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Fang Liu¹, Wentao Hu², Yongming Dai², Minfang Zhang³, and Yan Zhou^1
1Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China, ³Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Keywords: Kidney, Diffusion/other diffusion imaging techniques

Non-invasive evaluation of interstitial renal fibrosis would help monitoring chronic kidney disease (CKD) progression and prognosis prediction. This study was aimed to evaluate renal interstitial fibrosis by diffusion relaxation correlated spectrum imaging (DR-CSI). Correlation was found between DR-CSI volume fractions and interstitial fibrosis level (IFL). V_B illustrated best diagnostic performance among MRI indicators. We suggest DR-CSI is of potential value in the evaluation of renal interstitial fibrosis.

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Shan Pi¹, Jonathan M. Scott², Yin Li³, Huiquan Wen¹, Matthew C. Murphy², Jingbiao Chen¹, Meng Yin², Jun Chen⁴, Kevin J Glaser², Richard L Ehman², Hui Peng³, and Jin Wang^1
1Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, ²Department of Radiology, Mayo Clinic, Rochester, MN, United States, ³Department of Nephrology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, ⁴Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University (SYSU), Guangzhou, China

Keywords: Kidney, Elastography

Chronic kidney disease (CKD) is increasing in incidence and prevalence worldwide around the world, and early detection of CKD is a major challenge. MR elastography (MRE) is a noninvasive technique capable of quantifying the mechanical properties of tissue that has shown potential for assessing kidney diseases. Our results showedthe stiffness and damping ratio were significantly correlated with eGFR and biopsy score in CKD patients. The stiffness and damping ratio also decreased along with the progression of CKD. MRE using 60-Hz and 90-Hz vibration frequencies can provide potential quantitative biomarkers for evaluating kidney function and pathological injury in CKD patients. 

Yue Wang¹, Ye Ju¹, Dandan Zheng², and Ailian Liu^1
1the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Clinical & Technical Support, Philips Healthcare, China, Shanghai, China

Keywords: Kidney, CEST & MT, amide proton transfer

Early diagnosis of chronic kidney disease (CKD) is difficult because of its hidden condition, mild symptoms and imperceptible symptoms. Amide proton transfer weighted (APTw) is a new contrast-free MR imaging technique, which can non-invasively detect the changes of amide proton concentration in endogenous mobile proteins and polypeptides in tissues. Intravoxel income motion (IVIM) can simultaneously obtain the microcirculation perfusion and water molecule diffusion of patients. The results showed that APTw and IVIM parameters APT, D* and D had good diagnostic efficiency in evaluating CKD renal function, especially the cortex APT value. 

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Luis Carlos Sanmiguel Serpa^1,2,3, Pieter De Visschere^1,2, Marijn Speeckaert^4,5, and Pim Pullens^3,6
1Radiology, Ghent University Hospital, Ghent, Belgium, ²Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium, ³Ghent Institute of Functional and Metabolic Imaging, Ghent University, Ghent, Belgium, ⁴Nephrology, Ghent University Hospital, Ghent, Belgium, ⁵Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium, ⁶6IBiTech– Medisip, Ghent University, Ghent, Belgium

Keywords: Kidney, Arterial spin labelling

To date, renal ASL MRI images are analysed with methods that may underestimate renal perfusion or that may be observer-dependent. In this study, we implemented two analysis methods that take into account the complex morphology of the kidney. One analyses the kidney progressively, from the cortex to the medulla, and the second one, a new algorithm analyses the kidney in radial sections. Our results show that perfusion values change across the kidney and that healthy subjects have higher perfusion values. This study shows the importance of using more robust analysis on kidney ASL MRI images.

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Navin Michael¹, Liangjian Lu², Delicia Shu Qin Ooi³, Chang-Yien Chan^2,3, Kashthuri Thirumugan¹, Suresh Anand Sadananthan¹, Pottumarthi V. Prasad⁴, Marielle Fortier⁵, See Ling Loy^6,7, Tan Kok Hian^8,9, Fabian Yap^7,10,11, Yap Seng Chong¹², Keith Godfrey¹³, Peter Gluckman¹⁴, Johan G. Eriksson^12,15,16, Yung Seng Lee³, Karen Moritz¹⁷, Shiao-Yng Chan¹², Mary Wlodek^1,18,19, and S. Sendhil Velan^1
1Singapore Institute for Clinical Sciences, Singapore, Singapore, ²Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore, ³Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, ⁴Department of Radiology, NorthShore University Health System, Evanston, IL, United States, ⁵Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore, ⁶Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore, ⁷Duke-NUS Medical School, Singapore, Singapore, ⁸Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore, ⁹Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore, ¹⁰Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore, ¹¹Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore, ¹²Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, ¹³MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom, ¹⁴Liggins Institute, University of Auckland, Auckland, New Zealand, ¹⁵Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland, ¹⁶Folkhälsan Research Center, Helsinki, Helsinki, Finland, ¹⁷School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Australia, ¹⁸School of Molecular Sciences, The University of Western Australia, Crawley, Australia, ¹⁹Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia

