Multiparametric Renal MRI: An Intrasubject Test-Retest Repeatability Study

J Magn Reson Imaging. 2021 Mar;53(3):859-873. doi: 10.1002/jmri.27167. Epub 2020 Apr 16.

Abstract

Background: Renal multiparametric magnetic resonance imaging (MRI) is a promising tool for diagnosis, prognosis, and treatment monitoring in kidney disease.

Purpose: To determine intrasubject test-retest repeatability of renal MRI measurements.

Study type: Prospective.

Population: Nineteen healthy subjects aged over 40 years.

Field strength/sequences: T1 and T2 mapping, R2 * mapping or blood oxygenation level-dependent (BOLD) MRI, diffusion tensor imaging (DTI), and intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI), 2D phase contrast, arterial spin labelling (ASL), dynamic contrast enhanced (DCE) MRI, and quantitative Dixon for fat quantification at 3T.

Assessment: Subjects were scanned twice with ~1 week between visits. Total scan time was ~1 hour. Postprocessing included motion correction, semiautomated segmentation of cortex and medulla, and fitting of the appropriate signal model.

Statistical test: To assess the repeatability, a Bland-Altman analysis was performed and coefficients of variation (CoVs), repeatability coefficients, and intraclass correlation coefficients were calculated.

Results: CoVs for relaxometry (T1 , T2 , R2 */BOLD) were below 6.1%, with the lowest CoVs for T2 maps and highest for R2 */BOLD. CoVs for all diffusion analyses were below 7.2%, except for perfusion fraction (FP ), with CoVs ranging from 18-24%. The CoV for renal sinus fat volume and percentage were both around 9%. Perfusion measurements were most repeatable with ASL (cortical perfusion only) and 2D phase contrast with CoVs of 10% and 13%, respectively. DCE perfusion had a CoV of 16%, while single kidney glomerular filtration rate (GFR) had a CoV of 13%. Repeatability coefficients (RCs) ranged from 7.7-87% (lowest/highest values for medullary mean diffusivity and cortical FP , respectively) and intraclass correlation coefficients (ICCs) ranged from -0.01 to 0.98 (lowest/highest values for cortical FP and renal sinus fat volume, respectively).

Data conclusion: CoVs of most MRI measures of renal function and structure (with the exception of FP and perfusion as measured by DCE) were below 13%, which is comparable to standard clinical tests in nephrology.

Level of evidence: 2 TECHNICAL EFFICACY: Stage 1.

Keywords: MRI; functional; kidney; multiparametric; repeatability; reproducibility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diffusion
  • Female
  • Glomerular Filtration Rate
  • Healthy Volunteers
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Image Processing, Computer-Assisted
  • Kidney / diagnostic imaging*
  • Male
  • Middle Aged
  • Models, Statistical
  • Motion
  • Multiparametric Magnetic Resonance Imaging / methods*
  • Perfusion
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Spin Labels

Substances

  • Spin Labels