Abstract
Functional magnetic resonance imaging (fMRI) techniques enable noninvasive assessment of renal function. Diffusion-weighted imaging, diffusion tensor imaging, blood oxygen level–dependent MRI, magnetic resonance elastography, and arterial spin labeling are some of the emerging techniques that have potential to investigate renal function without the use of exogenous gadolinium contrast. This article discusses the principles of these techniques, as well as their possible applications and limitations. This will introduce the readers to these novel imaging tools, which appear to have promising futures.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C-based formulas for prediction of glomerular filtration rate in patients with chronic kidney disease. Nephron Clin Pract. 2010;114(2):c118–26.
Le Bihan D. Diffusion/perfusion MR imaging of the brain: from structure to function. Radiology. 1990;177(2):328–9.
Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988;168(2):497–505.
Le Bihan D, Breton E, Lallemand D, Grenier P, Cabanis E, Laval-Jeantet M. MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology. 1986;161(2):401–7.
Le Bihan D, Turner R: The capillary network: a link between IVIM and classical perfusion. Magnetic resonance in medicine: official journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine 1992, 27(1):171-178.
Dixon WT. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging: a modest proposal with tremendous potential. Radiology. 1988;168(2):566–7.
Pierpaoli C, Jezzard P, Basser PJ, Barnett A, Di Chiro G. Diffusion tensor MR imaging of the human brain. Radiology. 1996;201(3):637–48.
de Senneville BD, Mendichovszky IA, Roujol S, Gordon I, Moonen C, Grenier N. Improvement of MRI-functional measurement with automatic movement correction in native and transplanted kidneys. J magn reson imag: JMRI. 2008;28(4):970–8.
Chandarana H, Lee VS. Renal functional MRI: Are we ready for clinical application? AJR Am J Roentgenol. 2009;192(6):1550–7.
•• Kataoka M, Kido A, Yamamoto A, Nakamoto Y, Koyama T, Isoda H, Maetani Y, Umeoka S, Tamai K, Saga T et al: Diffusion tensor imaging of kidneys with respiratory triggering: optimization of parameters to demonstrate anisotropic structures on fraction anisotropy maps. Journal of magnetic resonance imaging: JMRI 2009, 29(3):736-744. This is a helpful paper for optimizing the acquisition technique.
Notohamiprodjo M, Glaser C, Herrmann KA, Dietrich O, Attenberger UI, Reiser MF, et al. Diffusion tensor imaging of the kidney with parallel imaging: initial clinical experience. Invest Radiol. 2008;43(10):677–85.
Mannelli L, Kim S, Hajdu CH, Babb JS, Clark TW, Taouli B. Assessment of tumor necrosis of hepatocellular carcinoma after chemoembolization: diffusion-weighted and contrast-enhanced MRI with histopathologic correlation of the explanted liver. AJR Am J Roentgenol. 2009;193(4):1044–52.
Mannelli L, Patterson AJ, Zahra M, Priest AN, Graves MJ, Lomas DJ, et al. Evaluation of nonenhancing tumor fraction assessed by dynamic contrast-enhanced MRI subtraction as a predictor of decrease in tumor volume in response to chemoradiotherapy in advanced cervical cancer. AJR Am J Roentgenol. 2010;195(2):524–7.
Mannelli L, Valentino M, Laffi G, Lomas DJ, Sigmund EE, Raz E, Chandarana H: [Functional MRI of the kidney]. Giornale italiano di nefrologia: organo ufficiale della Societa italiana di nefrologia 2010, 27(6):599-608.
Prasad PV, Priatna A. Functional imaging of the kidneys with fast MRI techniques. Eur J Radiol. 1999;29(2):133–48.
Sty JR, Pan CG. Genitourinary imaging techniques. Pediatr Clin N Am. 2006;53(3):339–61. v.
Taouli B, Thakur RK, Mannelli L, Babb JS, Kim S, Hecht EM, et al. Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology. 2009;251(2):398–407.
Thoeny HC, De Keyzer F, Oyen RH, Peeters RR. Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience. Radiology. 2005;235(3):911–7.
