Brian Allen

Many solid renal neoplasms have characteristic features on imaging. Imaging biomarkers can be used to non-invasively identify histology of the most common subtypes of renal cell carcinoma and can be used to assess response to therapy. No one biomarker can accurately differentiate all renal masses, as some renal masses have features in common, necessitating attention to all images, phases, or sequences.

Cornelius von Morze

KowsalyaDevi Pavuluri¹, Shaowei Bo¹, Farazad Sedaghat¹, Max Kates², and Michael T McMahon^1,3
1The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ³F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States

Urinary tract obstructions (UTOs) are impairments in urine flow which can lead to pain, infection and irreversible kidney damage if left undiagnosed or untreated. Chemical exchange saturation transfer (CEST) is a novel MRI contrast mechanism that is particularly sensitive to environmental changes including changes in pH values. In this study we developed a protocol by administering the FDA approved iopamidol to obtain dynamic pH and perfusion MRI contrast maps of the kidneys and compared these with iopamidol administered multi-phase CT in a unilateral urinary obstruction mouse model.

Luke Xie¹, Vineela D. Gandham¹, Kai H. Barck¹, Eric Suto¹, Wyne P. Lee¹, Oded Foreman¹, Richard A. D. Carano¹, Alex J. De Crespigny¹, and Robby M. Weimer^1
1Genentech, South San Francisco, CA, United States

System lupus erythematosus (SLE) is an autoimmune disease that can lead to lupus nephritis and glomerulonephritis. Studies have evaluated kidneys from SLE patients using diffusion-weighted imaging. However, specific MRI metrics most related to the underlying disease has not been identified. In this study, we evaluate a lupus model with MRI and determine the physical properties that contribute to the MRI signal. This is achieved through structural analysis of glomeruli with whole kidney 3D micro-CT and pathological evaluation of glomeruli, tubules, interstitium, and arterioles. Finally, a comprehensive correlation analysis is performed to determine top MRI metrics most sensitive to the disease. 

Steffen Ringgaard

Non-invasive assessment of kidney function and microstructure is important for diagnosis and treatment monitoring of patients with kidney diseases. Besides its ability to make high-resolution diagnostic images, MR also has the potential for evaluating a number of functional parameters. In this lecture we will discuss the most promising of these MR biomarkers for assessing kidney function and microstructure, and we will briefly touch up on some arising methodologies. This includes ASL, phase contrast, BOLD imaging, diffusion imaging, relaxation mapping and some non-proton methods.

Zhiyong Lin¹, Rui Wang¹, Jing Liu¹, Jinxia Zhu², Chengwen Liu², Bernd Kühn³, and Xiaoying Wang^1
1Department of Radiology, Peking University First Hospital, Beijing, China, ²MR Collaboration, Siemens Healthcare, Ltd., Beijing, China, ³Siemens Healthcare GmbH, Erlangen, Germany

Patients with renal artery stenosis (RAS) exhibit changes in renal artery hemodynamics. This study investigated the clinical value of pulsed arterial spin labeling (PASL) and pseudo-continuous arterial spin labeling (pCASL) in diagnosing and grading renal insufficiency in patients with RAS. PASL performed better for measuring renal blood flow (RBF) in the renal cortex to provide differential diagnosis of renal function, while the RBF values obtained with pCASL were more closely correlated with the glomerular filtration rate (GFR). These findings indicate that PASL and pCASL MRI have utility for diagnosing and grading renal insufficiency in patients with RAS. 

Charlotte Elizabeth Buchanan¹, Huda Mahmoud², Eleanor F Cox¹, Rebecca Noble², Benjamin L Prestwich¹, Isma Kazmi ², Maarten W Taal², Nicholas Selby², and Susan T Francis^1
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²Centre for Kidney Research and Innovation, University of Nottingham, Derby, United Kingdom

Acute kidney injury (AKI) is defined clinically using serum creatinine. We use multiparametric renal MRI to assess longitudinal changes in AKI. Nine participants were assessed at time of AKI, 7 were re-scanned at 3-months and 1-year. At peak AKI, total kidney volume (TKV) and cortex and medulla T₁ were elevated, and cortex perfusion reduced compared to HVs. After 3-months, TKV reduced compared to peak AKI, cortex and medulla T₁ remained slightly elevated compared to HVs. Perfusion remained reduced compared to HVs after 1-year. MRI showed incomplete recovery at 3 months, despite normalisation of biochemistry, providing potential to identify maladaptive repair.