and imaging sciences need to talk across domains. J Magn Reson Imaging 2017; 47:1140-1141. [PMID: 28758280 DOI: 10.1002/jmri.25829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/20/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sarah Brix
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Physiology, Integrative Kidney Physiology Lab, Berlin, Germany
| | - Kathleen Cantow
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Physiology, Integrative Kidney Physiology Lab, Berlin, Germany
| | - Bert Flemming
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Physiology, Integrative Kidney Physiology Lab, Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Erdmann Seeliger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Physiology, Integrative Kidney Physiology Lab, Berlin, Germany
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Cantow K, Flemming B, Seeliger E. Erroneous data on renal hemodynamics derived from DCE-MRI in rats. J Magn Reson Imaging 2016; 46:617. [DOI: 10.1002/jmri.25584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/22/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kathleen Cantow
- Integrative Kidney Physiology Lab Institute of Physiology and Center for Cardiovascular Research Charité-University Medicine Berlin; Berlin Germany
| | - Bert Flemming
- Integrative Kidney Physiology Lab Institute of Physiology and Center for Cardiovascular Research Charité-University Medicine Berlin; Berlin Germany
| | - Erdmann Seeliger
- Integrative Kidney Physiology Lab Institute of Physiology and Center for Cardiovascular Research Charité-University Medicine Berlin; Berlin Germany
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Cantow K, Arakelyan K, Seeliger E, Niendorf T, Pohlmann A. Assessment of Renal Hemodynamics and Oxygenation by Simultaneous Magnetic Resonance Imaging (MRI) and Quantitative Invasive Physiological Measurements. Methods Mol Biol 2016; 1397:129-154. [PMID: 26676132 DOI: 10.1007/978-1-4939-3353-2_11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In vivo assessment of renal perfusion and oxygenation under (patho)physiological conditions by means of noninvasive diagnostic imaging is conceptually appealing. Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) and quantitative parametric mapping of the magnetic resonance (MR) relaxation times T 2* and T 2 are thought to provide surrogates of renal tissue oxygenation. The validity and efficacy of this technique for quantitative characterization of local tissue oxygenation and its changes under different functional conditions have not been systematically examined yet and remain to be established. For this purpose, the development of an integrative multimodality approaches is essential. Here we describe an integrated hybrid approach (MR-PHYSIOL) that combines established quantitative physiological measurements with T 2* (T 2) mapping and MR-based kidney size measurements. Standardized reversible (patho)physiologically relevant interventions, such as brief periods of aortic occlusion, hypoxia, and hyperoxia, are used for detailing the relation between the MR-PHYSIOL parameters, in particular between renal T 2* and tissue oxygenation.
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Affiliation(s)
- Kathleen Cantow
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Karen Arakelyan
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Erdmann Seeliger
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Center for Cardiovascular Research, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Andreas Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany.
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Grosenick D, Cantow K, Arakelyan K, Wabnitz H, Flemming B, Skalweit A, Ladwig M, Macdonald R, Niendorf T, Seeliger E. Detailing renal hemodynamics and oxygenation in rats by a combined near-infrared spectroscopy and invasive probe approach. Biomed Opt Express 2015; 6:309-23. [PMID: 25780726 PMCID: PMC4354597 DOI: 10.1364/boe.6.000309] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 05/04/2023]
Abstract
We hypothesize that combining quantitative near-infrared spectroscopy (NIRS) with established invasive techniques will enable advanced insights into renal hemodynamics and oxygenation in small animal models. We developed a NIRS technique to monitor absolute values of oxygenated and deoxygenated hemoglobin and of oxygen saturation of hemoglobin within the renal cortex of rats. This NIRS technique was combined with invasive methods to simultaneously record renal tissue oxygen tension and perfusion. The results of test procedures including occlusions of the aorta or the renal vein, hyperoxia, hypoxia, and hypercapnia demonstrated that the combined approach, by providing different but complementary information, enables a more comprehensive characterization of renal hemodynamics and oxygenation.
