Evaluation of Renal Blood Flow in Chronic Kidney Disease Using Arterial Spin Labeling Perfusion Magnetic Resonance Imaging

Li, Luping; Tan, Huan; Thacker, Jon; Li, Wei; Zhou, Ying; Köhn, O.; Sprague, Stuart M.; Prasad, Pottumarthi V.

doi:10.1016/j.ekir.2016.09.003

Cited by 58 publications

(66 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These methods have been applied to the evaluation of individuals with different stages of CKD, either individually [12,[19][20][21][22][23], or in combination such as BOLD and diffusion MRI [24,25]. Recent studies have reported that the cortical oxygenation as evaluated by BOLD MRI can predict future loss of renal function [26,27].…”

Section: Introductionmentioning

confidence: 99%

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Prasad

Thacker

et al. 2019

Am J Nephrol

Self Cite

View full text Add to dashboard Cite

Background: Chronic hypoxia is a well-recognized factor in the pathogenesis of chronic kidney disease (CKD). Loss of microcirculation is thought to lead to enhanced renal hypoxia, which in turn results in the development of fibrosis, a hallmark of progressive CKD. To evaluate the role of functional magnetic resonance imaging (MRI), we performed perfusion, oxygenation, and diffusion MRI measurements in individuals with diabetes and stage 3 CKD. Methods: Fifty-four subjects (41 individuals with diabetes and stage 3 CKD and 13 healthy controls) participated in this study. Data with blood oxygenation level dependent (BOLD), arterial spin labeling perfusion and diffusion MRI were acquired using a 3T scanner. Results: Renal cortical perfusion was reduced in CKD compared to the controls (109.54 ± 25.38 vs. 203.17 ± 27.47 mL/min/100 g; p < 0.001). Cortical apparent diffusion coefficient showed no significant reduction in CKD compared to controls (1,596.10 ± 196.64 vs. 1,668.72 ± 77.29 × 10^–6 mm²/s; p = 0.45) but was significantly associated with perfusion. Cortical R2* values were modestly increased in CKD (20.76 ± 4.08 vs. 18.74 ± 2.37 s^–1; p = 0.12). Within the CKD group, R2*_Medulla and R2*_Kidney were moderately and negatively associated with estimated glomerular filtration rate. There was a significant association between cortical perfusion and medullary response to furosemide with annual loss of renal function, used as an estimate of CKD progression. Conclusions: Subjects with a moderate degree of CKD had significantly lower renal perfusion. Diffusion and BOLD MRI showed more modest differences between the groups. Individuals with progressive CKD had lower perfusion and response to furosemide.

show abstract

Section: Introductionmentioning

confidence: 99%

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Prasad

Thacker

et al. 2019

Am J Nephrol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Importantly, the change in CA concentration within tens of seconds should be negligible based on our flow measurements. Even more importantly, acidoCEST MRI may provide the most accurate measurements for the impaired kidney that has even lower flow and perfusion, providing an excellent imaging methodology for this specific pathology [27].…”

Section: Discussionmentioning

confidence: 99%

Measuring Kidney Perfusion, pH, and Renal Clearance Consecutively Using MRI and Multispectral Optoacoustic Tomography

et al. 2019

View full text Add to dashboard Cite

Purpose: To establish multi-modal imaging for the assessment of kidney pH, perfusion, and clearance rate using magnetic resonance imaging (MRI) and multispectral optoacoustic tomography (MSOT) in healthy mice. Kidney pH and perfusion values were measured on a pixel-by-pixel basis using the MRI acidoCEST and FAIR-EPI methods. Kidney filtration rate was measured by analyzing the renal clearance rate of IRdye 800 using MSOT. To test the effect of one imaging method on the other, a set of 3 animals were imaged with MSOT followed by MRI, and a second set of 3 animals were imaged with MRI followed by MSOT. In a subsequent study, the reproducibility of pH, perfusion, and renal clearance measurements were tested by imaging 4 animals twice, separated by 4 days. The contrast agents used for acidoCEST based pH measurements influenced the results of MSOT. Specifically, the exponential decay time from the kidney cortex, as measured by MSOT, was significantly altered when MRI was performed prior to MSOT. However, no significant difference in the cortex to pelvis area under the curve (AUC) was noted. When the order of experiments was reversed, no significant differences were noted in the pH or perfusion values. Reproducibility measurements demonstrated similar pH and cortex to pelvis AUC; however, perfusion values were significantly different with the cortex values being higher and the pelvic values being lower in the second imaging time. We demonstrate that using a combination of MRI and MSOT, physiological measurements of pH, blood flow, and clearance rates can be measured in the mouse kidney in the same imaging session.