Hardie AD, Naik M, Hecht EM, Chandarana H, Mannelli L, Babb JS, et al. Diagnosis of liver metastases: value of diffusion-weighted MRI compared with gadolinium-enhanced MRI. Eur Radiol. 2010;20(6):1431–41.
Blondin D, Lanzman RS, Mathys C, Grotemeyer D, Voiculescu A, Sandmann W, et al. Functional MRI of transplanted kidneys using diffusion-weighted imaging. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 2009;181(12):1162–7.
Bozgeyik Z, Kocakoc E, Sonmezgoz F. Diffusion-weighted MR imaging findings of kidneys in patients with early phase of obstruction. Eur J Radiol. 2009;70(1):138–41.
Kim S, Naik M, Sigmund E, Taouli B. Diffusion-weighted MR imaging of the kidneys and the urinary tract. Magn Reson Imaging Clin N Am. 2008;16(4):585–96. vii-viii.
Shah NS, Kruse SA, Lager DJ, Farell-Baril G, Lieske JC, King BF, et al. Evaluation of renal parenchymal disease in a rat model with magnetic resonance elastography. Magnetic resonance in medicine: official journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2004;52(1):56–64.
Yildirim E, Kirbas I, Teksam M, Karadeli E, Gullu H, Ozer I. Diffusion-weighted MR imaging of kidneys in renal artery stenosis. Eur J Radiol. 2008;65(1):148–53.
Binser T, Thoeny HC, Eisenberger U, Stemmer A, Boesch C, Vermathen P. Comparison of physiological triggering schemes for diffusion-weighted magnetic resonance imaging in kidneys. J Magn Reson Imag: JMRI. 2010;31(5):1144–50.
Thoeny HC, Grenier N. Science to practice: Can diffusion-weighted MR imaging findings be used as biomarkers to monitor the progression of renal fibrosis? Radiology. 2010;255(3):667–8.
Thoeny HC, Binser T, Roth B, Kessler TM, Vermathen P. Noninvasive assessment of acute ureteral obstruction with diffusion-weighted MR imaging: a prospective study. Radiology. 2009;252(3):721–8.
Xu Y, Wang X, Jiang X. Relationship between the renal apparent diffusion coefficient and glomerular filtration rate: preliminary experience. J Magn Reson Imag: JMRI. 2007;26(3):678–81.
Namimoto T, Yamashita Y, Mitsuzaki K, Nakayama Y, Tang Y, Takahashi M. Measurement of the apparent diffusion coefficient in diffuse renal disease by diffusion-weighted echo-planar MR imaging. J Magn Reson Imag: JMRI. 1999;9(6):832–7.
Toyoshima S, Noguchi K, Seto H, Shimizu M, Watanabe N. Functional evaluation of hydronephrosis by diffusion-weighted MR imaging. Relationship between apparent diffusion coefficient and split glomerular filtration rate. Acta Radiol. 2000;41(6):642–6.
Yang D, Ye Q, Williams DS, Hitchens TK, Ho C. Normal and transplanted rat kidneys: diffusion MR imaging at 7T. Radiology. 2004;231(3):702–9.
Sadowski EA, Bennett LK, Chan MR, Wentland AL, Garrett AL, Garrett RW, et al. Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology. 2007;243(1):148–57.
Thomsen HS, Marckmann P, Logager VB. Nephrogenic systemic fibrosis (NSF): a late adverse reaction to some of the gadolinium based contrast agents. Cancer imaging: the official publication of the International Cancer Imaging Society. 2007;7:130–7.
Thomsen HS, Marckmann P, Logager VB. Enhanced computed tomography or magnetic resonance imaging: a choice between contrast medium-induced nephropathy and nephrogenic systemic fibrosis? Acta Radiol. 2007;48(6):593–6.
Thoeny HC, De Keyzer F. Diffusion-weighted MR imaging of native and transplanted kidneys. Radiology. 2011;259(1):25–38.
• Eisenberger U, Thoeny HC, Binser T, Gugger M, Frey FJ, Boesch C, Vermathen P: Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging. European radiology 2010, 20(6):1374-1383. This paper opens the possibility to significant clinical applications.