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Affiliation(s)
- Dirk Grosenick
- Physikalisch-Technische Bundesanstalt (PTB), Berlin,
Germany
| | - Kathleen Cantow
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
| | - Karen Arakelyan
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine, Berlin,
Germany
| | - Heidrun Wabnitz
- Physikalisch-Technische Bundesanstalt (PTB), Berlin,
Germany
| | - Bert Flemming
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
| | - Angela Skalweit
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
| | - Mechthild Ladwig
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
| | | | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine, Berlin,
Germany
| | - Erdmann Seeliger
- Institut für Vegetative Physiologie, Charité – Universitätsmedizin Berlin, Berlin,
Germany
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Niendorf T, Pohlmann A, Arakelyan K, Flemming B, Cantow K, Hentschel J, Grosenick D, Ladwig M, Reimann H, Klix S, Waiczies S, Seeliger E. How bold is blood oxygenation level-dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions. Acta Physiol (Oxf) 2015; 213:19-38. [PMID: 25204811 DOI: 10.1111/apha.12393] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/04/2014] [Accepted: 09/04/2014] [Indexed: 12/11/2022]
Abstract
Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. Yet, in vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Many of the established approaches are invasive, hence not applicable in humans. Blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) offers an alternative. BOLD-MRI is non-invasive and indicative of renal tissue oxygenation. Nonetheless, recent (pre-) clinical studies revived the question as to how bold renal BOLD-MRI really is. This review aimed to deliver some answers. It is designed to inspire the renal physiology, nephrology and imaging communities to foster explorations into the assessment of renal oxygenation and haemodynamics by exploiting the powers of MRI. For this purpose, the specifics of renal oxygenation and perfusion are outlined. The fundamentals of BOLD-MRI are summarized. The link between tissue oxygenation and the oxygenation-sensitive MR biomarker T2∗ is outlined. The merits and limitations of renal BOLD-MRI in animal and human studies are surveyed together with their clinical implications. Explorations into detailing the relation between renal T2∗ and renal tissue partial pressure of oxygen (pO2 ) are discussed with a focus on factors confounding the T2∗ vs. tissue pO2 relation. Multi-modality in vivo approaches suitable for detailing the role of the confounding factors that govern T2∗ are considered. A schematic approach describing the link between renal perfusion, oxygenation, tissue compartments and renal T2∗ is proposed. Future directions of MRI assessment of renal oxygenation and perfusion are explored.
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Affiliation(s)
- T. Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - A. Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - K. Arakelyan
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. Flemming
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Cantow
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Hentschel
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - D. Grosenick
- Physikalisch-Technische Bundesanstalt (PTB); Berlin Germany
| | - M. Ladwig
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Reimann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - S. Klix
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - S. Waiczies
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin Germany
| | - E. Seeliger
- Institute of Physiology and Center for Cardiovascular Research (CCR); Charité - Universitätsmedizin Berlin; Berlin Germany
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Liu ZZ, Schmerbach K, Lu Y, Perlewitz A, Nikitina T, Cantow K, Seeliger E, Persson PB, Patzak A, Liu R, Sendeski MM. Iodinated contrast media cause direct tubular cell damage, leading to oxidative stress, low nitric oxide, and impairment of tubuloglomerular feedback. Am J Physiol Renal Physiol 2014; 306:F864-72. [PMID: 24431205 DOI: 10.1152/ajprenal.00302.2013] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Iodinated contrast media (CM) have adverse effects that may result in contrast-induced acute kidney injury. Oxidative stress is believed to play a role in CM-induced kidney injury. We test the hypothesis that oxidative stress and reduced nitric oxide in tubules are consequences of CM-induced direct cell damage and that increased local oxidative stress may increase tubuloglomerular feedback. Rat thick ascending limbs (TAL) were isolated and perfused. Superoxide and nitric oxide were quantified using fluorescence techniques. Cell death rate was estimated using propidium iodide and trypan blue. The function of macula densa and tubuloglomerular feedback responsiveness were measured in isolated, perfused juxtaglomerular apparatuses (JGA) of rabbits. The expression of genes related to oxidative stress and the activity of superoxide dismutase (SOD) were investigated in the renal medulla of rats that received CM. CM increased superoxide concentration and reduced nitric oxide bioavailability in TAL. Propidium iodide fluorescence and trypan blue uptake increased more in CM-perfused TAL than in controls, indicating increased rate of cell death. There were no marked acute changes in the expression of genes related to oxidative stress in medullary segments of Henle's loop. SOD activity did not differ between CM and control groups. The tubuloglomerular feedback in isolated JGA was increased by CM. Tubular cell damage and accompanying oxidative stress in our model are consequences of CM-induced direct cell damage, which also modifies the tubulovascular interaction at the macula densa, and may therefore contribute to disturbances of renal perfusion and filtration.
