Noninvasive Assessment of Early Kidney Allograft Dysfunction by Blood Oxygen Level-Dependent Magnetic Resonance Imaging

Djamali, Arjang; Sadowski, Elizabeth A.; Samaniego-Picota, Millie; Fain, Sean B.; Muehrer, Rebecca J.; Alford, Sara K.; Grist, Thomas M.; Becker, Bryan N.

doi:10.1097/01.tp.0000234815.23630.4a

Cited by 70 publications

(72 citation statements)

References 23 publications

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“…Nevertheless, other studies using blood oxygen level-dependent magnetic resonance imaging (19) are consistent with the hypothesis of Rosenberger and colleagues that HIF-1␣ expression in rejected kidneys reflects hypoxia in the kidney.…”

supporting

confidence: 73%

The Heat Is On

Nangaku¹

2007

Journal of the American Society of Nephrology

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supporting

confidence: 73%

The Heat Is On

Nangaku¹

2007

Journal of the American Society of Nephrology

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“…Evolution of BOLD MRI into a more reliable and reproducible indicator of renal oxygenation is required before this technique can realize its full potential to contribute to our Cortex A Djamali et al 64 Park et al 79 Sadowski et al 65 Sadowski et al 66 Han et al 67 Xiao et al 75 offers great promise in addressing analytic and technical issues that currently limit the ability of BOLD MRI to address intracompartmental heterogeneity in oxygenation, while the work of Zhang et al 5 offers great promise in enhancing the ability of BOLD MRI signal strength to reflect intrarenal pO 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Sadowski and coworkers reported BOLD MRI measurements in kidney allografts with ATN (n=4-6) within 4 months post-transplantation. [64][65][66] There was no significant difference in cortical oxygenation in the ATN group compared with normal functioning allografts, although one study showed a trend toward cortical hypoxia. Medullary oxygenation was significantly increased in the ATN group in one study, but not in the other two.…”

Section: Acute Tubular Necrosismentioning

confidence: 93%

“…[64][65][66][67]79,80 In three separate publications, Djamali et al 64 and Sadowski et al 65,66 found that within the first 4 months after renal transplantation, acute rejection (n=8-13) was associated with increased renal medullary oxygenation, despite reduced medullary blood flow, as compared with both normally functioning allografts and allografts with ATN. Cortical oxygenation was similar in all groups.…”

Section: Kidney Transplantationmentioning

confidence: 99%

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Blood oxygenation level-dependent MRI for assessment of renal oxygenation

Neugarten¹,

Golestaneh²

2014

IJNRD

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Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) has recently emerged as an important noninvasive technique to assess intrarenal oxygenation under physiologic and pathophysiologic conditions. Although this tool represents a major addition to our armamentarium of methodologies to investigate the role of hypoxia in the pathogenesis of acute kidney injury and progressive chronic kidney disease, numerous technical limitations confound interpretation of data derived from this approach. BOLD MRI has been utilized to assess intrarenal oxygenation in numerous experimental models of kidney disease and in human subjects with diabetic and nondiabetic chronic kidney disease, acute kidney injury, renal allograft rejection, contrast-associated nephropathy, and obstructive uropathy. However, confidence in conclusions based on data derived from BOLD MRI measurements will require continuing advances and technical refinements in the use of this technique.

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“…Blood oxygen level-dependent (BOLD) MRI has been shown to be of potential clinical value in transplanted kidneys [8] and may be helpful for evaluation and separation of kidney allograft dysfunction like ATN or acute rejection [22,23]. Previously we have shown that the relaxation rate from BOLD MRI and F P from DW-MRI provide complementary information [8].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging

et al. 2009

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Aims: To determine the inter-patient variability of apparent diffusion coefficients (ADC) and concurrent micro-circulation contributions from diffusion-weighted MR imaging (DW-MRI) in renal allografts early after transplantation, and to obtain initial information on whether these measures are altered in histologically proven acute allograft rejection (AR). Methods: DW-MRI was performed in 15 renal allograft recipients 5-19 days after transplantation. Four patients presented with AR and one with acute tubular necrosis (ATN). Total ADC (ADC T ) was determined, which includes diffusion and microcirculation contributions. Furthermore, diffusion and micro-circulation contributions were separated, yielding the "perfusion fraction" (F P ), and "perfusion-free" diffusion (ADC D ). Results: Diffusion parameters in the ten allografts with stable function early after transplantation demonstrated low variabilities. Values for ADC T and ADC D were (×10 −5 mm 2 /s) 228±14 and 203±9, respectively, in cortex and 226±16 and 199±9, respectively, in medulla. F P values were 18±5% in cortex and 19±5% in medulla. F P values were strongly reduced to less than 12% in cortex and medulla of renal transplants with AR and ATN. F P values correlated with creatinine clearance. Conclusion: DW-MRI allows reliable determination of diffusion and micro-circulation contributions in renal allografts shortly after transplantation; deviations in AR indicate potential clinical utility of this method to non-invasively monitor derangements in renal allografts.

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Noninvasive Assessment of Early Kidney Allograft Dysfunction by Blood Oxygen Level-Dependent Magnetic Resonance Imaging

Abstract: BOLD-MRI demonstrated significant changes in medullary oxygen bioavailability in allografts with biopsy-proven ATN and acute rejection, suggesting that there may be a role for this noninvasive tool to evaluate kidney function early after transplantation.

Cited by 70 publications

References 23 publications

The Heat Is On

The Heat Is On

Blood oxygenation level-dependent MRI for assessment of renal oxygenation

Evaluation of renal allograft function early after transplantation with diffusion-weighted MR imaging

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