Keywords: Kidney, Diffusion/other diffusion imaging techniques, Intravoxel Incoherent Motion Imaging, Renal Inflammation

Developmental factors that impair nephrogenesis can increase risk for chronic kidney disease (CKD). The early stages of CKD are characterized by an increased infiltration of inflammatory cells into the renal interstitium, which can restrict the molecular diffusion of water. We found that maternal gestational diabetes and preterm birth were associated with 2-fold and 4-fold higher risk of having restricted water diffusion (IVIM diffusion coefficient < 10^th centile) in the renal cortex of preadolescents, respectively. Preadolescents with restricted diffusion had elevated urinary pro-inflammatory, chemotactic and pro-fibrotic cytokines, without elevations in blood markers of systemic inflammation, which was suggestive of renal inflammation.  

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Alexander J Daniel¹, Sarah Fawaz², Philip Charles³, Mohamed Elzawahry², Jane I Grove⁴, David Long⁵, James Hunter², Maria Kaisar², and Susan T Francis^1
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²Nuffield Department of Surgical Sciences, Oxford University, Oxford, United Kingdom, ³Big Data Institute, Oxford University, Oxford, United Kingdom, ⁴NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom, ⁵Developmental Biology and Cancer Department, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom

Keywords: Kidney, Transplantation

Kidney transplantation is the preferred treatment for end-stage kidney disease. Donor kidney viability is currently assessed using donor age, medical history, and serum creatinine, but these have limited predictive power. As part of a study to determine if MRI can be used as an alternative, more accurate, measurement of donor kidney viability, we outline a multiparametric MRI protocol (high resolution structural scans, relaxometry (T₁, T₂ and T₂*) mapping, susceptibility-weighted-imaging (SWI), diffusion-weighted imaging (DWI), and magnetisation transfer ratio (MTR)) to study human whole kidneys that have been declined as transplants. MRI measures will be integrated with 3D-histology and tissue proteomics datasets.

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Alexander J Daniel¹, Mohamed Elzawahry², Philip Charles³, Sarah Fawaz², Maria Kaisar², James Hunter², and Susan T Francis^1
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²Nuffield Department of Surgical Sciences, Oxford University, Oxford, United Kingdom, ³Big Data Institute, Oxford University, Oxford, United Kingdom

Keywords: Kidney, Transplantation

Here, we investigate in a porcine model how MR parameters change as donor kidneys are cold stored, by studying the effect of temperature, cold ischaemia time and compare static cold storage (SCS) with hypothermic machine perfusion (HMP).
Variation in relaxometry measurements with temperature has been modelled allowing the comparison of in-vivo and ex-vivo datasets, especially important when considering T₁ measurements. The effects of cold ischemia time on relaxometry measures have also been quantified allowing this confounding factor to be accounted for in larger studies of human deceased donor organs. Susceptibility Weighted Imaging observed blood products in an SCS porcine kidney.

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Atsushi Nakamoto¹, Hiromitsu Onishi¹, Takahiro Tsuboyama¹, Takashi Ota¹, Hideyuki Fukui¹, Keigo Yano¹, Toru Honda¹, Kengo Kiso¹, Shohei Matsumoto¹, Mitsuaki Tatsumi¹, and Noriyuki Tomiyama^1
1Osaka University Graduate School of Medicine, Suita, Japan

Keywords: Kidney, Diffusion/other diffusion imaging techniques

This retrospective study investigated the correlation between shifted apparent diffusion coefficient (sADC) of the kidney measured using diffusion-weighted imaging obtained with b = 200, 1500 and estimated glomerular filtration rates (eGFR), and the performance in discriminating patients with impaired renal function was compared between sADC and ADC. sADC of the renal cortex showed the highest correlation coefficient in correlation with eGFR. In discriminating cases with eGFR <45, <60, or <90, sADC of renal cortex showed higher area under the curve compared to ADC, although the difference was not significant. sADC might be more useful in predicting renal function than ADC.

Yunfei Zhang¹, Yongming Dai¹, and Mengsu Zeng^2
1MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China, ²Zhongshan Hospital of Fudan University, Shanghai, China

Keywords: New Devices, Diffusion/other diffusion imaging techniques

Reduced field-of-view (rFOV) technique is a feasible approach to counter the constraints of conventional DWI. Most recently, the 5.0 T whole-body MRI system was developed, which provides an alternative choice for high field abdominal DWI. This research aims to evaluate the image quality of 5.0 T rFOV-DWI with the 3.0 T rFOV-DWI as the reference. The results indicated that 5.0 T rFOV-DWI had better overall image quality and improved SNR compared to 3.0 T rFOV-DWI, which holds clinical potential for identifying the abdominal abnormalities in routine practice.