Powers TA, Lorenz CH, Holburn GE, Price RR. Renal artery stenosis: in vivo perfusion MR imaging. Radiology. 1991;178(2):543–8.
Fukuda Y, Ohashi I, Hanafusa K, Nakagawa T, Ohtani S, An-naka Y, et al. Anisotropic diffusion in kidney: apparent diffusion coefficient measurements for clinical use. J Magn Reson Imag: JMRI. 2000;11(2):156–60.
Ries M, Jones RA, Basseau F, Moonen CT, Grenier N. Diffusion tensor MRI of the human kidney. J Magn Reson Imag: JMRI. 2001;14(1):42–9.
Kido A, Kataoka M, Yamamoto A, Nakamoto Y, Umeoka S, Koyama T, et al. Diffusion tensor MRI of the kidney at 3.0 and 1.5 Tesla. Acta Radiol. 2010;51(9):1059–63.
Notohamiprodjo M, Dietrich O, Horger W, Horng A, Helck AD, Herrmann KA. Diffusion tensor imaging (DTI) of the kidney at 3 tesla-feasibility, protocol evaluation and comparison to 1.5 Tesla. Investig Radiol. 2010;45(5):245–54.
Notohamiprodjo M, Reiser MF, Sourbron SP. Diffusion and perfusion of the kidney. Eur J Radiol. 2010;76(3):337–47.
•• Hueper K, Gutberlet M, Rodt T, Gwinner W, Lehner F, Wacker F, et al.: Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction-initial results. Eur Radiol 2011. This is a very interesting paper on potential clinical applications.
Djamali A, Sadowski EA, Muehrer RJ, Reese S, Smavatkul C, Vidyasagar A, et al. BOLD-MRI assessment of intrarenal oxygenation and oxidative stress in patients with chronic kidney allograft dysfunction. Am J Physiol Renal Physiol. 2007;292(2):F513–22.
Juillard L, Lerman LO, Kruger DG, Haas JA, Rucker BC, Polzin JA, et al. Blood oxygen level-dependent measurement of acute intra-renal ischemia. Kidney Int. 2004;65(3):944–50.
Prasad PV, Chen Q, Goldfarb JW, Epstein FH, Edelman RR. Breath-hold R2* mapping with a multiple gradient-recalled echo sequence: application to the evaluation of intrarenal oxygenation. J magn Reson Imag: JMRI. 1997;7(6):1163–5.
Sadowski EA, Fain SB, Alford SK, Korosec FR, Fine J, Muehrer R, et al. Assessment of acute renal transplant rejection with blood oxygen level-dependent MR imaging: initial experience. Radiology. 2005;236(3):911–9.
Textor SC, Glockner JF, Lerman LO, Misra S, McKusick MA, Riederer SJ, et al. The use of magnetic resonance to evaluate tissue oxygenation in renal artery stenosis. J Am Soc Nephrol: JASN. 2008;19(4):780–8.
Sadowski EA, Djamali A, Wentland AL, Muehrer R, Becker BN, Grist TM, et al. Blood oxygen level-dependent and perfusion magnetic resonance imaging: detecting differences in oxygen bioavailability and blood flow in transplanted kidneys. Magn Reson Imaging. 2010;28(1):56–64.
Prasad P, Li LP, Halter S, Cabray J, Ye M, Batlle D. Evaluation of renal hypoxia in diabetic mice by BOLD MRI. Invest Radiol. 2010;45(12):819–22.
•• Yin WJ, Liu F, Li XM, Yang L, Zhao S, Huang ZX, et al.: Noninvasive evaluation of renal oxygenation in diabetic nephropathy by BOLD-MRI. Eur J Radiol 2011. This paper is interesting for both the potential clinical application and the imaging technique.
Ehman EC, Rossman PJ, Kruse SA, Sahakian AV, Glaser KJ. Vibration safety limits for magnetic resonance elastography. Phys Med Biol. 2008;53(4):925–35.
