TY - JOUR
T1 - Probing Renal Microstructure and Function with Advanced Diffusion MRI
T2 - Concepts, Applications, Challenges, and Future Directions
AU - Stabinska, Julia
AU - Wittsack, Hans Jörg
AU - Lerman, Lilach O.
AU - Ljimani, Alexandra
AU - Sigmund, Eric E.
N1 - Publisher Copyright:
© 2023 International Society for Magnetic Resonance in Medicine.
PY - 2023
Y1 - 2023
N2 - Diffusion measurements in the kidney are affected not only by renal microstructure but also by physiological processes (i.e., glomerular filtration, water reabsorption, and urine formation). Because of the superposition of passive tissue diffusion, blood perfusion, and tubular pre-urine flow, the limitations of the monoexponential apparent diffusion coefficient (ADC) model in assessing pathophysiological changes in renal tissue are becoming apparent and motivate the development of more advanced diffusion-weighted imaging (DWI) variants. These approaches take advantage of the fact that the length scale probed in DWI measurements can be adjusted by experimental parameters, including diffusion-weighting, diffusion gradient directions and diffusion time. This forms the basis by which advanced DWI models can be used to capture not only passive diffusion effects, but also microcirculation, compartmentalization, tissue anisotropy. In this review, we provide a comprehensive overview of the recent advancements in the field of renal DWI. Following a short introduction on renal structure and physiology, we present the key methodological approaches for the acquisition and analysis of renal DWI data, including intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), non-Gaussian diffusion, and hybrid IVIM-DTI. We then briefly summarize the applications of these methods in chronic kidney disease and renal allograft dysfunction. Finally, we discuss the challenges and potential avenues for further development of renal DWI. Level of Evidence: 5. Technical Efficacy: Stage 2.
AB - Diffusion measurements in the kidney are affected not only by renal microstructure but also by physiological processes (i.e., glomerular filtration, water reabsorption, and urine formation). Because of the superposition of passive tissue diffusion, blood perfusion, and tubular pre-urine flow, the limitations of the monoexponential apparent diffusion coefficient (ADC) model in assessing pathophysiological changes in renal tissue are becoming apparent and motivate the development of more advanced diffusion-weighted imaging (DWI) variants. These approaches take advantage of the fact that the length scale probed in DWI measurements can be adjusted by experimental parameters, including diffusion-weighting, diffusion gradient directions and diffusion time. This forms the basis by which advanced DWI models can be used to capture not only passive diffusion effects, but also microcirculation, compartmentalization, tissue anisotropy. In this review, we provide a comprehensive overview of the recent advancements in the field of renal DWI. Following a short introduction on renal structure and physiology, we present the key methodological approaches for the acquisition and analysis of renal DWI data, including intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), non-Gaussian diffusion, and hybrid IVIM-DTI. We then briefly summarize the applications of these methods in chronic kidney disease and renal allograft dysfunction. Finally, we discuss the challenges and potential avenues for further development of renal DWI. Level of Evidence: 5. Technical Efficacy: Stage 2.
KW - diffusion kurtosis imaging
KW - diffusion tensor imaging
KW - intravoxel incoherent motion
KW - kidney
KW - non-Gaussian diffusion
KW - renal diffusion-weighted imaging
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U2 - 10.1002/jmri.29127
DO - 10.1002/jmri.29127
M3 - Review article
AN - SCOPUS:85177600931
SN - 1053-1807
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
ER -