Magnetic resonance imaging evaluation of renal structure and function related to disease: Technical review of image acquisition, postprocessing, and mathematical modeling steps

Abstract

Kidney disease represents a leading cause of morbidity, with high healthcare costs. The existing methods used to evaluate renal function include measures of glomerular filtration rate (GFR), yet the clinical methods are generally inaccurate and poorly reproducible. A method that improves measures of renal function as part of a comprehensive examination that also evaluates renal structure represents an important unmet clinical need. Use of dynamic contrast-enhanced magnetic resonance imaging (MRI) for the evaluation of renal function has been undergoing development by several groups. The methodology has been referred to as MR Urography (MRU) or MR Nephrourography (MRNU). MRU/MRNU shows promise for providing new insights into the evaluation of renal structure and function in relation to important disease processes, including urinary obstruction and in relation to renal transplantation. MRU/MRNU generally requires consideration of imaging acquisition technique, image postprocessing strategies, and subsequent kinetic mathematical modeling of the data in reference to specific physiological renal processes, such as renal blood flow and GFR. Here we review the specifics of proposed methods in light of the overall strengths and limitations of each of these strategies. The overall objective is to provide a roadmap for future developments in this evolving field of novel MRI applications.

Design of a novel class of protein‐based magnetic resonance imaging contrast agents for the molecular imaging of cancer biomarkers

“…With improvement of the technology, MRI has become one of the leading imaging techniques for diagnostics, monitoring treatment, and progression of many types of diseases, such as central nervous system (CNS) disorders, cardiovascular disorders, and cancer. 4–9,13 Applications of noninvasive MRI techniques with high resolution becomes even more important for imaging-guided targeted therapy and drug delivery against biomarkers, molecular targets, and personalized medicine.…”

Measurement of single-kidney glomerular filtration function from magnetic resonance perfusion renography

“…This approach uses the parameters such as TR, TE and a range of T 1 values to estimate contrast concentration, so that the linearity between SI and concentration is unnecessary. [10] The concentration based on SI can derive from the equation [2,3]: c = (1/R 1 )((1/T 1 ) − (1/T 10 )) and…”

“…And recent years, the improvement of DCE MR perfusion imaging (DCE MRPR) techniques whether hardware or software, make it possible to reveal renal physiological characteristics qualitatively and quantitatively such as GFR, even the ERPF and renal excreting function, and it's being applied to detect the blood flow or transfer constant and concentration of interesting organ or tissue through tracing contrast agent-Gd-DTPA as the pharmacokinetic modeling. And low dose of contrast agent and no radioactive damage were also recommended [2,3]. In this article, we outline the techniques of DCE MRPR to evaluate renal function quantitatively, and some new challenges of MRPR faced in prospective clinical application.…”

Basic Science Input into Clinical MR Modalities

“…Renal blood flow can also be estimated by DCE-MRI as well as by phase contrast imaging (Martin et al, 2008). Overall, ongoing developments in MRI provide opportunities to noninvasively evaluate renal morphology, vasculature, and function, including glomerular filtration, perfusion, oxygenation, inflammation, tubular dysfunction, cell viability, fibrosis, and followup of renal cell therapy (Jones et al, 2011). Overall, ongoing developments in MRI provide opportunities to noninvasively evaluate renal morphology, vasculature, and function, including glomerular filtration, perfusion, oxygenation, inflammation, tubular dysfunction, cell viability, fibrosis, and followup of renal cell therapy (Jones et al, 2011).…”

“…Changes in the signal intensity in the medulla, shortly after injection of a gadolinium-based contrast agent, indicated decreased renal concentrating ability caused by the ureteric obstruction (Jones et al, 2011;Wen, 2002 and references cited therein). Dilation of the renal pelvis, the intrarenal collecting structure, and ureter were detected by T 1 -and T 2 -weighted images.…”