ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Combined Educational & Scientific Session

Quantitative Biomarkers in Renal MRI: From Morphology to Physiology


ORGANIZERS: Lorenzo Mannelli, M.D., Ph.D., Ivan Pedrosa, M.D., Scott B. Reeder, M.D., Ph.D. & Edwin J.R. van Beek, M.D., Ph.D., M.Ed., FRCR

Monday 1 June 2015

This two-hour course focuses on the evaluation of quantitative MRI biomarkers for the evaluation of renal physiology. State-of-the-art approaches for characterization of renal physiology including blood flow, oxygenation, and water diffusion will be described. In addition, the applicability of these quantitative biomarkers for the assessment of renal disease will be presented. Didactic presentations and scientific abstracts on each area of interest will be presented to enhance the educational and scientific value of this course on each specific area of interest.

Target Audience
This course is aimed at radiologists, imaging scientists and MR technologists who wish to review the state-of-art MRI methods for quantification of renal physiology, and to learn about the potential use of these metods for the characterization of renal disease.

Educational Objectives
As a result of attending this course, participants should be able to:
• Illustrate the potential role of MRI biomarkers of renal disease;
• Convey the relationship between emerging quantitative MRI biomarkers and renal physiology; and
• Implement novel applications of MRI for diagnosis of renal disease.

Moderators: Rotem S. Lanzman, Ph.D., Glen Morrell, M.D., Ph.D.
16:30   Introduction
16:33   Arterial Spin Labelling
Susan T. Francis, Ph.D.
16:48 0255.   Correlation analysis between renal perfusion and estimated glomerular filtration rate in volunteers and patients with chronic kidney disease: an arterial spin labeling in 3.0T MRI study
Yuelang Zhang1, Chenxia Li1, Jie Gao1, Xiang Li1, and Jian Yang1
1Department of Diagnostic Radiology, The First Hospital of Medical School, Xi'an Jiaotong University, Xi¡¯an, Shaanxi, China

The aim of this study is investigate the correlation between renal perfusion and estimated glomerular filtration rate (eGFR) in volunteers and patients with chronic kidney disease (CKD) by using the flow-sensitive alternating inversion recovery technique in 3.0T magnetic resonance imaging (MRI). The results demonstrated that the significant difference in perfusion among healthy volunteers, CKD group with eGFR ¡Ý 60ml/min/1.73m2, and CKD group with eGFR< 60ml/min/1.73m2. Moreover, the perfusion values in CKD patients increased with the increase of eGFR. It indicates that FAIR-ASL can reflect the renal blood flow perfusion, thus indirectly reflecting early renal function change.

17:00 0256.   Evaluation of Readout Schemes for Arterial Spin Labelling in the Human Kidney
Charlotte E Buchanan1,2, Eleanor F Cox1, and Susan T Francis1
1SPMIC, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom, 2Division of Medical Sciences and Graduate Entry Medicine, Royal Derby Hospital, Nottingham, United Kingdom

Readout schemes for multi-slice pulsed ASL of the human kidney at 3T are evaluated. Gradient echo (GE) based schemes of balanced fast field echo (bFFE) and gradient echo echo-planar imaging (GE-EPI) and spin echo (SE) based schemes of spin echo EPI (SE-EPI) and turbo spin echo (TSE) are compared for temporal SNR (tSNR), image SNR, spatial coverage, perfusion quantification and variability across slices and subjects. Gradient echo based schemes (bFFE and GE-EPI) provide optimal PWI-SNR and tSNR, with GE-EPI yielding multi-slice coverage in a short acquisition time.

17:12   Blood Oxygen Level Dependent
Pottumarthi V. Prasad, Ph.D.
17:27 0257.   
Determination of Technically and Physiologically caused Variation of Parameters from DTI and BOLD MRI in Native Kidneys: A Repeatability Study
Maryam Seif1, Chris Boesch1, and Peter Vermathen1
1Depts. Radiology and Clinical Research, University Bern, Bern, Switzerland

We evaluated the reproducibility of DTI and BOLD MRI parameters in native kidneys of healthy volunteers by performing three scans. Two scans were performed back-to-back with one hour break in between, followed by the third scan after three weeks. High reproducibility was obtained for ADC, FA, and R2* from DTI and BOLD measurements. The coefficients of variation between the scans separated by 3 weeks were similar to those for the back-to-back scans, indicating that the variances are primarily due to technically caused variances between scans rather than normal physiological variation over time.

17:39 0258.   Blood oxygen level dependent (BOLD) and diffusion tensor (DTI) imaging of the kidneys in patients with Type 1 diabetes: preliminary clinical experience with reference to healthy control subjects
Elissa Botterill1, Windell Ang1, Jas-mine Seah1, Claire Mulcahy2, Elif Ekinci1,3, George Jerums1,3, Richard MacIsaac3,4, Pippa Storey5, Eric Sigmund5, Tim Spelman6, and Ruth P Lim1,3
1Austin Health, Melbourne, Victoria, Australia, 2The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia, 3The University of Melbourne, Melbourne, Victoria, Australia, 4St Vincent's Hospital, East Melbourne, Victoria, Australia, 5CAIIR, Bernard and Irene Schwartz Center for Biomedical Imaging, NYU School of Medicine, New York, NY, United States, 6Burnet Institute, Melbourne, Victoria, Australia

Reliable identification of diabetic kidney disease (DKD) in Type 1 diabetic patients (T1DM) and prediction of disease progression is challenging. BOLD and diffusion tensor imaging (DTI) has potential to non-invasively evaluate renal function and microstructure. 25 T1DM with a) normal and b) low eGFR, and c) 10 healthy controls were recruited for BOLD and DTI at 3T. No differences were seen in medullary or cortical R2* values, and ADC between the three groups. Significant differences were seen with medullary and cortical FA in T1DM with low eGFR. DTI may be a promising tool for identification and monitoring of DKD.

17:51   Diffusion
Rotem S. Lanzman, Ph.D.
18:06 0259.   
Diffusion-weighted magnetic resonance imaging in partially nephrectomized kidneys
Moritz Jörg Schneider1, Olaf Dietrich1, Katharina Stella Winter1, Maximilian Reiser1, Michael Staehler2, and Mike Notohamiprodjo3
1Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Bavaria, Germany, 2Department of Urology, Ludwig-Maximilians-University Hospital Munich, Munich, Bavaria, Germany, 3Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Baden-Württemberg, Germany

Diffusion-weighted magnetic resonance imaging (DW-MRI) and the associated method of intravoxel incoherent motion imaging (IVIM) are of increasing relevance in the clinical routine. The purpose of our study was to investigate the effects of partial nephrectomy in kidneys with solid renal masses on DW-MRI and IVIM-derived parameters. We were able to show that perfusion related IVIM parameters are highly sensitive to partial nephrectomy and are promising candidates to assess kidney functionality without the need for contrast agents.

18:18 0260.   Detecting the Acute Renal Allograft Rejection in Early Stage: a Comparison of Different MR sequences
Xinyao Zhao1, Tianyi Qian2, Xiaoqin Kong1, Kezhou Xing1, and Hao Shi1
1Radiology, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China, 2MR Collaborations NE Asia, Siemens Healthcare, Beijing, China

Acute rejection is one of the key influencing factors associated with the survival period of renal allograft. The aim of this study is to find useful indications for diagnosing acute renal allograft rejection in the early stage. The results shows that DKI and ASL were both able to detect the early functional changes by measuring diffusion and perfusion properties of transplanted kidneys, showing a reduction of cortical and medullary values, especially in the cortex.

18:30   Adjournment & Meet the Teachers