Soham Mukherjee¹, Mahon L Maguire¹, Jack Sharkey¹, Sourav Bhaduri¹, Patricia Murray², Rachel Bearon³, Bettina Wilm², and Harish Poptani^1
1Centre for Preclinical Imaging, University of Liverpool, Liverpool, United Kingdom, ²Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom, ³Department of Mathematical Sciences, University of Liverpool, Liverpool, United Kingdom

Quantitative analysis of kidney function is essential part of monitoring disease progression. The most common parameter of evaluating kidney functioning is by measurement of glomerular filtration rate. Here, we describe that dynamic contrast enhanced magnetic resonance imaging can be used to determine the permeability parameter K^trans, which can be used to assess renal activity. We used three different pharmacokinetic models and arterial input functions to get the K^trans value. It was seen that the raw arterial input function used along with shutter speed model has strong correlation with findings obtained from transcutaneous GFR measurement device.

Julia Stabinska¹, Hans-Joerg Wittsack¹, and Alexandra Ljimani^1
1Department of Diagnostic and Interventional Radiology, Heinrich Heine University Dusseldorf, Dusseldorf, Germany

Due to non-Gaussian nature of water diffusion in tissues, the measured diffusion-related parameters depend on b-values and diffusion time. In fact, our study shows that the apparent diffusion coefficient (ADC) and IVIM-related diffusion coefficient D obtained in the human kidney slightly increase with the diffusion time in the range between 20 ms and 45 ms, as opposed to ADC and D of skeletal muscle. Among all investigated diffusion parameters, the IVIM-based pseudodiffusion coefficient D* exhibits the strongest dependence on diffusion time and could potentially provide valuable information regarding the blood vessels and urine flow in the kidney.

Maysam Jafar¹ and Jan Weis^2
1Clinical Science, Philips Healthcare, Stockholm, Sweden, ²Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden

Phosphorous (31P) spectra of healthy human kidney are invaluable in studies of kidney physiology, disease and in the evaluation of allograft viability pre and post renal transplantation. However, 31P-spectroscopy of the kidney in-situ is challenging due to the relatively large distance between the kidney and the surface coil. The aim of this study was to investigate whether it is possible to acquire 31P spectra of normal kidney in a clinically acceptable measurement time using a 3T MR scanner. We demonstrate that localized phosphorous spectroscopy of normal kidney in-situ is feasible in today’s 3T clinical MR systems.

Kanishka Sharma¹, Bashair Alhummiany², David Shelley^2,3, Margaret Saysell^2,3, Maria-Alexandra Olaru⁴, Bernd Kühn⁴, Julie Bailey³, Kelly Wroe³, Cherry Coupland³, Michael Mansfield³, and Steven Sourbron^1
1Department of Imaging, Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ²Department of Biomedical Imaging Sciences, University of Leeds, Leeds, United Kingdom, ³Leeds Teaching Hospitals, Leeds, United Kingdom, ⁴Siemens Healthcare GmbH, Erlangen, Germany

The iBEAt study MRI biomarker panel has been developed to determine if imaging biomarkers can improve predictions of renal function decline in diabetic kidney disease. The aim of this pilot study was to inform the approach to quality control and image processing of iBEAt data. Repeatability in 5 healthy volunteers (4 scans per subject) was analysed with a prototype image-processing pipeline. The results indicated that repeatability of renal T₁, T₂* and phase-contrast renal blood flow was comparable to literature, and measurement precision was sufficient to detect differences between volunteers. ASL had poor repeatability presumably from B₀ inhomogeneities in labelling plane.

Anneloes de Boer¹, Bashair Al Hummiany², Kanishka Sharma³, and Steven Sourbron^3
1University Medical Center Utrecht, Utrecht, Netherlands, ²University of Leeds, Leeds, United Kingdom, ³University of Sheffield, Sheffield, United Kingdom

Medullary perfusion potentially is an early marker of renal damage, but cannot be measured using existing models in MR renography. In this study a novel 7-compartment, 10-parameter model is proposed and evaluated in synthetic and patient data. Robustness of an iterative fitting approach was assessed by the coefficient of variation over multiple fits, resulting in median values <2.5% both in synthetic and patient data. According to simulations, medullary perfusion was underestimated by 5.3%, but in diabetic patients medullary perfusion was relatively high (81 mL/100mL/min). Future studies will be needed to determine this model’s sensitivity to pathophysiological changes in medullary perfusion.