McDannold N, Maier SE. Magnetic resonance acoustic radiation force imaging. Med Phys. 2008;35(8):3748–58.
Mannelli L, Godfrey E, Joubert I, Patterson AJ, Graves MJ, Gallagher FA, et al. MR elastography: Spleen stiffness measurements in healthy volunteers–preliminary experience. AJR Am J Roentgenol. 2010;195(2):387–92.
Chung S, Breton E, Mannelli L, Axel L. Liver stiffness assessment by tagged MRI of cardiac-induced liver motion. Magnetic resonance in medicine: official journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2011;65(4):949–55.
Mannelli L, Godfrey E, Graves MJ, Patterson AJ, Beddy P, Bowden D, Joubert I, Priest AN, Lomas DJ: Magnetic resonance elastography: Feasibility of liver stiffness measurements in healthy volunteers at 3T. Clinical radiology 2011.
Muthupillai R, Lomas DJ, Rossman PJ, Greenleaf JF, Manduca A, Ehman RL. Magnetic resonance elastography by direct visualization of propagating acoustic strain waves. Science. 1995;269(5232):1854–7.
Rouviere O, Souchon R, Pagnoux G, Menager JM, Chapelon JY. Magnetic resonance elastography of the kidneys: Feasibility and reproducibility in young healthy adults. J Magn Reson Imag: JMRI. 2011;34(4):880–6.
Robson PM, Madhuranthakam AJ, Dai W, Pedrosa I, Rofsky NM, Alsop DC. Strategies for reducing respiratory motion artifacts in renal perfusion imaging with arterial spin labeling. Magnetic resonance in medicine: official journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2009;61(6):1374–87.
Artz NS, Sadowski EA, Wentland AL, Grist TM, Seo S, Djamali A, et al. Arterial spin labeling MRI for assessment of perfusion in native and transplanted kidneys. Magn Reson Imaging. 2011;29(1):74–82.
Fenchel M, Martirosian P, Langanke J, Giersch J, Miller S, Stauder NI, et al. Perfusion MR imaging with FAIR true FISP spin labeling in patients with and without renal artery stenosis: initial experience. Radiology. 2006;238(3):1013–21.
Martirosian P, Klose U, Mader I, Schick F. FAIR true-FISP perfusion imaging of the kidneys. Magnetic resonance in medicine: official journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2004;51(2):353–61.
Szolar DH, Preidler K, Ebner F, Kammerhuber F, Horn S, Ratschek M, et al. Functional magnetic resonance imaging of human renal allografts during the post-transplant period: preliminary observations. Magn Reson Imaging. 1997;15(7):727–35.
Acknowledgements
The authors would like to acknowledge the Magnetic Resonance Imaging and Spectroscopy (MRIS) Unit, Addenbrooke's Hospital, Cambridge, United Kingdom.
The authors participated equally in the writing of this manuscript.
Disclosures
L. Mannelli: none. Dr. Jeffrey H. Maki has served as a consultant for Bayer Medical, has received grants from Bracco Diagnostics, and has received payment for lectures from Lantheus Medical. S. F. Osman: none. Dr. Hersh Chandarana has received research support from Siemens Health Care. D. J. Lomas: none. Dr. William Shuman has received grants from GE Healthcare. K. F. Linnau: none. D. E. Green: none; G. Laffi: none; M. Moshiri: none.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mannelli, L., Maki, J.H., Osman, S.F. et al. Noncontrast Functional MRI of the Kidneys. Curr Urol Rep 13, 99–107 (2012). https://doi.org/10.1007/s11934-011-0229-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11934-011-0229-6
Keywords
- Renal cell carcinoma
- Chronic kidney disease
- Renal function
- Glomerular filtration rate
- GFR
- Magnetic resonance imaging
- MRI
- Diffusion-weighted imaging
- Apparent diffusion coefficient
- Diffusion tensor imaging
- Magnetic resonance elastography
- Elastography
- Blood oxygenation level dependent MRI
- BOLD
- Functional MRI
- fMRI
- DCE
- ASL
- Arterial spin labeling
- Dynamic
- Contrast
- Renography