Estimation of differential renal function on routine abdominal imaging employing compressed-sensed contrast-enhanced MR: a feasibility study referenced against dynamic renal scintigraphy in patients with deteriorating renal retention parameters

• Published in: Abdominal imaging Vol. 48; no. 4; pp. 1329 - 1339
• Main Authors: Schulze-Zachau, Victor, Winkel, David J., Kaul, Felix, Demerath, Theo, Potthast, Silke, Heye, Tobias J., Boll, Daniel T.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2023; Springer Nature B.V
• Subjects: Contrast Media; Feasibility Studies; Gastroenterology; Glomerular filtration rate; Hepatology; Humans; Image acquisition; Image Interpretation, Computer-Assisted - methods; Imaging; Impairment; Kidney - diagnostic imaging; Kidney - physiology; Kidneys; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; Medicine; Medicine & Public Health; Parameters; Pyramids; Radiology; Radionuclide Imaging; Renal function; Retrospective Studies; Scintigraphy; Spatial discrimination; Spatial resolution; Technical; Verification; Golden-angle radial sparse parallel (GRASP); Renal function; Image processing; Contrast media
• ISSN: 2366-0058; 2366-004X; 2366-0058
• DOI: 10.1007/s00261-023-03823-2

Purpose To assess whether high temporal/spatial resolution GRASP MRI acquired during routine clinical imaging can identify several degrees of renal function impairment referenced against renal dynamic scintigraphy. Methods This retrospective study consists of method development and method verification parts. During method development, patients subject to renal imaging using gadoterate meglumine and GRASP post-contrast MRI technique (TR/TE 3.3/1.6 ms; FoV320 × 320 mm; FA12°; Voxel1.1 × 1.1x2.5 mm) were matched into four equally-sized renal function groups (no-mild-moderate-severe impairment) according to their laboratory-determined estimated glomerular filtration rates (eGFR); 60|120 patients|kidneys were included. Regions-of-interest (ROIs) were placed on cortices, medullary pyramids and collecting systems of bilateral kidneys. Cortical perfusion, tubular concentration and collecting system excretion were determined as Time Cortex=Pyramid (sec), Slope Tubuli (sec −1 ), and Time Collecting System (sec), respectively, and were measured by a combination of extraction of time intensity curves and respective quantitative parameters. For method verification, patients subject to GRASP MRI and renal dynamic scintigraphy (99mTc-MAG3, 100 MBq/patient) were matched into three renal function groups (no-mild/moderate-severe impairment). Split renal function parameters post 1.5–2.5 min as well as MAG3 TER were correlated with time intensity parameters retrieved using GRASP technique; 15|30 patients|kidneys were included. Results Method development showed differing values for Time Cortex=Pyramid (71|75|93|122 s), Slope Tubuli (2.6|2.1|1.3|0.5 s −1 ) and Time Collecting System (90|111|129|139 s) for the four renal function groups with partial significant tendencies (several p -values <  0.001). In method verification, 29/30 kidneys (96.7%) were assigned to the correct renal function group. Conclusion High temporal and spatial resolution GRASP MR imaging allows to identify several degrees of renal function impairment using routine clinical imaging with a high degree of accuracy.