Abstract
ObjectiveTo assess the feasibility of renal proton magnetic resonance spectroscopy for quantification of triglyceride content and to compare spectral quality and reproducibility without and with respiratory motion compensation in vivo.Materials and MethodsThe Institutional Review Board of our institution approved the study protocol, and written informed consent was obtained. After technical optimization, a total of 20 healthy volunteers underwent renal proton magnetic resonance spectroscopy of the renal cortex both without and with respiratory motion compensation and volume tracking. After the first session the subjects were repositioned and the protocol was repeated to assess reproducibility. Spectral quality (linewidth of the water signal) and triglyceride content were quantified. Bland-Altman analyses and a test by Pitman were performed.ResultsLinewidth changed from 11.5±0.4 Hz to 10.7±0.4 Hz (all data pooled, p<0.05), without and with respiratory motion compensation respectively. Mean % triglyceride content in the first and second session without respiratory motion compensation were respectively 0.58±0.12% and 0.51±0.14% (P = NS). Mean % triglyceride content in the first and second session with respiratory motion compensation were respectively 0.44±0.10% and 0.43±0.10% (P = NS between sessions and P = NS compared to measurements with respiratory motion compensation). Bland-Altman analyses showed narrower limits of agreement and a significant difference in the correlated variances (correlation of −0.59, P<0.05).ConclusionMetabolic imaging of the human kidney using renal proton magnetic resonance spectroscopy is a feasible tool to assess cortical triglyceride content in humans in vivo and the use of respiratory motion compensation significantly improves spectral quality and reproducibility. Therefore, respiratory motion compensation seems a necessity for metabolic imaging of renal triglyceride content in vivo.
Highlights
The global increase in chronic kidney disease (CKD) parallels the obesity epidemic [1]
Linewidth changed from 11.560.4 Hz to 10.760.4 Hz, without and with respiratory motion compensation respectively
Mean % triglyceride content in the first and second session with respiratory motion compensation were respectively 0.4460.10% and 0.4360.10% (P = NS between sessions and P = NS compared to measurements with respiratory motion compensation)
Summary
The global increase in chronic kidney disease (CKD) parallels the obesity epidemic [1]. Obese subjects have a weight-dependent 2- to 7-fold increased risk in progression of CKD irrespective of the underlying cause [2,3]. A recent study found a ten-fold increased incidence of ORG in native kidney biopsies between 1986–2000, suggesting a newly emerging epidemic [4]. Accumulating evidence from experimental and scarce limited human biopsy studies link ectopic lipid deposition in the kidney (renal adiposity or fatty kidney) to the development of ORG [5,6,7,8]. Clinical research on renal adiposity is hampered by the fact that it is considered unethical to biopsy human kidneys (repeatedly) without clear evidence of (late) renal disease
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