Noninvasive evaluation of renal tissue oxygenation with blood oxygen level-dependent magnetic resonance imaging early after transplantation has a limited predictive value for the delayed graft function

Sławińska, Agata; Serafin, Zbigniew; Zawada, Elżbieta; Białecki, Marcin; Wypych, Katarzyna; Woderska, Aleksandra; Słupski, Maciej; Włodarczyk, Zbigniew

doi:10.5114/pjr.2018.78622

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…A strong negative correlation between R2* and RBF was observed in the present study, which may explain the small diagnostic value added by the combination of R2* and RBF compared to RBF values alone. Previous studies (33,34) have evaluated renal function using ASL and BOLD, and reported an 8.3% reduction in the medullary R2* values of transplant patients during a 2-year follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies ( 19 , 33 ) have investigated the function of renal allografts using ASL and other functional MRI techniques and have identified renal blood flow and regional renal perfusion as major determinants of oxygen delivery and thus oxygenation of renal tissues. BOLD imaging can detect hypoxic states but may be limited in distinguishing between increased oxygen consumption and decreased blood supply.…”

Section: Discussionmentioning

confidence: 99%

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A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

Jin¹,

Yang²,

Zhu³

et al. 2023

Transl Androl Urol

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Background: This retrospective study aims to evaluate the effectiveness of renal transplantation function by comparing arterial spin labeling (ASL) and blood oxygen level dependent (BOLD) imaging with the receiver operating characteristic (ROC) curve.Methods: According to the estimated glomerular filtration rate (eGFR) values, 42 patients with normal kidney grafts (the normal kidney graft group, eGFR <60 mL/min/1.73 m 2 ) and 93 patients with injured grafts (the kidney graft injury group, eGFR <60 mL/min/1.73 m 2 ) were included in the present study. Renal blood flow (RBF) and the effective transverse relaxation rate (R2*) were calculated by comparing ASL and BOLD imaging. The ROC curve and the youden index were used to evaluate the diagnostic performance of ASL, BOLD, and the combination of them. Results:The results showed that all the clinical features of the patients, except for gender, differed significantly between the 2 groups (P<0.05). The mean RBF value of the renal transplant injury group (104.33±54.76 mL/100 g/min) was significantly lower than that of the normal group (191.84±63.96 mL/ 100 g/min, P<0.01). The mean medullary R2* value of the renal transplant injury group (27.91±3.35 1/s) was significantly higher than that of the normal group (25.22±2.94 1/s, P<0.01). Negative correlations were found between R2* and eGFR (r=-0.44), and RBF and R2* (r=-0.54; both P<0.01). The ROC analysis showed that both RBF and R2* reflected injured renal function [area under the curves (AUC) =0.86 and 0.72, respectively]. In addition, the AUC of RBF and R2* combined was 0.86, which was comparable to that of RBF alone (P=0.95), while combining R2* and RBF improved the diagnostic performance of R2* alone (AUC =0.86 versus 0.72, respectively; P<0.01). The youden index analysis showed that the diagnostic accuracy of ASL was 80.00%, better than 71.85% of BOLD; the sensitivity and specificity of ASL in diagnosing renal allograft dysfunction were 79.57% and 80.95%, superior to 77.42% and 59.52% of BOLD.Conclusions: Our results showed that the non-invasive assessment of ASL in clinical kidney transplant function is a more promising imaging technique than BOLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

Jin¹,

Yang²,

Zhu³

et al. 2023

Transl Androl Urol

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“…BOLD fMRI uses the R2 value, a measure of deoxyhemoglobin in the kidney, and its decrease indicates higher free oxygen availability in the kidney and vice versa. Sławińska et al experimented on patients with early kidney transplantation to detect the blood oxygenation level in the allografts, and they noticed a minimal change in the R2 value, which is a parameter of BOLD fMRI [ 33 ]. Hence it didn't provide any predictive value for the future.…”

Section: Reviewmentioning

confidence: 99%

The Role of Arterial Spin Labeling Functional MRI in Assessing Perfusion Impairment of Renal Allografts: A Systematic Review

Chhabra¹,

Karwarker²,

Rajamanuri³

et al. 2022

Cureus

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Arterial spin labeling (ASL) is a functional magnetic resonance imaging (fMRI) technique that uses water in arterial blood as a tracer to map an area of interest where the intravascular and extravascular compartments exchange. Our review article focuses primarily on the role of ASL fMRI in assessing perfusion impairment in renal allografts in order to take appropriate steps to eliminate the cause of perfusion impairment at an early stage, thereby extending graft life. The study also highlights various other fMRI techniques that are used to analyze other parameters that affect kidney transplants both acutely and chronically. We gathered our data in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and our search strategy included exclusion/inclusion criteria. Several databases were used in the search strategy, including PubMed, Cochrane, and Science Direct, and the Medical Subject Headings (MeSH) strategy was specifically used for PubMed, and two people scrutinized those papers to conclude that a total of 10 research papers are included in our study. This review article includes papers involving 20 to 98 subjects who had renal allografts within the previous six months and had renal cortical perfusion values measured by ASL fMRI ranging from 35 to 304 ml/100 g/min. Furthermore, when compared to healthy kidney transplant patients, renal ASL perfusion values were significantly lower in subjects with the functional imbalance of kidney transplants. It had a positive correlation with the estimated glomerular filtration rate (eGFR). To summarize, ASL fMRI is critical in detecting renal allograft perfusion impairment.

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“…With the use of BOLD imaging, Slawinska et al found higher cortical R2* values in patients with an eGFR ≥ 40 ml/min/1.73 m2 compared to recipients with an eGFR < 40 ml/min/1.73 m2, but R2* was not useful in the prediction of DGF [77]. Thoeny et al compared patients with a stable allograft function with healthy individuals who all underwent DWI and BOLD MRI.…”

Section: Oxygenation Biomarkersmentioning

confidence: 99%

MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

Schutter

Lantinga

Borra

et al. 2019

Magn Reson Mater Phy

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Kidney transplantation has developed into a widespread procedure to treat end stage renal failure, with transplantation results improving over the years. Postoperative complications have decreased over the past decades, but are still an important cause of morbidity and mortality. Early accurate diagnosis and treatment is the key to prevent renal allograft impairment or even graft loss. Ideally, a diagnostic tool should be able to detect post-transplant renal dysfunction, differentiate between the different causes and monitor renal function during and after therapeutic interventions. Non-invasive imaging modalities for diagnostic purposes show promising results. Magnetic resonance imaging (MRI) techniques have a number of advantages, such as the lack of ionizing radiation and the possibility to obtain relevant tissue information without contrast, reducing the risk of contrast-induced nephrotoxicity. However, most techniques still lack the specificity to distinguish different types of parenchymal diseases. Despite some promising outcomes, MRI is still barely used in the post-transplantation diagnostic process. The aim of this review is to survey the current literature on the relevance and clinical applicability of diagnostic MRI modalities for the detection of various types of complications after kidney transplantation.

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Noninvasive evaluation of renal tissue oxygenation with blood oxygen level-dependent magnetic resonance imaging early after transplantation has a limited predictive value for the delayed graft function

Cited by 6 publications

References 23 publications

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

A clinical study of using ROC to compare the efficiency of ASL and BOLD in diagnosis of renal allograft function

The Role of Arterial Spin Labeling Functional MRI in Assessing Perfusion Impairment of Renal Allografts: A Systematic Review

MRI for diagnosis of post-renal transplant complications: current state-of-the-art and future perspectives

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