Diffusion-weighted magnetic resonance imaging to assess diffuse renal pathology: a systematic review and statement paper.
De Seigneux, Sophie
Thoeny, Harriet C
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Caroli, A., Schneider, M., Friedli, I., Ljimani, A., De Seigneux, S., Boor, P., Gullapudi, L., et al. (2018). Diffusion-weighted magnetic resonance imaging to assess diffuse renal pathology: a systematic review and statement paper.. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 33 (suppl_2), ii29-ii40. https://doi.org/10.1093/ndt/gfy163
Diffusion-weighted magnetic resonance imaging (DWI) is a noninvasive method sensitive to local water motion in the tissue. As a tool to probe the microstructure, including the presence and potentially the degree of renal fibrosis, DWI has the potential to become an effective imaging biomarker. The aim of this review is to discuss the current status of renal DWI in diffuse renal diseases. DWI biomarkers can be classified in 3 main categories: i) the apparent diffusion coefficient (ADC) – an overall measure of water diffusion and microcirculation in the tissue, ii) true diffusion (D), pseudodiffusion (D*), and flowing fraction (F) – providing separate information on diffusion and perfusion or tubular flow, and iii) fractional anisotropy (FA) – measuring the microstructural orientation. An overview of human studies applying renal DWI in diffuse pathologies is given, demonstrating the feasibility and intra-study reproducibility of DWI but also highlighting the need for standardization of methods, additional validation and qualification. The current and future role of renal DWI in clinical practice is reviewed, emphasizing its potential as a surrogate and monitoring biomarker for interstitial fibrosis in chronic kidney disease, as well as a surrogate biomarker for the inflammation in acute kidney diseases that may impact patient selection for renal biopsy in acute graft rejection. As part of the international COST action PARENCHIMA, aimed at eliminating the barriers to the clinical use of functional renal MRI, this paper provides practical recommendations for future design of clinical studies and the use of renal DWI in clinical practice.
Kidney, Humans, Diffusion Magnetic Resonance Imaging, Renal Insufficiency, Chronic, Practice Guidelines as Topic, Biomarkers
EU COST Programme
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External DOI: https://doi.org/10.1093/ndt/gfy163
This record's URL: https://www.repository.cam.ac.uk/handle/1810/280557
Attribution-NonCommercial 4.0 International
Licence URL: http://creativecommons.org/licenses/by-nc/4.0/