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Affiliation(s)
- Zhi Zhao Liu
- Institut für Vegetative Physiologie, Charité, Universitätsmedizin Berlin, Berlin, Germany.
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Arakelyan K, Cantow K, Hentschel J, Flemming B, Pohlmann A, Ladwig M, Niendorf T, Seeliger E. Early effects of an x-ray contrast medium on renal T(2) */T(2) MRI as compared to short-term hyperoxia, hypoxia and aortic occlusion in rats. Acta Physiol (Oxf) 2013; 208:202-13. [PMID: 23480578 DOI: 10.1111/apha.12094] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/08/2013] [Accepted: 03/05/2013] [Indexed: 01/26/2023]
Abstract
AIM X-ray contrast media (CM) can cause acute kidney injury (AKI). Medullary hypoxia is pivotal in CM-induced AKI, as indicated by invasively and pin-point measured tissue oxygenation. MRI provides spatially resolved blood oxygenation level-dependent data using T2 * and T2 mapping. We studied CM effects on renal T2 */T2 and benchmarked them against short periods of hyperoxia, hypoxia and aortic occlusion (AO). METHODS Rats were equipped with carotid artery catheters (tip towards aorta) and supra-renal aortic occluders. T2 */T2 mapping was performed using a 9.4-T animal scanner. CM (1.5 mL iodixanol) was injected into the thoracic aorta with the animal in the scanner followed by 2 h of T2 */T2 mapping. For T2 */T2 assessment, regions of interest in the cortex (C), outer medulla (OM), inner medulla (IM) and papilla (P) were determined according to morphological features. RESULTS Hyperoxia increased T2 * in C (by 17%) and all medullary layers (25-35%). Hypoxia decreased T2 * in C (40%) and all medullary layers (55-60%). AO decreased T2 * in C (18%) and all medullary layers (30-40%). Upon injection of CM, T2 * increased transiently, then decreased, reaching values 10-20% below baseline in C and OM and 30-40% below baseline in IM and P. CONCLUSION T2 * mapping corroborates data previously obtained with invasive methods and demonstrates that CM injection affects renal medullary oxygenation. CM-induced T2 * decrease in OM was small vs. hypoxia and aortic occlusion. T2 * decrease obtained for hypoxia was more pronounced than for AO. This indicates that T2 * may not accurately reflect blood oxygenation under certain conditions.
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Affiliation(s)
| | - K. Cantow
- Center for Cardiovascular Research; Institut für Vegetative Physiologie; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - J. Hentschel
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin; Germany
| | - B. Flemming
- Center for Cardiovascular Research; Institut für Vegetative Physiologie; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - A. Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin; Germany
| | - M. Ladwig
- Center for Cardiovascular Research; Institut für Vegetative Physiologie; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | | | - E. Seeliger
- Center for Cardiovascular Research; Institut für Vegetative Physiologie; Charité - Universitätsmedizin Berlin; Berlin; Germany
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Pohlmann A, Cantow K, Hentschel J, Arakelyan K, Ladwig M, Flemming B, Hoff U, Persson PB, Seeliger E, Niendorf T. Linking non-invasive parametric MRI with invasive physiological measurements (MR-PHYSIOL): towards a hybrid and integrated approach for investigation of acute kidney injury in rats. Acta Physiol (Oxf) 2013; 207:673-89. [PMID: 23336404 DOI: 10.1111/apha.12065] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/17/2012] [Accepted: 01/16/2013] [Indexed: 01/11/2023]
Abstract
Acute kidney injury of various origins shares a common link in the pathophysiological chain of events: imbalance between renal medullary oxygen delivery and oxygen demand. For in vivo assessment of kidney haemodynamics and oxygenation in animals, quantitative but invasive physiological methods are established. A very limited number of studies attempted to link these invasive methods with parametric Magnetic Resonance Imaging (MRI) of the kidney. Moreover, the validity of parametric MRI (pMRI) as a surrogate marker for renal tissue perfusion and renal oxygenation has not been systematically examined yet. For this reason, we set out to combine invasive techniques and non-invasive MRI in an integrated hybrid setup (MR-PHYSIOL) with the ultimate goal to calibrate, monitor and interpret parametric MR and physiological parameters by means of standardized interventions. Here we present a first report on the current status of this multi-modality approach. For this purpose, we first highlight key characteristics of renal perfusion and oxygenation. Second, concepts for in vivo characterization of renal perfusion and oxygenation are surveyed together with the capabilities of MRI for probing blood oxygenation-dependent tissue stages. Practical concerns evoked by the use of strong magnetic fields in MRI and interferences between MRI and invasive physiological probes are discussed. Technical solutions that balance the needs of in vivo physiological measurements together with the constraints dictated by small bore MR scanners are presented. An early implementation of the integrated MR-PHYSIOL approach is demonstrated including brief interventions of hypoxia and hyperoxia.