Quan Tao¹, Peiwei Yi¹, Zimeng Cai¹, Yingjie Mei², Ruiyuan Liu¹, and Yanqiu Feng^1
1School of Biomedical Engineering, Southern Medical University, Guangzhou, China, ²Philips healthcare, Guangzhou, China

Various Iodinated agents were supposed to be pH sensors in kidney or tumor based on chemical exchange saturation transfer (CEST) mechanism. We compared different contrast agents (CAs) and their combination, established a ratiometric CEST pH imaging method to improve the accuracy of pH measurement in vivo, by combined the molar concentration ratio of two nonequivalent amide protons resonated at 4.3 ppm and 5.6 ppm.

Yuki Oda¹, Tosiaki Miyati¹, Naoki Ohno¹, Seiya Nakagawa¹, and Satoshi Kobayashi^1
1Division of Health Sciences, Kanazawa University, Kanazawa, Japan

We assessed the effect of gravity on regional kidney function in the supine and upright positions using an original MRI that can obtain functional information in any posture (multiposture MRI). We compared the mean blood flow, T₂, and T₂’, apparent diffusion coefficient of the kidney between the supine and upright positions. Gravity reduced the blood flow and T₂ of the kidney, and these differences between postures potentially provide new diagnostic information.

El-Sayed H Ibrahim¹, Abdul Parchur¹, Srividya Kidambi¹, Allen Cowley¹, and Mingyu Liang^1
1Medical College of Wisconsin, Milwaukee, WI, United States

Enhanced sensitivity of blood pressure to salt intake is observed in many hypertensive patients. The kidney plays a key role in the development of hypertension including salt-sensitive hypertension. In this study, we used BOLD MRI to examine the temporal response of renal medullary and cortical oxygenation levels during saline infusion in a small set of young subjects. The results showed that during the period of fast saline infusion, tissue oxygenation levels remained almost constant in the cortex but showed 10%-15% average reduction in the medulla. The responses, however, varied between subjects, which may reflect differences in salt-sensitive versus salt-insensitive individuals.

Feng Wang^1,2, Tadashi Otsuka³, Zhongliang Zu^1,2, Mark P de Caestecker³, Raymond C Harris³, Takamune Takahashi³, and John C Gore^1,2
1Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, ²Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, ³Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, United States

Acute kidney injury (AKI) is a predictor of mortality, often resulting in incomplete recovery, giving rise to chronic kidney disease (CKD). AKI is defined in clinical practice as a rapid decline in kidney function that occurs over a 7-day period or less, but concerns about the risks of renal biopsies in patients with AKI have limited our ability to identify diagnostic features that are predictive of CKD progression.  Multi-parametric MRI, including quantitative spin-lock imaging, relaxometry, and magnetization transfer, can be used to identify features of experimental AKI that are predictive of CKD progression without need for renal biopsy.

Pete Thelwall^1,2, Jehill Parikh¹, Benjamin Pippard¹, Caroline Wroe³, Rob Janiczek⁴, Steven Sourbron⁵, and Neil Sheerin^1
1Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom, ²Centre for In Vivo Imaging, Newcastle University, Newcastle upon Tyne, United Kingdom, ³South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom, ⁴GlaxoSmithKline, Philadelphia, PA, United States, ⁵University of Sheffield, Sheffield, United Kingdom

A multiparametric renal MRI scan protocol was employed to characterise the impact of renal fibrosis on tissue relaxation properties. The study recruited patients with moderate renal dysfunction (CKD stage 3, eGFR between 30 and 60 ml/min/1.73 m2) with biopsy-proven fibrosis and age-matched healthy volunteers. Statistically significant differences in kidney cortical native T1 and T2 were observed between patients and controls, ascribed to tissue microstructural changes associated with the mild fibrosis observed in the patient group.

