Purpose:To investigate the possibility of using combined blood oxygen level-dependent (BOLD) imaging and diffusion-weighted imaging (DWI) to detect pathological and physiological changes in renal tissue damage of the kidney induced by chronic renal hyperfiltration. Materials and Methods:The apparent diffusion coefficient (ADC) and the T 2 * value within the inner compartments of the kidneys of 17 rats with diabetes mellitus were compared with the results obtained from a control group (N ϭ 16). The influence of dynamic changes of the renal function on the blood-oxygen saturation was evaluated by comparing the T 2 * values before and after the active reduction of tubular transport by furosemide injection.Results: All compartments of the diabetic kidney showed significantly (P Ͻ 0.05) lower T 2 *-values compared to the control group. In particular, the very low values in the outer stripe (OS) of the outer medulla (OM) (T 2 *-normal: 69.4 Ϯ 10.9 msec; T 2 *-diabetic: 51.4 Ϯ 13.9 msec) indicated either hypoxia due to hyperfiltration, or renal blood volume changes. Diffusion imaging of the same area showed significantly lower ADC values (ADC-normal: 1.45 Ϯ 0.26; ADCedema: 1.19 Ϯ 0.25 [10 -9 m 2 /s]) that correlated with pathological findings on histopathology. The injection of furosemide significantly (P Ͻ 0.05) increased T 2 * in all compartments of both populations while the ADC remained unchanged.Conclusion: BOLD-contrast imaging appears to be able to depict tissue at risk from ischemia by revealing information about the balance between tubular workload and delivery of oxygen, and thus may reflect a measure of the reserve capacity. The diffusion measurements apparently reveal complementary information. Although ADC imaging is not sensitive to the current energy metabolism, it appears toreflect the pathological changes within the tissue. Therefore, ADC measurements may be a sensitive indicator of the severity of ischemic lesions.
Localized hydrogen-1 magnetic resonance (MR) spectroscopy and fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) were employed to obtain metabolic information from intracranial gliomas. Advantages and difficulties associated with comparison of results from the two modalities were realized. Forty patients were studied with H-1 MR spectroscopy. MR signal intensities from lactate, N-acetylaspartate (NAA), choline, and creatine from a volume of interest containing the tumor and a contralateral volume were obtained and evaluated. NAA signal intensities were generally decreased in the tumor spectra, and choline signal intensities were elevated. H-1 MR spectroscopy was unsuccessful in eight patients, and FDG PET scans were not obtained in four of the patients with successful MR spectroscopic examinations. Lactate signal intensity was detected in 10 of the 28 patients who had successful H-1 MR spectroscopic and FDG PET studies. Lactate signal intensities were observed in lesions shown at FDG PET to be hypermetabolic, as well as in lesions found to be hypometabolic.
A method is presented which allows precise temperature and longitudinal (T 1 ) relaxation time measurements with high spatial and temporal resolution. This is achieved by combining dynamic variable flip angle based T 1 relaxation mapping with proton resonance frequency shift based thermometry. Herein, dynamic T 1 mapping is either used as a complementary measure of temperature or for the detection of T 1 contrast agent release. For the first application, the temperature evolution during a high-intensity focused ultrasound tissue ablation experiment was measured in both, porcine fat and muscle, simultaneously. In this application, temperature accuracies of 2.5 K for
Thermotherapies can now be guided in real-time using magnetic resonance imaging (MRI). This technique is rapidly gaining importance in interventional therapies for abdominal organs such as liver and kidney. An accurate online estimation and characterization of organ displacement is mandatory to prevent misregistration and correct for motion related thermometry artifacts. In addition, when the ablation is performed with an extracorporal heating device such as high intensity focused ultrasound (HIFU), the continuous estimation of the organ displacement is the basis for the dynamic adjustment of the focal point position to track the targeted pathological tissue. In this paper, we describe the use of an optimized principal component analysis (PCA)-based motion descriptor to characterize in real-time the complex organ deformation during the therapy. The PCA was used to detect, in a preparative learning step, spatio-temporal coherences in the motion of the targeted organ. During hyperthermia, incoherent motion patterns could be discarded, which enabled improvements in motion estimation robustness, the compensation of motion related errors in thermal maps, and the adjustment of the beam position. The suggested method was evaluated for a moving phantom, and tested in vivo in the kidney and the liver of 12 healthy volunteers under free breathing conditions. The ability to perform a MR-guided thermotherapy in vivo during HIFU intervention was finally demonstrated on a porcine kidney.
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