Dynamic contrast-enhanced MRI measurement of renal function in healthy participants.
Background High repeatability, accuracy, and precision for renal function measurements need to be achieved to establish renal dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as a clinically useful diagnostic tool. Purpose To investigate the repeatability, accuracy, and precision of DCE-MRI measured renal perfusion and glomerular filtration rate (GFR) using iohexol-GFR as the reference method. Material and Methods Twenty healthy non-smoking volunteers underwent repeated DCE-MRI and an iohexol-GFR within a period of 10 days. Single-kidney (SK) MRI measurements of perfusion (blood flow, Fb) and filtration (GFR) were derived from parenchymal intensity time curves fitted to a two-compartment filtration model. The repeatability of the SK-MRI measurements was assessed using coefficient of variation (CV). Using iohexol-GFR as reference method, the accuracy of total MR-GFR was determined by mean difference (MD) and precision by limits of agreement (LoA). Results SK-Fb(MR1, 345 ± 84; MR2, 371 ± 103 mL/100 mL/min) and SK-GFR (MR1, 52 ± 14; MR2, 54 ± 10 mL/min/1.73 m2) measurements achieved a repeatability (CV) in the range of 15-22%. With reference to iohexol-GFR, MR-GFR was determined with a low mean difference but high LoA (MR1, MD 1.5 mL/min/1.73 m2, LoA [-42, 45]; MR2, MD 6.1 mL/min/1.73 m2, LoA [-26, 38]). Eighty percent and 90% of MR-GFR measurements were determined within ± 30% of the iohexol-GFR for MR1 and MR2, respectively. Conclusion Good repeatability of SK-MRI measurements and good agreement between MR-GFR and iohexol-GFR provide a high clinical potential of DCE-MRI for renal function assessment. A moderate precision in MR-derived estimates indicates that the method cannot yet be used in clinical routine.
1 Department of Radiology, Haukeland University Hospital, Bergen, Norway.|2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Eli
E
Eikefjord
1 Department of Radiology, Haukeland University Hospital, Bergen, Norway.|3 Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway.
Erling
E
Andersen
2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.|4 Christian Michelsen Research (CMR) AS, Bergen, Norway.
Erlend
E
Hodneland
5 Department of Mathematics, University of Bergen, Bergen, Norway.
Erik A
EA
Hanson
6 Faculty of Medicine and Health, University of Leeds, Leeds, UK.
Steven
S
Sourbron
2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.|7 Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Einar
E
Svarstad
1 Department of Radiology, Haukeland University Hospital, Bergen, Norway.|8 Department of Biomedicine, University of Bergen, Bergen, Norway.
Arvid
A
Lundervold
1 Department of Radiology, Haukeland University Hospital, Bergen, Norway.|2 Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Jarle T
JT
Rørvik
D000328:Adult; D003287:Contrast Media; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007472:Iohexol; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012016:Reference Values; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D055815:Young Adult
D003287:Contrast Media; D007472:Iohexol
MR functional imaging; Urinary; adults; imaging sequence; kidney; technology assessment