show abstract

“…In fact, RBF measurements in sepsis-associated AKI have shown much discrepancy; reduced, normal, or even increased RBF have been reported (3)(4)(5). In patients with chronic kidney disease (CKD), RBF is reduced compared with controls (6,7), possibly contributing to the progression of renal dysfunction. In renal circulation studies, most patients with essential hypertension display reduced RBF (8,9); the greatest reduction demonstrated in malignant hypertension (9,10).…”

Section: Introductionmentioning

confidence: 99%

Estimation of renal perfusion based on measurement of Rubidium-82 clearance by PET/CT scanning in healthy subjects

Langaa

Lauridsen²,

Mose³

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundChanges in renal blood flow (RBF) may play a pathophysiological role in hypertension and kidney disease. However, RBF determination in humans has proven difficult. We aimed to confirm the feasibility of RBF estimation based on positron emission tomography/ computed tomography (PET/CT) and rubidium-82 (82Rb) using the abdominal aorta as input function in a 1-tissue compartment model. MethodsEighteen healthy subjects underwent two dynamic 82Rb PET/CT scans in two different fields of view (FOV). FOV-A included the left ventricular blood pool (LVBP), the abdominal aorta (AA) and the majority of the kidneys. FOV-B included AA and the kidneys in their entirety. In FOV-A, an input function was derived from LVBP and from AA; in FOV-B from AA. 1-tissue compartmental modeling was performed using tissue time activity curves generated from volumes of interest contouring the kidneys, where the renal clearance of 82Rb is represented by the K1 kinetic parameter. To investigate the correct interpretation of K1, we assumed to first estimate effective renal plasma flow (ERPF) by extrapolating clearance values (ml/min/cm3) to whole kidney values (ml/min) using the estimated total kidney volume. Thereafter, RPF was estimated from ERPF using an assumed extraction fraction (0.89). Lastly, RBF was estimated from RPF using measured haematocrit values. Intra-assay coefficients of variation and inter-observer variation were calculated.ResultsFor both kidneys, K1 values derived from AA did not differ significantly from values obtained from LVBP, neither were significant differences seen between AA in FOV-A and AA in FOV-B, nor between the right and left kidneys. For both kidneys, the intra-assay coefficients of variation were low (~ 5%) for both input functions. The measured K1 of 2.04 ml/min/cm3 suggests an estimated total renal perfusion normalized to body surface area of 628 ± 95 ml/min/1.73 m2 and subsequently an estimated RBF of 1091 ± 162 ml/min/1.73 m2. ConclusionRBF estimation based on PET/CT and 82Rb using AA as input function in a 1-tissue compartment model is feasible in a single FOV. The measured K1 clearance values are most likely representative of ERPF rather than estimated RBF values.

show abstract

Evaluation of Renal Blood Flow in Chronic Kidney Disease Using Arterial Spin Labeling Perfusion Magnetic Resonance Imaging

Cited by 58 publications

References 34 publications

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Cortical Perfusion and Tubular Function as Evaluated by Magnetic Resonance Imaging Correlates with Annual Loss in Renal Function in Moderate Chronic Kidney Disease

Measuring Kidney Perfusion, pH, and Renal Clearance Consecutively Using MRI and Multispectral Optoacoustic Tomography

Estimation of renal perfusion based on measurement of Rubidium-82 clearance by PET/CT scanning in healthy subjects

Contact Info

Product

Resources

About