Towards the identification of multi-parametric quantitative MRI biomarkers in lupus nephritis

Abstract

Keywords:Renal function Multi-parametric quantitative MRI (qMRI) Arterial spin labeling (ASL) Blood oxygen level dependent (BOLD) T1rho MRI Lupus nephritis (LN) Purpose: To identify potential biomarkers of the renal impairment in lupus nephritis using a multi-parametric renal quantitative MRI (qMRI) protocol including diffusion weighted imaging (DWI), blood oxygen level dependent (BOLD), arterial spin labeling (ASL) and T1rho MRI between a cohort of healthy volunteers and lupus nephritis (LN) patients. Materials and methods: The renal qMRI protocol was performed twice with repositioning in between on 10 LN patients and 10 matched controls at 1.5 T. Navigator-gated and breath-hold acquisitions followed by non-rigid image registration were used to control respiratory motion. The repeatability of the 4 MRI modalities was evaluated with the intra-class correlation coefficient (ICC) and within-subject coefficient of variation (wsCV). Unpaired t-test and stepwise logistic regression were carried out to evaluate qMRI parameters between the LN and control groups. Results: The reproducibility of the 4 qMRI modalities ranged from moderate to good (ICC = 0.4-0.91, wsCV ≤ 12%) with a few exceptions. T1rho MRI and ASL renal blood flow (RBF) demonstrated significant differences between the LN and control groups. Stepwise logistic regression yielded only one significant parameter (medullar T1rho) in differentiating LN from control groups with 95% accuracy. Conclusion: A reasonable degree of test-retest repeatability and accuracy of a multi-parametric renal qMRI protocol has been demonstrated in healthy volunteers and LN subjects. T1rho and ASL RBF are promising imaging biomarkers of LN.

Assessment of Renal Pathological Changes in Lupus Nephritis Using Diffusion Weighted Imaging: A Multiple Correspondence Analysis

“…One study, published by Rapacchi et al in 2015, evaluated 10 LN patients and 10 matched healthy volunteers. In this study, the ADC values determined by DWI-MRI were not significantly different between the LN and control groups [12]. Another study by , which recruited 65 LN patients and 16 healthy volunteers, found a negative correlation between the mean ADC values and renal pathology chronicity indices [13].…”

Tubulointerstitial damage predicts end stage renal disease in lupus nephritis with preserved to moderately impaired renal function: A retrospective cohort study

“…Further studies are needed to determine if early treatment with MMF in these patients may be beneficial to prevent TID. Novel approaches including molecular imaging, cell distance mapping, functional magnetic resonance imaging, as well as integrative biology approaches are being developed to identify early inflammatory changes, biomarkers and response to treatment in lupus nephritis [52–55]. …”

Quantitative Methods in Abdominal MRI

“…ASL-derived estimates of cortical perfusion also correlate with CKD stage and the estimated glomerular filtration rate (eGFR) in patients with diabetic nephropathy (34). Similarly, ASL-derived estimates of renal blood flow are statistically different between patients with lupus nephritis and controls (35). ASL is particularly well suited to assess renal transplants because of the common superficial location of renal allografts in the pelvis.…”