Joint Annual Meeting ISMRM-ESMRMB 2014 10-16 May 2014 Milan, Italy

Renal Imaging: Development & Applications

Tuesday 13 May 2014
Blue 1 & 2  16:00 - 18:00 Moderators: Hersh Chandarana, M.D., Harriet C. Thoeny, M.D.

16:00 0447.   Developing 3D Wavefield Renal MR Elastography: Primary Hyperoxaluria Pilot Study
Scott A. Kruse1, Kevin J. Glaser1, Jun Chen1, Dawn S. Milliner2, Sudhakar K. Venkatesh1, and Richard L. Ehman1
1Department of Radiology, Mayo Clinic, Rochester, Minn., United States, 2Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minn., United States

There is a clinical need for more effective noninvasive tools for assessing the extent of renal parenchymal disease. MR Elastography has been shown to be effective in staging hepatic fibrosis. Here we developed a 3D wavefield protocol for applying MRE to the kidneys. Four normal volunteers and five patient volunteers with primary hyperoxaluria were enrolled. The mean renal parenchymal stiffness for the normal volunteers was 2.99 + 1.08 kPa at 60 Hz. In addition, the patient results provide preliminary evidence of a trend of decreased parenchymal stiffness with increasing urinary oxalate levels.

16:12 0448.   High resolution mechanical imaging of the human kidney
Jing Guo1, Kaspar-Josche Streitberger1, Heiko Tzschaetzsch1, Sebastian Hirsch1, Juergen Braun2, and Ingolf Sack1
1Department of Radiology, Charite - Universitaetsmedizin Berlin, Berlin, Berlin, Germany, 2Department of Medical Informatics, Charite - Universitaetsmedizin Berlin, Berlin, Germany

Renal fibrosis can be detected by MR elastography (MRE) based on altered mechanical tissue properties. However, MRE has been limited in providing high resolution mechanical parameter maps of the kidney due to low-resolution shear wave images and ill-posed solutions of the inverse problem of MRE. We here overcome both problems by an optimized single shot MRE sequence and multifrequency dual elasto visco inversion. As a result, high resolution MRE maps are obtained which for the first time enable radiologists to analyze the regional variation of the kidney's viscoelastic properties on a pixel-to-pixel base.

16:24 0449.   
A two-compartment model with automatic time interval selection for estimation of GFR using DCE-MRI in cohort of 28 survivors of unilateral Wilms’ tumor
Aaryani Tipirneni-Sajja1,2, Ralf B Loeffler1, Niels Oesingmann3, Yutong Duan1, Adam M Winchell1,2, Ruitian Song1, Beth McCarville1, Melissa Hudson4, Sherri L Spunt4, and Claudia M Hillenbrand1
1Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, United States, 2Biomedical Engineering, University of Memphis, Memphis, TN, United States, 3Siemens Medical Solutions USA, Inc, New York, NY, United States, 4Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States

Renal GFR is a very important quantitative index of renal function in health and disease. Several methods are available to estimate GFR using DCE-MRI, but a precise and unbiased method to estimate GFR remains to be developed. This study estimates GFR by DCE-MRI using a two-compartment (2C) model that disregards tubular outflow and automatically picks the end-of-uptake point (auto2C) and compares these results with those from the gold standard GFR measurement (99mTc-DTPA) in long-term survivors of unilateral Wilms’ tumor.

16:36 0450.   
Assessment of Intratumoral Heterogeneity of Vascularity in Renal Masses with Arterial Spin Labeling (ASL) and Dynamic Contrast Enhanced (DCE) MRI at 3T
Yue Zhang1, Ananth Madhuranthakam1,2, Qing Yuan1, Ivan Dimitrov2,3, Yin Xi1, Naira Muradyan4, Vitaly Margulis5, James Brugarolas6,7, Payal Kapur8, and Ivan Pedrosa1,2
1Radiology, UT Southwestern Medical Center, Dallas, Texas, United States, 2Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, United States, 3Philips Medical Systems, Cleveland, Ohio, United States, 4iCAD, Inc., Nashua, New Hampshire, United States, 5Urology, UT Southwestern Medical Center, Dallas, Texas, United States, 6Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, United States,7Developmental Biology, UT Southwestern Medical Center, Dallas, Texas, United States, 8Pathology, UT Southwestern Medical Center, Dallas, Texas, United States

The purpose of this study was to investigate the correlation between in vivo assessments of vascular heterogeneity within renal masses measured by arterial spin labeling (ASL) MRI and dynamic contrast-enhanced (DCE) MRI techniques at 3T. Quantitative ASL and DCE parameters were obtained from the whole tumor, and from areas with high- and low- blood flow within the tumor. ASL measured blood flow in renal masses correlates with DCE-derived parameters of tumor vascularity. Both ASL and DCE MRI at 3T allow for detection of intra-tumoral vascular heterogeneity in renal masses, providing a tool for assessment and monitoring of angiogenesis in renal cancer.

