Abstract
Dynamic contrast-enhanced (DCE) MRI monitors the transit of contrast agents, typically gadolinium chelates, through the intrarenal regions, the renal cortex, the medulla, and the collecting system. In this way, DCE-MRI reveals the renal uptake and excretion of the contrast agent. An optimal DCE-MRI acquisition protocol involves finding a good compromise between whole-kidney coverage (i.e., 3D imaging), spatial and temporal resolution, and contrast resolution. By analyzing the enhancement of the renal tissues as a function of time, one can determine indirect measures of clinically important single-kidney parameters as the renal blood flow, glomerular filtration rate, and intrarenal blood volumes. Gadolinium-containing contrast agents may be nephrotoxic in patients suffering from severe renal dysfunction, but otherwise DCE-MRI is clearly useful for diagnosis of renal functions and for assessing treatment response and posttransplant rejection.Here we introduce the concept of renal DCE-MRI, describe the existing methods, and provide an overview of preclinical DCE-MRI applications to illustrate the utility of this technique to measure renal perfusion and glomerular filtration rate in animal models.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction is complemented by two separate publications describing the experimental procedure and data analysis.
Highlights
Glomerular filtration rate (GFR) is a standard measure of kidney function
We introduce the concept of renal Dynamic contrast-enhanced (DCE)-Magnetic resonance imaging (MRI), describe the existing methods, and provide an overview of preclinical DCE-MRI applications to illustrate the utility of this technique to measure renal perfusion and glomerular filtration rate in animal models
Previous studies have taken this constraint into account in three different ways: (1) by assuming that the signal intensity is linearly related to the concentration of contrast agent, (2) by making calibration of water doped with contrast agent and assume the same signal-vs-concentration can be applied in the living tissue, and (3) by introducing the mathematical complex relationship between signal and concentration
Summary
Glomerular filtration rate (GFR) is a standard measure of kidney function. In past decades, simplified plasma clearance employing radiopharmaceuticals (51Cr-EDTA, 125I-iothalamate, 99mTcDTPA) was introduced and validated to provide very accurate estimates of total GFR [1–4]. Dynamic contrast enhanced (DCE-MRI) is an alternative to these techniques that uses gadolinium chelates as contrast agents (CAs), providing functional information analogous to that obtained from radionuclide studies [7, 8]. These chelates are generally considered glomerular filtration markers, since they are removed from the circulation exclusively by glomerular filtration. Dynamic data acquisition allows for monitoring of the contrast agent in the renal cortex, the medulla, and the collecting system, providing a renographic representation with underlying information about the renal perfusion, filtration, and vascularization [9– 12] Postprocessing analyses of these signal-vs-time curves reveal kidney functionality in terms of filtration and perfusion, including both heuristic nonmodel approaches and model-based quantitative methods [13, 14].
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