Quantitative MRI of kidneys in renal disease

Abstract

Purpose

To evaluate the reproducibility and utility of quantitative magnetic resonance imaging (MRI) sequences for the assessment of kidneys in young adults with normal renal function (eGFR ranged from 90 to 130 mL/min/1.73 m2) and patients with early renal disease (autosomal dominant polycystic kidney disease).

Materials and methods

This prospective case–control study was performed on ten normal young adults (18–30 years old) and ten age- and sex-matched patients with early renal parenchymal disease (autosomal dominant polycystic kidney disease). All subjects underwent a comprehensive kidney MRI protocol, including qualitative imaging: T1w, T2w, FIESTA, and quantitative imaging: 2D cine phase contrast of the renal arteries, and parenchymal diffusion weighted imaging (DWI), magnetization transfer imaging (MTI), blood oxygen level dependent (BOLD) imaging, and magnetic resonance elastography (MRE). The normal controls were imaged on two separate occasions ≥24 h apart (range 24–210 h) to assess reproducibility of the measurements.

Results

Quantitative MR imaging sequences were found to be reproducible. The mean ± SD absolute percent difference between quantitative parameters measured ≥24 h apart were: MTI-derived ratio = 4.5 ± 3.6%, DWI-derived apparent diffusion coefficient (ADC) = 6.5 ± 3.4%, BOLD-derived R2* = 7.4 ± 5.9%, and MRE-derived tissue stiffness = 7.6 ± 3.3%. Compared with controls, the ADPKD patient’s non-cystic renal parenchyma (NCRP) had statistically significant differences with regard to quantitative parenchymal measures: lower MTI percent ratios (16.3 ± 4.4 vs. 23.8 ± 1.2, p < 0.05), higher ADCs (2.46 ± 0.20 vs. 2.18 ± 0.10 × 10−3 mm2/s, p < 0.05), lower R2*s (14.9 ± 1.7 vs. 18.1 ± 1.6 s−1, p < 0.05), and lower tissue stiffness (3.2 ± 0.3 vs. 3.8 ± 0.5 kPa, p < 0.05).

Conclusion

Excellent reproducibility of the quantitative measurements was obtained in all cases. Significantly different quantitative MR parenchymal measurement parameters between ADPKD patients and normal controls were obtained by MT, DWI, BOLD, and MRE indicating the potential for detecting and following renal disease at an earlier stage than the conventional qualitative imaging techniques.

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Corresponding author

Correspondence to Timothy L. Kline.

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Funding

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under NIH Grant/Award Number P30 DK090728 “Mayo Translational PKD Center (MTPC),” Robert M. and Billie Kelley Pirnie, the PKD Foundation Grant 206g16a, and the National Cancer Institute (NCI) under Grant/Award CA160045.

Conflict of interest

T.L.K. declares that he has no conflict of interest. M.E.E declares that she has no conflict of interest. I.G. declares that he has no conflict of interest. M.V.I. declares that she has no conflict of interest. P.K. declares that he has no conflict of interest. P.C.H. declares that he has no conflict of interest. B.F.K. declares that he has no conflict of interest. V.E.T. declares that he has no conflict of interest. S.K.V. declares that he has no conflict of interest. B.J.E. declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kline, T.L., Edwards, M.E., Garg, I. et al. Quantitative MRI of kidneys in renal disease. Abdom Radiol 43, 629–638 (2018). https://doi.org/10.1007/s00261-017-1236-y

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Keywords

  • Autosomal dominant polycystic kidney disease
  • Magnetic resonance imaging
  • Quantitative magnetic resonance imaging
  • Segmentation
  • Total kidney volume