16:48 0451.   Intravoxel Incoherent Motion Imaging of Renal Tumors: Subtype Differentiation Using Voxel-based Histogram Analysis
Byron Gaing1, Eric Edward Sigmund1, William Huang2, James Babb1, David Stoffel1, and Hersh Chandarana1
1Radiology, NYU Langone Medical Center, New York, New York, United States, 2Urology, NYU Langone Medical Center, New York, United States

Renal cell carcinomas are a heterogeneous group of tumors not only with their varying biologic behavior but also in their response to targeted therapies. Previous work has shown that IVIM parameters are useful in differentiating common subtypes of RCC based on whole ROI analysis. Our results confirm previous work showing a clear trend separating more vascular (clear cell) from less vascular (papillary) tumor subtypes using the IVIM metric fp. Additionally, our initial results suggest differentiation between benign and malignant subtypes of renal tumors may also be possible. These findings could potentially impact surgical planning.

17:00 0452.   Evaluation of the changes in renal artery flow in patients with cirrhotic liver disease pre and post meal in comparison to healthy subjects
Harald Kramer1,2, Alejandro Roldan-Alzate2, Chrstopher J Francois2, Scott B Reeder2,3, and Oliver Wieben2,3
1Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany, 2Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States, 3Department of Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, United States

Ingestion of a meal alters blood flow in the entire mesenteric vasculature. The same accounts for portal hypertension. The presented study evaluates changes in blood flow alterations pre and post meal in patients with portal hypertension and healthy volunteers. After a meal cardiac output and thus flow in the supraceliac aorta increases. However, changes in flow in patients with portal hypertension and healthy subjects are significantly different.

17:12 0453.   Assessment of renal allograft function early after transplantation with diffusion tensor imaging
Wenjun Fan1,2, Panli Zuo3, and Wen Shen1
1Radiology, Tianjin First Center Hospital, Tianjin, Tianjin, China, 2Armed Police Corps Hospital of Henan, Zhengzhou, Henan, China, 3Siemens Healthcare, MR Collaborations NE Asia, Beijing, China

51 renal allograft recipients 2-3 weeks after transplantation and 26 healthy volunteers received 3.0T MR DTI examination. Patients were divided into three groups with good allograft function, moderately impaired allograft function and severely impaired allograft function according to the estimated glomerular filtration rate£®Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were compared between groups with significant differences being found. A significant correlation between eGFR and medullary FA, cortical ADC and medullary ADC was also observed. Meanwhile, differences of DTI images and tractography demonstrated the potential of DTI to visually discriminate allograft with varied function.

17:24 0454.   Multiparametric functional MRI for assessment of delayed renal allograft function - permission withheld
Dagmar Hartung1,2, Marcel Gutberlet1,2, Frank Lehner2,3, Nicolas Richter3, Nils Hanke4, Jan Becker2,5, Matti Peperhove1, Antonia Zapf6, Hermann Haller4, Frank Wacker1, Wilfried Gwinner2,4, and Katja Hueper1,2
1Radiology, Hannover Medical School, Hannover, Germany, 2Integrated Research and Treatment Center Transplantation (IFB Tx), Hannover, Germany,3Transplantation Surgery, Hannover Medical School, Hannover, Germany, 4Nephrology, Hannover Medical School, Hannover, Germany, 5Pathology, Hannover Medical School, Hannover, Germany, 6Medical Statistics, University Goettingen, Goettingen, Germany

Delayed renal allograft function (DGF) is associated with an increased risk of graft complications. We investigated whether multiparametric functional MRI allows evaluation of DGF. Fourty patients between day 4-10 after kidney transplantation were examined using a 1.5T-scanner. Renal perfusion, apparent diffusion coefficients and fractional anisotropy were significantly reduced in patients with DGF compared to patients with normal initial graft function. Furthermore, functional MRI parameters were inversely correlated with serum creatinine at the day of MRI and at 3-months follow-up. Thus, multiparametric functional MRI may improve non-invasive diagnosis of DGF.

17:36 0455.   Detailing the Relation Between Renal T2* and Renal Tissue pO2 Using a Hybrid and Integrated Approach of Parametric MRI and Invasive Physiological Measurements (MR-PHYSIOL)
Andreas Pohlmann1, Jan Hentschel1, Karen Arakelyan1, Kathleen Cantow2, Bert Flemming2, Mechthild Ladwig2, Uwe Hoff3, Erdmann Seeliger2, and Thoralf Niendorf1
1Berlin Ultrahigh Field Facility, Max Delbrueck Center for Moleculare Medicine, Berlin, Germany, 2Institute of Physiology and Center for Cardiovascular Research, Charité Medical Faculty, Berlin, Germany, 3Nephrology and Intensive Care Medicine, Campus Virchow-Klinikum and Center for Cardiovascular Research, Charite-Universitaetsmedizin Berlin, Berlin, Germany

Acute kidney injuries of various origins share one common feature: imbalance between renal oxygen delivery and demand. T2* mapping offers a non-invasive approach to probe renal oxygenation. Changes in tissue pO2 and T2* may be closely related but for a physiological interpretation of T2* a calibration using an integrative approach that combines parametric MR with physiological measurements is prudent if not essential. This work employs an integrative hybrid approach that combines established invasive but quantitative techniques with a small animal MR system (MR-PHYSIOL) with the ultimate goal to detail the relation between tissue pO2 and T2* using (patho)physiologically relevant interventions.

17:48 0456.   Initial experience with BOLD imaging of the kidneys at 7T
Hans Hoogduin1, Alexander Raaijmakers2, Fredy Visser2, and Peter Luijten2
1UMC Utrecht, Utrecht, Utrecht, Netherlands, 2UMC Utrecht, Utrecht, Netherlands

BOLD imaging of the kidneys is explored at 7T.