Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease

Background: This paper outlines a multiparametric renal MRI acquisition and analysis protocol to allow non-invasive assessment of hemodynamics (renal artery blood flow and perfusion), oxygenation (BOLD T2*), and microstructure (diffusion, T1 mapping). Methods: We use our multiparametric renal MRI...

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Main Authors: Cox, Eleanor F., Buchanan, Charlotte E., Bradley, Christopher R., Prestwich, Benjamin, Mahmoud, Huda, Taal, Maarten, Selby, Nicholas M., Francis, Susan T.
Format: Article
Published: Frontiers Media 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/46261/
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author Cox, Eleanor F.
Buchanan, Charlotte E.
Bradley, Christopher R.
Prestwich, Benjamin
Mahmoud, Huda
Taal, Maarten
Selby, Nicholas M.
Francis, Susan T.
author_facet Cox, Eleanor F.
Buchanan, Charlotte E.
Bradley, Christopher R.
Prestwich, Benjamin
Mahmoud, Huda
Taal, Maarten
Selby, Nicholas M.
Francis, Susan T.
author_sort Cox, Eleanor F.
building Nottingham Research Data Repository
collection Online Access
description Background: This paper outlines a multiparametric renal MRI acquisition and analysis protocol to allow non-invasive assessment of hemodynamics (renal artery blood flow and perfusion), oxygenation (BOLD T2*), and microstructure (diffusion, T1 mapping). Methods: We use our multiparametric renal MRI protocol to provide (1) a comprehensive set of MRI parameters [renal artery and vein blood flow, perfusion, T1, T2*, diffusion (ADC, D, D*, fp), and total kidney volume] in a large cohort of healthy participants (127 participants with mean age of 41 ± 19 years) and show the MR field strength (1.5 T vs. 3 T) dependence of T1 and T2* relaxation times; (2) the repeatability of multiparametric MRI measures in 11 healthy participants; (3) changes in MRI measures in response to hypercapnic and hyperoxic modulations in six healthy participants; and (4) pilot data showing the application of the multiparametric protocol in 11 patients with Chronic Kidney Disease (CKD). Results: Baseline measures were in-line with literature values, and as expected, T1-values were longer at 3 T compared with 1.5 T, with increased T1 corticomedullary differentiation at 3 T. Conversely, T2* was longer at 1.5 T. Inter-scan coefficients of variation (CoVs) of T1 mapping and ADC were very good at <2.9%. Intra class correlations (ICCs) were high for cortex perfusion (0.801), cortex and medulla T1 (0.848 and 0.997 using SE-EPI), and renal artery flow (0.844). In response to hypercapnia, a decrease in cortex T2* was observed, whilst no significant effect of hyperoxia on T2* was found. In CKD patients, renal artery and vein blood flow, and renal perfusion was lower than for healthy participants. Renal cortex and medulla T1 was significantly higher in CKD patients compared to healthy participants, with corticomedullary T1 differentiation reduced in CKD patients compared to healthy participants. No significant difference was found in renal T2*. Conclusions: Multiparametric MRI is a powerful technique for the assessment of changes in structure, hemodynamics, and oxygenation in a single scan session. This protocol provides the potential to assess the pathophysiological mechanisms in various etiologies of renal disease, and to assess the efficacy of drug treatments.
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spelling nottingham-462612024-08-15T15:24:04Z https://eprints.nottingham.ac.uk/46261/ Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease Cox, Eleanor F. Buchanan, Charlotte E. Bradley, Christopher R. Prestwich, Benjamin Mahmoud, Huda Taal, Maarten Selby, Nicholas M. Francis, Susan T. Background: This paper outlines a multiparametric renal MRI acquisition and analysis protocol to allow non-invasive assessment of hemodynamics (renal artery blood flow and perfusion), oxygenation (BOLD T2*), and microstructure (diffusion, T1 mapping). Methods: We use our multiparametric renal MRI protocol to provide (1) a comprehensive set of MRI parameters [renal artery and vein blood flow, perfusion, T1, T2*, diffusion (ADC, D, D*, fp), and total kidney volume] in a large cohort of healthy participants (127 participants with mean age of 41 ± 19 years) and show the MR field strength (1.5 T vs. 3 T) dependence of T1 and T2* relaxation times; (2) the repeatability of multiparametric MRI measures in 11 healthy participants; (3) changes in MRI measures in response to hypercapnic and hyperoxic modulations in six healthy participants; and (4) pilot data showing the application of the multiparametric protocol in 11 patients with Chronic Kidney Disease (CKD). Results: Baseline measures were in-line with literature values, and as expected, T1-values were longer at 3 T compared with 1.5 T, with increased T1 corticomedullary differentiation at 3 T. Conversely, T2* was longer at 1.5 T. Inter-scan coefficients of variation (CoVs) of T1 mapping and ADC were very good at <2.9%. Intra class correlations (ICCs) were high for cortex perfusion (0.801), cortex and medulla T1 (0.848 and 0.997 using SE-EPI), and renal artery flow (0.844). In response to hypercapnia, a decrease in cortex T2* was observed, whilst no significant effect of hyperoxia on T2* was found. In CKD patients, renal artery and vein blood flow, and renal perfusion was lower than for healthy participants. Renal cortex and medulla T1 was significantly higher in CKD patients compared to healthy participants, with corticomedullary T1 differentiation reduced in CKD patients compared to healthy participants. No significant difference was found in renal T2*. Conclusions: Multiparametric MRI is a powerful technique for the assessment of changes in structure, hemodynamics, and oxygenation in a single scan session. This protocol provides the potential to assess the pathophysiological mechanisms in various etiologies of renal disease, and to assess the efficacy of drug treatments. Frontiers Media 2017-09-14 Article PeerReviewed Cox, Eleanor F., Buchanan, Charlotte E., Bradley, Christopher R., Prestwich, Benjamin, Mahmoud, Huda, Taal, Maarten, Selby, Nicholas M. and Francis, Susan T. (2017) Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease. Frontiers in Physiology, 8 . 696/1-696/15. ISSN 1664-042X magnetic resonance imaging hemodynamics oxygenation renal function arterial spin labeling http://journal.frontiersin.org/article/10.3389/fphys.2017.00696/full doi:10.3389/fphys.2017.00696 doi:10.3389/fphys.2017.00696
spellingShingle magnetic resonance imaging
hemodynamics
oxygenation
renal function
arterial spin labeling
Cox, Eleanor F.
Buchanan, Charlotte E.
Bradley, Christopher R.
Prestwich, Benjamin
Mahmoud, Huda
Taal, Maarten
Selby, Nicholas M.
Francis, Susan T.
Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title_full Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title_fullStr Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title_full_unstemmed Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title_short Multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
title_sort multiparametric renal magnetic resonance imaging: validation, interventions, and alterations in chronic kidney disease
topic magnetic resonance imaging
hemodynamics
oxygenation
renal function
arterial spin labeling
url https://eprints.nottingham.ac.uk/46261/
https://eprints.nottingham.ac.uk/46261/
https://eprints.nottingham.ac.uk/46261/