Original Research

REnal Flow and Microstructure AnisotroPy (REFMAP) MRI in Normal and Peritumoral Renal Tissue

Corresponding Author

Andrea L. Liu BA

[email protected]

New York University School of Medicine, New York, New York, USA

Address reprint requests to: A.L.L., 660 First Ave., New York, NY 10016. E-mail: [email protected]Search for more papers by this author

Artem Mikheev BS,

Artem Mikheev BS

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Henry Rusinek PhD,

Henry Rusinek PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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William C. Huang MD,

William C. Huang MD

Department of Urology, New York University School of Medicine, New York, New York, USA

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James S. Wysock MD, MS,

James S. Wysock MD, MS

Department of Urology, New York University School of Medicine, New York, New York, USA

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James S. Babb PhD,

James S. Babb PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Thorsten Feiweier PhD,

Thorsten Feiweier PhD

Siemens Healthcare GmbH, Erlangen, Germany

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David Stoffel BS,

David Stoffel BS

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Hersh Chandarana MD,

Hersh Chandarana MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Eric E. Sigmund PhD,

Eric E. Sigmund PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Andrea L. Liu BA,

Corresponding Author

Andrea L. Liu BA

[email protected]

New York University School of Medicine, New York, New York, USA

Address reprint requests to: A.L.L., 660 First Ave., New York, NY 10016. E-mail: [email protected]Search for more papers by this author

Artem Mikheev BS,

Artem Mikheev BS

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

Search for more papers by this author

Henry Rusinek PhD,

Henry Rusinek PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

Search for more papers by this author

William C. Huang MD,

William C. Huang MD

Department of Urology, New York University School of Medicine, New York, New York, USA

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James S. Wysock MD, MS,

James S. Wysock MD, MS

Department of Urology, New York University School of Medicine, New York, New York, USA

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James S. Babb PhD,

James S. Babb PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Thorsten Feiweier PhD,

Thorsten Feiweier PhD

Siemens Healthcare GmbH, Erlangen, Germany

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David Stoffel BS,

David Stoffel BS

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Hersh Chandarana MD,

Hersh Chandarana MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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Eric E. Sigmund PhD,

Eric E. Sigmund PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging and Innovation (CAI²R), New York University School of Medicine, New York, New York, USA

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First published: 13 January 2018

https://doi.org/10.1002/jmri.25940

Citations: 12

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Abstract

Background

Diffusion-weighted imaging (DWI) provides insight into the pathophysiology underlying renal dysfunction. Variants of DWI include intravoxel incoherent motion (IVIM), which differentiates between microstructural diffusion and vascular or tubular flow, and diffusion tensor imaging (DTI), which quantifies diffusion directionality.

Purpose

To investigate the reproducibility of joint IVIM-DTI and compare controls to presurgical renal mass patients.

Study Type

Prospective cross-sectional.

Subjects

Thirteen healthy controls and ten presurgical renal mass patients were scanned. Ten controls were scanned twice to investigate reproducibility.

Field Strength/Sequence

Subjects were scanned on a 3T system using 10 b-values and 20 diffusion directions for IVIM-DTI in a study approved by the local Institutional Review Board.

Assessment

Retrospective coregistration and measurement of joint IVIM-DTI parameters were performed.

Statistical Analysis

Parameter reproducibility was defined as intraclass correlation coefficient (ICC) >0.7 and coefficient of variation (CV) <30%. Patient data were stratified by lesion side (contralateral/ipsilateral) for comparison with controls. Corticomedullary differentiation was evaluated.

Results

In controls, the reproducible subset of REnal Flow and Microstructure AnisotroPy (REFMAP) parameters had average ICC = 0.82 and CV = 7.5%. In renal mass patients, medullary fractional anisotropy (FA) was significantly lower than in controls (0.227 ± 0.072 vs. 0.291 ± 0.044, P = 0.016 for the kidney contralateral to the mass and 0.228 ± 0.070 vs. 0.291 ± 0.044, P = 0.018 for the kidney ipsilateral). In the kidney ipsilateral to the mass, cortical D_p,radial was significantly higher than in controls (P = 0.012). Conversely, medullary D_p,axial was significantly lower in contralateral than ipsilateral kidneys (P = 0.027) and normal controls (P = 0.044).

Data Conclusion

REFMAP-MRI parameters provide unique information regarding renal dysfunction. In presurgical renal mass patients, directional flow changes were noted that were not identified with IVIM analysis alone. Both contralateral and ipsilateral kidneys in patients show reductions in structural diffusivities and anisotropy, while flow metrics showed opposing changes in contralateral vs. ipsilateral kidneys.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018.

Conflict of Interest

Thorsten Feiweier is an employee of Siemens Healthcare GmbH, owns stocks of Siemens AG, and holds patents filed by Siemens.

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Citing Literature

Volume48, Issue1

July 2018

Pages 188-197

REnal Flow and Microstructure AnisotroPy (REFMAP) MRI in Normal and Peritumoral Renal Tissue

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Analysis

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Information

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REnal Flow and Microstructure AnisotroPy (REFMAP) MRI in Normal and Peritumoral Renal Tissue

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Analysis

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Related

Information