Purpose: To improve 2D software for motion correction of renal dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to evaluate its effect using the PatlakRutland model.
Materials and Methods:A subpixel-accurate method to correct for kidney motion during DCE-MRI was evaluated on native and transplanted kidneys using data from two different institutions with different magnets and protocols. The Patlak-Rutland model was used to calculate glomerular filtration rate (GFR) on a voxel-by-voxel basis providing mean (K p ) and uncertainty ( ͑K p ͒) values for GFR.
Results:In transplanted kidneys, average absolute variation of K p was 6.4% Ϯ 4.8% (max ϭ 16.6%). In native kidneys average absolute variation of K p was 12.11% Ϯ 6.88% (max ϭ 25.6%) for the right and 11.6% Ϯ 6% (max ϭ 20.8%) for the left. Movement correction showed an average reduction of ͑K p ͒ of 6.9% Ϯ 6.6% (max ϭ 21.4%) in transplanted kidneys, 30.9% Ϯ 17.6% (max ϭ 60.8%) for the right native kidney, and 31.8% Ϯ 14% (max ϭ 55.3%) for the left kidney.
Conclusion:The movement correction algorithm showed improved uncertainty on GFR computation for both native and transplanted kidneys despite different spatial resolution from the different MRI systems and different levels of signal-to-noise ratios on DCE-MRI. VIRTUALLY ALL DISEASES of the kidney affect perfusion and glomerular filtration. Noninvasive and accurate measurement of both perfusion and glomerular filtration rate (GFR) could have a major impact in understanding renal physiopathology and for serial monitoring of the course of both acute and chronic kidney diseases. Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) is advocated to evaluate these functional parameters. However, publications in the literature show poor correlation when MRI-GFR has been compared with GFR measured by reference methods (1,2); this poor correlation precludes the use of DCE-MRI for GFR estimation in daily clinical practice. The inaccuracy is multifactorial, with unsolved problems regarding the ideal acquisition sequence; the dual MR effect (T1 and T2*) of contrast agents; the conversion of signal intensity into concentration; the pharmacokinetic models applied; as well as the difficulties in postprocessing (segmentation and region of interest [ROI]). DCE-MRI images are usually acquired during spontaneous breathing that will result in kidney movement. Since respiratory-gated sequences (3) would lead to loss of temporal resolution, most groups studying DCE-MRI GFR have either repositioned images manually or ignored movement. However, movement causes artifacts in the pixel-based time-intensity analysis that will lead to inaccurate GFR quantification. A compromise in choosing the acquisition parameters is required to achieve a sufficiently high signal-tonoise ratio (SNR). An ideal rapid isotropic 3D imaging of the moving kidneys is not achievable, and thus slices are usually oriented along the long axis of the kidney that will allow the best approximation of movement to be estimated. During DCE-MRI, ...