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Affiliation(s)
- A. Pohlmann
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin; Germany
| | - K. Cantow
- Institute of Physiology; Charité - Universitätsmedizin Berlin; Campus Mitte, and Center for Cardiovascular Research; Berlin; Germany
| | - J. Hentschel
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max Delbrück Center for Molecular Medicine; Berlin; Germany
| | | | - M. Ladwig
- Institute of Physiology; Charité - Universitätsmedizin Berlin; Campus Mitte, and Center for Cardiovascular Research; Berlin; Germany
| | - B. Flemming
- Institute of Physiology; Charité - Universitätsmedizin Berlin; Campus Mitte, and Center for Cardiovascular Research; Berlin; Germany
| | - U. Hoff
- Nephrology and Intensive Care Medicine; Charité - Universitätsmedizin Berlin; Campus Virchow-Klinikum, and Center for Cardiovascular Research; Berlin; Germany
| | - P. B. Persson
- Institute of Physiology; Charité - Universitätsmedizin Berlin; Campus Mitte, and Center for Cardiovascular Research; Berlin; Germany
| | - E. Seeliger
- Institute of Physiology; Charité - Universitätsmedizin Berlin; Campus Mitte, and Center for Cardiovascular Research; Berlin; Germany
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Pohlmann A, Hentschel J, Fechner M, Hoff U, Bubalo G, Arakelyan K, Cantow K, Seeliger E, Flemming B, Waiczies H, Waiczies S, Schunck WH, Dragun D, Niendorf T. High temporal resolution parametric MRI monitoring of the initial ischemia/reperfusion phase in experimental acute kidney injury. PLoS One 2013; 8:e57411. [PMID: 23468984 PMCID: PMC3585384 DOI: 10.1371/journal.pone.0057411] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/21/2013] [Indexed: 12/12/2022] Open
Abstract
Ischemia/reperfusion (I/R) injury, a consequence of kidney hypoperfusion or temporary interruption of blood flow is a common cause of acute kidney injury (AKI). There is an unmet need to better understand the mechanisms operative during the initial phase of ischemic AKI. Non-invasive in vivo parametric magnetic resonance imaging (MRI) may elucidate spatio-temporal pathophysiological changes in the kidney by monitoring the MR relaxation parameters T2* and T2, which are known to be sensitive to blood oxygenation. The aim of our study was to establish the technical feasibility of fast continuous T2*/T2 mapping throughout renal I/R. MRI was combined with a remotely controlled I/R model and a segmentation model based semi-automated quantitative analysis. This technique enabled the detailed assessment of in vivo changes in all kidney regions during ischemia and early reperfusion. Significant changes in T2* and T2 were observed shortly after induction of renal ischemia and during the initial reperfusion phase. Our study demonstrated for the first time that continuous and high temporal resolution parametric MRI is feasible for in-vivo monitoring and characterization of I/R induced AKI in rats. This technique may help in the identification of the timeline of key events responsible for development of renal damage in hypoperfusion-induced AKI.
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Affiliation(s)
- Andreas Pohlmann
- Berlin Ultrahigh Field Facility, Max Delbrück Center for Molecular Medicine, Berlin, Germany.
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