Shisi Li¹, Yanjun Chen¹, Yingjie Mei², Xianfu Mo¹, Jialing Chen¹, Yongqiang Li³, and Xiaodong Zhang^1
1Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China, ²Philips Healthcare, Guangzhou, China, ³Department of Nephrology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics· Guangdong Province), Guangzhou, China

Renal fat content has been known as correlated with renal injury in type 2 diabetes. However, it is not clear the change of renal fat content in patients with metabolic syndrome (MS), which is a more popular disease threatened human health. In the present study, we assess the feasibility and reproducibility of renal fat fraction (FF) using PDFF imaging with MR mDixon-Quant sequence. And we aim to investigate the changes of renal FF in patients with MS, whose estimated glomerular filtration rate (eGFR) grade were G1(normal or elevated) and G2(mild decline) described in KDIGO (Kidney Disease: Improving Global Outcomes). In addition, we evaluate the correlation of renal FF and eGFR and the major factors of eGFR. The results show that with eGFR decreasing, renal FF in patients with MS-G2 group increased significantly compared with control and MS-G1 group. And the renal FF is an important affection factor of eGFR with a significant negative correlation. The noninvasive quantitative Dixon-based MRI may be a new biomarker for the evaluation of early renal impairment.

Haoyang Jiang¹, Ailian Liu², Ye Ju², Jiazheng Wang³, Changyu Du¹, Lingli Qi¹, Xinmiao Bu², Wenjun Hu², Nan Wang², and Liangjie Lin^3
1Dalian Medical University, Dalian, China, ²The First Affiliated Hospital Of Dalian Medical University, Dalian, China, ³Philips Healthcare, Beijing, China

Early diagnosis and treatment of chronic kidney disease (CKD) can significantly improve the prognosis and reduce the occurrence of end-stage renal disease. This study aims to explore the performance of fat-fraction and R* value measured by mDIXON-quant for differential diagnosis between heathy controls, mild and acute CKD patients. The renal cortex R2* values of CKD patients (mild or severe) were significantly higher than those of heathy controls. The fat fraction in renal cortex and medulla of acute CKD patients was significantly higher than those mild CKD patients and healthy controls.

Jiayuan Shan¹, Jinggang Zhang¹, Jie Chen¹, Wei Xing¹, and Jilei Zhang^2
1Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China, ²Philips Healthcare, Shanghai, China

The purpose was to explore if quantitative susceptibility mapping (QSM) can assess renal fibrosis about early diabetic nephropathy (DN) in type 2 diabetes (T2D). 32 patients with early DN in T2D were included in the study to evaluate the potential clinical relevance of QSM. We found that susceptibility values of the medulla were statistically significant among different fibrosis. Susceptibility value of the medulla was highly correlated with estimated glomerular filtration rate (eGFR). QSM could serve as a quantitative biomarker to assess the renal fibrosis and monitor the treatment in patients with DN. 

Akira Yamamoto¹, Tsutomu Tamada², Yu Ueda³, Takeshi Fukunaga², and Atsushi Higaki^2
1Radiology, Kawasaki Medical School, Kurashiki, Japan, ²Kawasaki Medical School, Kurashiki, Japan, ³Phillips Japan, Tokyo, Japan

The purpose of this study was to identify the changes in multiparametric magnetic resonance imaging (MRI) findings in early diabetic nephropathy. Measurements were made of the renal cortex and renal medulla T2 values, T2* values and R2* values, as well as optimal TI, inverted TI value and cortico-medullary difference on optimal TI in SSFP with ssIR pulse with multi TI. Also, renal cortical thickness and renal length were measured, representing morphological changes. Significant differences were seen between the healthy and early diabetic nephropathy (grade1 and grade2) in T2 values of cortex and T2* values of medulla. This study suggests the possibility that MRI using the values of T2 of cortex and T2* of medulla can be used to evaluate early diabetic nephropathy non-invasively and in a short period of time.

Jiaxin Yan¹, Weiqiang Dou², Hongmei Gu¹, Xinquan Wang¹, Weiyin Vivian Liu², Huijian Lu¹, Ying Zhou¹, Xuejun Zhou¹, and LI Yuan^1
1Affiliated Hospital of Nantong University, Nantong, China, ²GE Healthcare, MR Research China, Beijing, China

In this study, we explore the quantitative T1 and R2* mapping in theclassification on renal function in chronic kidney disease (CKD) . 146 CKD patients and 26 healthy volunteers（HVs）underwent T1 mapping and renal BOLD-MRI for R2* mapping. All CKD cases were divided into two groups according to the estimated glomerular filtration (eGFR)：mild renal impairment group and moderate to severe group.Clincal information were collected.Compared with HVs,the T1 and R2* values of renal cortex were significantly higher and were well correlated with renal function.Therefore,T1 mapping and BOLD-MRI derived R2* mapping might provide an effective method in assessing renal function.