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Florian Schmid¹, Georgios Koukos¹, Matt Sooknah¹, Sanam Assili¹, and Johannes Riegler^1
1Calico Life Sciences, South San Francisco, CA, United States

Keywords: Kidney, Kidney

We investigated quantitative T₂ mapping as an MRI biomarker for disease progression in mouse models of autosomal dominant polycystic kidney disease and its correlation with kidney function. Our results show a good correlation between the fraction of the kidney tissue with elevated T₂ and cyst load quantified by histology. There was also a good correlation between high T₂ values and kidney function decline indicated by reduced glomerular filtration rates.

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Ye Wang^1,2, Zexuan Hu³, Chutong He^1,2, Ruili Wei^1,2, Xinrui Pang^1,2, Fangrong Liang^1,2, Aaron Zhang⁴, Yongzhou Xu⁴, Shiwen Yuan^1,5, and Ruimeng Yang^1,2
1The second Affiliated Hospital Guangzhou, School of Medicine, South China University of Technology, Guangzhou, China, ²Department of Radiology, Guangzhou First People’s Hospital, Guangzhou, China, ³Department of Radiology, TCM-integrated Hospital of Southern Medical University, Guangzhou, China, ⁴Philips Healthcare, Guangzhou, China, Guangzhou, China, ⁵Department of Rheumatology, Guangzhou First People’s Hospital, Guangzhou, China

Keywords: Kidney, fMRI, split-renal function

Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE) that can progress to end-stage kidney disease. This study aimed to detect the split-renal function changes in early-LN by using BOLD-MRI. The results demonstrated the R2*, as a biomarker for tissue oxygenation, was significantly lower in cortex and medulla in the early-LN patients compared to the healthy volunteers. Moreover, The R2* in medulla remained a considerable good power in predicting early-LN, suggesting it has the potential to be employed as a noninvasive imaging biomarker for early-LN patients with SLE.

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Chutong He^1,2, Ye Wang^1,2, Xinrui Pang^1,2, Ruili Wei^1,2, Fangrong Liang^1,2, Yongzhou Xu³, Aaron Zhang³, Shiwen Yuan^4,5, and Ruimeng Yang^1,2
1The second Affiliated Hospital Guangzhou, School of Medicine, South China University of Technology, Guangzhou, China, ²Department of Radiology, Guangzhou First People’s Hospital, Guangzhou, China, ³Philips Healthcare, Guangzhou, China, ⁴Department of Rheumatology, The second Affiliated Hospital Guangzhou, School of Medicine, South China University of Technology, Guangzhou, China, ⁵Department of Rheumatology, Guangzhou First People’s Hospital, Guangzhou, China

Keywords: Kidney, Diffusion Tensor Imaging, Lupus nephritis

Lupus nephritis (LN) is a substantial cause of death in patients with systemic lupus erythematosus (SLE). The purpose of this study was to explore the value of Diffusion tensor imaging (DTI) in evaluating renal function in patients with early-stage LN. The results showed apparent diffusion coefficient (ADC) values in the cortex and fractional anisotropy (FA) values in the cortex and medulla were significantly lower in early-stage LN patients compared with healthy volunteers. Furthermore, FA values in the cortex and medulla were also independent predictors of early-stage LN, suggesting that FA values can be a potentially sensitive imaging biomarker.

Chun Yang^1,2, Yishi Wang³, Wei Li¹, and Yuxin Wang^1,2
1The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China, ²Shandong First Medical University, Jinan, China, ³Philips Healthcare, Beijing, China

Keywords: Kidney, Endocrine, mDixon-Quant, type 2 diabetes mellitus, renal function

mDixon-Quant adopts a multi-echo 3D fast GRE sequence that can be used to obtain fat fraction, T2* and R2* mapping in a single breath hold. The variation of deoxyhemoglobin in the kidney can reflect the oxygen metabolism in patients with diabetic nephropathy under pathological and physiological conditions. FF maps can be used for fat quantification. mDixon-Quant provides the assessment both fat metabolism and oxygen metabolism of the kidney at the same time and may be valuable in detecting changes in renal function and pathology.

