Consensus-based technical recommendations for clinical translation of renal BOLD MRI

Bane, Octavia; Mendichovszky, Iosif; Milani, Bastien; Dekkers, Ilona A.; Deux, J.-F.; Eckerbom, Per; Grenier, N.; Hall, Michael E.; Inoue, Tsutomu; Laustsen, Christoffer; Lerman, Lilach O.; Liu, Chunlei; Morrell, Glen; Pedersen, Michael; Pruijm, Menno; Sadowski, Elizabeth A.; Seeliger, Erdmann; Sharma, Kanishka; Thoeny, Harriet C.; Vermathen, Peter; Wang, Zhen J.; Serafin, Zbigniew; Zhang, Jeff L.; Francis, Susan T.; Sourbron, Steven; Pohlmann, Andreas; Fain, Sean B.; Prasad, Pottumarthi V.

doi:10.1007/s10334-019-00802-x

Cited by 78 publications

(73 citation statements)

References 51 publications

(74 reference statements)

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“…This is solely a limiting case in small animals, and as such, focal differentiation is possible in humans. All MRI methods can be applied in humans [ 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. However, the use of gadolinium contrast agents is contradicted in severe CKD, and as such, alternative methods would likely be used to determine the hemodynamic nature of kidneys in humans [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Assessment of Fibrosis Following Ischemia/Reperfusion Injury in Rodents Utilizing Na Magnetic Resonance Imaging

et al. 2020

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Fibrosis is often heterogeneously distributed, and classical biopsies do not reflect this. Noninvasive methods for renal fibrosis have been developed to follow chronic kidney diseases (CKD) and to monitor anti-fibrotic therapy. In this study, we combined two approaches to assess fibrosis regression following renal ischemia-reperfusion injury (IRI): magnetic resonance imaging (MRI) and noninvasive extracellular matrix (ECM) biomarkers. MRI was used to evaluate fibrosis in bilateral IRI in rats after reperfusion at 7, 14, and 21 days. This was performed with 1HT1 and T2* mapping, dynamic contrast-enhanced (DCE)-MRI, and chemical shift imaging (CSI)-23Na. The degradation of laminin gamma-1 chain (LG1M) and type III collagen (C3M) was measured in urine and plasma. Fibrosis was analyzed in tissue using fibronectin (FN) and alpha-smooth muscle actin (α-SMA) using quantitative polymerase chain reaction qPCR and western blotting. We found increased fibrosis 7 days after reperfusion, which dropped to sham levels after 21 days. Single kidney glomerular filtration rate (skGFR), perfusion (DCE-MRI), and total 23Na kidney content correlated positively with fibrotic markers FN and α-SMA as well as noninvasive LG1M and C3M. We showed that novel MRI protocols and ECM markers could track fibrogenic development. This could give rise to a multi-parametric practice to diagnose and assess fibrosis whilst treating kidney disease without using invasive methods.

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Section: Discussionmentioning

confidence: 99%

Noninvasive Assessment of Fibrosis Following Ischemia/Reperfusion Injury in Rodents Utilizing Na Magnetic Resonance Imaging

et al. 2020

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“…with their own strengths and weaknesses (30). International effort is now being made to standardize the BOLD-MRI protocols, including patient preparation, image acquisition, and analysis (30,31). Urine oximetry is another method that has a potential to be used in clinical settings.…”

Section: Methods To Detect Hypoxia In the Kidneymentioning

confidence: 99%

Hypoxia-Inducible Factor and Oxygen Biology in the Kidney

2020

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Kidney tissue hypoxia is detected in various kidney diseases and is considered to play an important role in the pathophysiology of both AKI and CKD. Because of the characteristic vascular architecture and high energy demand to drive tubular solute transport, the renal medulla is especially prone to hypoxia. Injured kidneys often present capillary rarefaction, inflammation, and fibrosis, which contribute to sustained kidney hypoxia, forming a vicious cycle promoting progressive CKD. Hypoxia-inducible factor (HIF), a transcription factor responsible for cellular adaptation to hypoxia, is generally considered to protect against AKI. On the contrary, consequences of sustained HIF activation in CKD may be either protective, neutral, or detrimental. The kidney outcomes seem to be affected by various factors, such as cell types in which HIF is activated/inhibited, disease models, balance between two HIF isoforms, and time and methods of intervention. This suggests multifaceted functions of HIF and highlights the importance of understanding its role within each specific context. Prolyl-hydroxylase domain (PHD) inhibitors, which act as HIF stabilizers, have been developed to treat anemia of CKD. Although many preclinical studies demonstrated renoprotective effects of PHD inhibitors in CKD models, there may be some situations in which they lead to deleterious effects. Further studies are needed to identify patients who would gain additional benefits from PHD inhibitors and those who may need to avoid them.

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“…MR axial images were acquired during breath-hold (≤ 20 s). BOLD-MRI mostly followed PARENCHIMA guidelines, and the MRI parameters used in this study as well as PARENCHIMA's recommendations are summarized in the Supplementary Table 1 16,23 .…”

Section: Methodsmentioning

confidence: 99%

Renal fibrosis detected by diffusion-weighted magnetic resonance imaging remains unchanged despite treatment in subjects with renovascular disease

Ferguson

Eirin

Abumoawad

et al. 2020

Sci Rep

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Tissue fibrosis is an important index of renal disease progression. Diffusion-weighted magnetic resonance imaging’s (DWI-MRI) apparent diffusion coefficient (ADC) reveals water diffusion is unobstructed by microstructural alterations like fibrosis. We hypothesized that ADC may indicate renal injury and response to therapy in patients with renovascular disease (RVD). RVD patients were treated with medical therapy (MT) and percutaneous transluminal renal angioplasty (MT + PTRA) (n = 11, 3 bilaterally, n = 14 kidneys) or MT (n = 9). ADC and renal hypoxia (R2*) by blood-oxygen-level-dependent MRI were studied before (n = 27) and 3 months after (n = 20) treatment. Twelve patients underwent renal biopsies. Baseline ADC values were correlated with changes in eGFR, serum creatinine (SCr), systolic blood pressure (SBP), renal hypoxia, and renal vein levels of pro-inflammatory marker tumor necrosis-factor (TNF)-α. Renal oxygenation, eGFR, and SCr improved after MT + PTRA. ADC inversely correlated with the histological degree of renal fibrosis, but remained unchanged after MT or MT + PTRA. Basal ADC values correlated modestly with change in SBP, but not in renal hypoxia, TNF-α levels, or renal function. Lower ADC potentially reflects renal injury in RVD patients, but does not change in response to medical or interventional therapy over 3 months. Future studies need to pinpoint indices of kidney recovery potential.

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Consensus-based technical recommendations for clinical translation of renal BOLD MRI

Cited by 78 publications

References 51 publications

Noninvasive Assessment of Fibrosis Following Ischemia/Reperfusion Injury in Rodents Utilizing Na Magnetic Resonance Imaging

Noninvasive Assessment of Fibrosis Following Ischemia/Reperfusion Injury in Rodents Utilizing Na Magnetic Resonance Imaging

Hypoxia-Inducible Factor and Oxygen Biology in the Kidney

Renal fibrosis detected by diffusion-weighted magnetic resonance imaging remains unchanged despite treatment in subjects with renovascular disease

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