Renal blood oxygenation level-dependent magnetic resonance imaging to measure renal tissue oxygenation: a statement paper and systematic review.
Textor, Stephen C
Lerman, Lilach O
Krediet, CT Paul
Prasad, Pottumarthi Vara
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Pruijm, M., Mendichovszky, I., Liss, P., Van der Niepen, P., Textor, S. C., Lerman, L. O., Krediet, C. P., et al. (2018). Renal blood oxygenation level-dependent magnetic resonance imaging to measure renal tissue oxygenation: a statement paper and systematic review.. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 33 (suppl_2), ii22-ii28. https://doi.org/10.1093/ndt/gfy243
Tissue hypoxia plays a key role in the development and progression of many kidney diseases. Blood oxygenation-level dependent MRI (BOLD-MRI) is the most promising imaging technique to monitor renal tissue oxygenation in humans. BOLD-MRI measures renal tissue deoxyhaemoglobin levels voxel by voxel. Increases in its outcome measure R2* (transverse relaxation rate expressed as sec-1) correspond to higher deoxyhaemoglobin concentrations and suggest lower oxygenation, whereas decreases in R2* indicate higher oxygenation. BOLD-MRI has been validated against micropuncture techniques in animals. Its reproducibility has been demonstrated in humans, provided that physiological and technical conditions are standardized. BOLD-MRI has shown that patients suffering from chronic kidney disease (CKD) or kidneys with severe renal artery stenosis have lower tissue oxygenation than controls. Additionally, CKD patients with the lowest cortical oxygenation have the worst renal outcome. Finally, BOLD-MRI has been used to assess the influence of drugs on renal tissue oxygenation, and may offer the possibility to identify drugs with nephroprotective or nephrotoxic effects at an early stage. Unfortunately, different methods are used to prepare patients, acquire MRI data and analyze the BOLD images. International efforts such as the COST action PARENCHIMA are aiming to harmonize this process, to facilitate the introduction of this technique in clinical practice in the near future. This article represents an extensive overview of the studies performed in this field, summarizes the strengths and weaknesses of the technique, provides recommendations about patient preparation, image acquisition and analysis, and suggests clinical applications and future developments.
Kidney, Humans, Oxygen, Magnetic Resonance Imaging, Oxygen Consumption, Renal Insufficiency, Chronic, Practice Guidelines as Topic, Biomarkers, Hypoxia
EU COST Action PARENCHIMA
External DOI: https://doi.org/10.1093/ndt/gfy243
This record's URL: https://www.repository.cam.ac.uk/handle/1810/280554