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Jin Peng^1,2, Yajun Hong³, Feipeng Zhu⁴, Yanjun Li⁴, Song Luo⁵, Pu-Yeh Wu⁶, and Guangming Lu^1,5
1The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China, ²Department of Interventional Therapy, Chenggong Hospital, Xiamen University, Xiamen, Fujian, China, ³Office of Medical Case Statistics, Department of Medical Affairs, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China, ⁴Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China, ⁵Department of Radiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China, ⁶GE Healthcare, Beijing, China

Keywords: Kidney, Quantitative Imaging, Arterial spin labelling, Blood oxygen level-dependent imaging, Renal allograft

In this study, we aimed to assess the renal allografts function after transplantation using ASL and BOLD MRI. We found that RBF and R2* values were significantly lower and higher in the renal transplant injury group, respectively. RBF and R2* were positively and negatively correlated with eGFR, respectively. ROC analysis demonstrated both RBF and R2* reflected injured renal function, and the combination of RBF and R2* showed an AUC of 0.86, comparable to that of RBF alone. In conclusion, compared to BOLD, ASL may be a more promising imaging technique for noninvasive assessment of renal graft function for clinical purposes.

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Yun Xu¹, Qingxuan Wan¹, Xihui Ren¹, Fang Wang¹, Aijun Shen¹, Peng WU², and Peijun Wang^1
1Tongji Hospital, School of Medicine, Tongji University, Shanghai, China, ²Philips Healthcare, Shanghai, China

Keywords: Kidney, CEST & MT, amide proton transfer,RCC

This study aims to assess the feasibility of amide proton transfer-weighted (APTw) imaging in depicting renal lesions and its ability to differentiate malignant from benign tumors. The results show that APTw can be used to discriminate renal tumors from normal kidney tissues, as well as to identify benign and malignant renal tumors. However, the technique still needs to be improved to reduce artifacts.

Gang Tian¹, Xia Wang¹, Ruirui Ma¹, Wei Zhang¹, Na Zhao¹, Min Jia¹, Chanjuan Yu¹, Xiuzheng Yue², Queenie Chan², and Yuedong Han^1
1Department of Radiology, Xi'an GaoXin Hospital, Xi'an Jiao Tong University, Xi'an, Shaanxi, China;, Xi'an, China, ²Philips Healthcare, Beijing, China

Keywords: Kidney, CEST & MT

APTw imaging is able to detect free protein and peptide molecules in cells non-invasively. The aim of this study was to investigate the influence of age, gender and BMI on the APT values of right normal kidney. The results showed that there was a low correlation of APT values and age or BMI; and the male mean APT values was lower than that in female. The influence of age, gender and BMI factors should be taken into account in scientific research and clinical application of renal APTw imaging.

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Qing Liu¹, Qi Liu², Jing Li¹, Zhongqi Zhang², Jian Xu², Jeff L Zhang³, and Haoran Sun^4
1Radiology, Beichen Hospital, Tianjin, China, ²UIH America, Inc., Houston, TX, United States, ³School of Biomedical Engineering, ShanghaiTech University, Shanghai, China, ⁴Radiology, Tianjin Medical University General Hospital, Tianjin, China

Keywords: Kidney, DSC & DCE Perfusion

A 3D, free-breathing renal DCE MRI technique is developed using MRI Multitasking. It produces motion-resolved, high spatial and temporal resolutions images, thus does not require image registration post-processing. The feasibility of this technique in renal DCE MRI is evaluated on healthy subjects.

Xia Wang¹, Ruirui Ma¹, Wei Zhang¹, Na Zhao¹, Gang Tian¹, Chanjuan Yu¹, Xiuzheng Yue², and Yuedong Han^1
1Department of Radiology, Xi'an GaoXin Hospital, Xi'an, China, ²Philips Healthcare, Beijing, China

Keywords: Kidney, CEST & MT

Renal tumors are often containing lipid components, ischemic-hypoxia and hemorrhage. These components can be reflected by the proton density fat fraction (PDFF) and R2* levels of the mDIXON_Quant. Amide proton transfer-weighted (APTw) imaging has made breakthroughs in tumor research, however, its signal intensity is affected by many factors. This study focused on the effect of PDFF and R2* values on APTw values in renal tumors. The preliminary results showed that renal tumor APT values were  correlated with PDFF and R2* values. Thus, precision APTw imaging studies of renal tumors need to consider the effects of differential composition.

Wei Zhang¹, Xia Wang¹, Ruirui Ma¹, Na Zhao¹, Gang Tian¹, Chanjuan Yu¹, Min Jia¹, Xiuzheng Yue², and Yuedong Han^1
1Department of Radiology, Xi'an GaoXin Hospital, Xi'an, China, ²Philips Healthcare, Beijing, China

Keywords: Kidney, CEST & MT

Amide proton transfer-weighted (APTw) is a promising molecular imaging technique that has been employed in clinics for the detection and grading of tumors. APT value is easily influenced by B0 inhomogeneity causing image artifacts; This variation becomes more complex in abdominal motion organs than that in the brain. This study focused on the effect of variation in B0 field drift with different examination orientations on renal APT image quality. The results showed when head-first and foot-first scanning were used on 3D-APT imaging of normal kidneys, the change of B0 drift on the quality of renal APT image should be noticed.