Jing Yang ¹, Shuohui Yang ², Zheng He³, Mengxiao Liu⁴, and Caixia Fu^5
1Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, ²Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, ³Ultrasonography, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, ⁴MR Scientific Marketing, Siemens Healthcare, Shanghai, China, ⁵MR Applications Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China

The purpose of this study was to observe the alteration of renal oxygenation and renal hemodynamics in CKD patients using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) and intrarenal Doppler ultrasonography (IDU). The result showed that renal oxygenation and blood flow velocities declined as the CKD stage progressed. The BOLD-MRI and IDU techniques were able to dynamically evaluate intrarenal oxygenation and hemodynamics changes, respectively, in CKD patients. Combination these two techniques can detect the abnormalities associated with CKD stage sensitively.
 

Michinobu Nagao¹, Kiyoe Ando¹, Yasuhiro Goto¹, Isao Shiina¹, Kazuo Kodaira¹, Masami Yoneyama², Takashi Namiki², Atsushi Yamamoto¹, Eri Watanabe¹, Akiko Sakai¹, Risako Nakao¹, and Shuji Sakai^1
1Tokyo Women's Medical University, Tokyo, Japan, ²Philips Japan, Tokyo, Japan

O2-inhalation T2*-BOLD MRI is a non-invasive imaging techniqueto evaluate renal oxygenation. This analysis revealed that renal hypoxia is strongly associated with renal dysfunction, and that early left ventricular remodeling in cardiomyopathy leads to renal hypoxia. This renal hypoxia image helps clarify chronic cardiorenal interaction and the effects of drugs for cardiorenal disease.

Dejuan Shan^1,2, Xianquan Cui³, Xiangtao Lin^1,2, Ruiyuan Diao², Peng Zhao², Mengxiao Liu⁴, Shuai Zhang², Xiaoli Li², Nan Lin², Zhongyu Hou², and Bing Liu^5
1Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China, Jinan, China, ²Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical Uiversity, Jinan, China, ³Qilu Hospital of Shandong University, Jinan, China, ⁴MR Scientific Marketing, Diagnostic Imaging, Siemens Healthcare Ltd., Shanghai 201318, China, Shanghai, China, ⁵Department of Radiology, China-Japan Friendship Hospital, Beijing, China, Beijing, China

The objective of this study was to evaluate renal function of renal transplantation using intravoxel incoherent movement（IVIM） and T1-Mapping. The results showed that the T1-Mapping was significantly superior than IVIM in distinguishing between the groups with good graft function (Group A), impaired graft function (Group B) and normal kidney (Control Group).

Zhaoyu Shi¹, Fangfang Shang¹, Xinquan Wang¹, Hongmei Gu¹, Xiaoyan Liu¹, Weiqiang Dou², Weiyin Vivian Liu², Yuan Zhang¹, Jianhua Wu¹, and Li Yuan^1
1Affiliated Hospital of Nantong University, Nantong, China, ²GE Healthcare, MR Research China, Beijing, China

119 patients with chronic glomerulonephritis (CGN) and 19 healthy controls (HCs) were recruited in this study. Among these patients, 43 patients had kidney biopsy. Patients underwent a native renal T1 map examination within 1 week before kidney biopsy. Clinical information and biopsy pathological scores were collected. Compared to HCs, the T1 values of renal cortex in CGN patients were significantly higher and well correlated with renal function, chronic kidney disease (CKD) stage and renal fibrosis. Therefore, native T1 mapping has demonstrated good diagnostic performance in non-invasive detection of CGN fibrosis.

Ye Ju¹, Ailian Liu¹, Jiazheng Wang², Wenjun Hu¹, Changyu Du³, Lingli Qi³, Haoyang Jiang³, Xinmiao Bu¹, Nan Wang¹, and Peng Sun^2
1First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China, ³Dalian Medical University, Dalian, China

Amide proton transfer (APT) and mDixon - Quant techniques have been applied in clinical work, However, there was no study on the degree of renal damage in chronic kidney disease (CKD). We discussed the value of APT combined with R2* to assess the degree of renal damage.