Value of dynamic MRI using the Ktrans technique for assessment of native kidneys in pre-emptive renal transplantation

Abstract

Background Different non-invasive imaging techniques such as Doppler ultrasonography and renal scintigraphy are commonly employed to assess allograft function and associated complications. However, all such methods lack sufficient specificity to discriminate between residual renal function of native kidneys. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) evaluates signal dynamics during the passage of contrast material through the renal cortex, medulla, and collecting system. Purpose To investigate the value of DCE 3T MRI using a quantitative pharmacokinetic parameter (Ktrans) for the assessment of native kidneys before and after pre-emptive renal transplantation. Material and Methods Twenty-five consecutive patients with end-stage renal disease underwent DCE MRI before and 6 months after kidney transplantation. MRI was performed using a 3T scanner. Regions of interests were drawn over each kidney, encompassing the cortex and medulla but excluding the collecting system and any coexisting cysts. Parametric Ktrans values were automatically generated. Results In the pre-transplantation group, mean Ktrans values for the right and left kidneys were 0.55 ± 0.09 min and 0.44 ± 0.15 min, respectively. In the post-transplantation group, mean Ktrans values of the right and left kidneys were 0.27 ± 0.07 min and 0.25 ± 0.10 min, respectively. There were statistically significant differences between right and left kidneys in terms of mean Ktrans values in the pre- and post-transplantation groups ( P < 0.001). Conclusion Our preliminary results show that native kidneys were still functioning 6 months after transplantation. MR perfusion using Ktrans may constitute a non-invasive means of determination of the viability of native kidneys after renal transplantation.

Renal Functional MRI and Its Application

“…In transplant recipients, acute or chronic renal dysfunction commonly occurs after renal allograft. Using DCE‐MRI in conjunction with GFR‐related quantitative pharmacokinetic parameters such as K trans may provide a noninvasive approach for determining the viability of native kidneys after renal transplantation . DTI can potentially detect deteriorating allograft function as well.…”

Morphological, Functional and Texture Analysis Magnetic Resonance Imaging Features in the Assessment of Radiotherapy-Induced Xerostomia in Oropharyngeal Cancer

“…DCE-PWI is crucial in the detection of focal lesions since it mainly assesses the vascular permeability [23]. Changes in hemodynamic parameters can precede abnormalities on conventional MRI and can thus be used to help with the diagnosis [22][23][24][25][26].…”

In vitro T2 relaxivities of the Gd-based contrast agents (GBCAs) in human blood at 1.5 and 3 T

“…In recent years, quantitative assessment of the changes following Gd chelate administration has become possible. For this assessment, the T 1 relaxivity of each GBCAs is a key factor in the calculation of tissue perfusion, which has been shown to be a valuable biomarker for tumor response to therapy as well as differentiation among different tumor types, for example with the calculation of the transfer constant from the blood plasma into the extracellular extravascular space (Ktrans) (6)(7)(8)(9). Emerging techniques have also shown benefit in exploiting r 2 properties of the GBCAs for contrast-enhanced T2-weighted imaging (10).…”