Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography

Akira Yamamoto, Jeff L. Zhang, Henry Rusinek, Hersh Chandarana, Pierre Hugues Vivier, James S. Babb, Thomas Diflo, Devon G. John, Judith A. Benstein, Laura Barisoni-Thomas, David R. Stoffel, Vivian S. Lee

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance(MR) renography to help identify the cause of acute graft dysfunction. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years;age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate(GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTTA), the tubular compartment (MTTT), and the collecting system compartment (MTTC) were calculated. Also derived was MTT for the whole kidney (MTTK = MTTA + MTTT + MTTC) and fractional MTT of each compartment (MTTA/K = MTTA /MTTK, MTTT/K = MTTT /MTTK, MTTC/K = MTTC/MTTK). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance. Results: There were significant differences in GFR and MTTK between the acute dysfunction group(36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P<.001 and P =.004). The MTTA/K was significantly higher in the acute rejection group (mean, 12.7% ± 2.9) than in the normal function group (mean, 8.3% ± 2.2; P<.001) or in the ATN group (mean, 7.1% ± 1.4; P<.001). The MTTT/K was significantly higher in the ATN group (mean, 83.2% ± 9.2) than in the normal function group (mean, 72.4% ± 10.2; P =.031) or in the acute rejection group (mean, 69.2% ± 6.1; P =.003). Conclusion: Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.

Original languageEnglish
Pages (from-to)781-789
Number of pages9
JournalRadiology
Volume260
Issue number3
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

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Radioisotope Renography
Magnetic Resonance Spectroscopy
Transplants
Kidney
Necrosis
Glomerular Filtration Rate
Health Insurance Portability and Accountability Act
(5-methoxy-2-thienyl)thioacetic acid
Research Ethics Committees
Drug-Related Side Effects and Adverse Reactions
Informed Consent
Kidney Transplantation
Blood Vessels

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Yamamoto, A., Zhang, J. L., Rusinek, H., Chandarana, H., Vivier, P. H., Babb, J. S., ... Lee, V. S. (2011). Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography. Radiology, 260(3), 781-789. https://doi.org/10.1148/radiol.11101664

Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography. / Yamamoto, Akira; Zhang, Jeff L.; Rusinek, Henry; Chandarana, Hersh; Vivier, Pierre Hugues; Babb, James S.; Diflo, Thomas; John, Devon G.; Benstein, Judith A.; Barisoni-Thomas, Laura; Stoffel, David R.; Lee, Vivian S.

In: Radiology, Vol. 260, No. 3, 01.09.2011, p. 781-789.

Research output: Contribution to journalArticle

Yamamoto, A, Zhang, JL, Rusinek, H, Chandarana, H, Vivier, PH, Babb, JS, Diflo, T, John, DG, Benstein, JA, Barisoni-Thomas, L, Stoffel, DR & Lee, VS 2011, 'Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography', Radiology, vol. 260, no. 3, pp. 781-789. https://doi.org/10.1148/radiol.11101664
Yamamoto A, Zhang JL, Rusinek H, Chandarana H, Vivier PH, Babb JS et al. Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography. Radiology. 2011 Sep 1;260(3):781-789. https://doi.org/10.1148/radiol.11101664
Yamamoto, Akira ; Zhang, Jeff L. ; Rusinek, Henry ; Chandarana, Hersh ; Vivier, Pierre Hugues ; Babb, James S. ; Diflo, Thomas ; John, Devon G. ; Benstein, Judith A. ; Barisoni-Thomas, Laura ; Stoffel, David R. ; Lee, Vivian S. / Quantitative evaluation of acute renal transplant dysfunction with low-dose threedimensional MR renography. In: Radiology. 2011 ; Vol. 260, No. 3. pp. 781-789.
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abstract = "Purpose: To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance(MR) renography to help identify the cause of acute graft dysfunction. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years;age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate(GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTTA), the tubular compartment (MTTT), and the collecting system compartment (MTTC) were calculated. Also derived was MTT for the whole kidney (MTTK = MTTA + MTTT + MTTC) and fractional MTT of each compartment (MTTA/K = MTTA /MTTK, MTTT/K = MTTT /MTTK, MTTC/K = MTTC/MTTK). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance. Results: There were significant differences in GFR and MTTK between the acute dysfunction group(36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P<.001 and P =.004). The MTTA/K was significantly higher in the acute rejection group (mean, 12.7{\%} ± 2.9) than in the normal function group (mean, 8.3{\%} ± 2.2; P<.001) or in the ATN group (mean, 7.1{\%} ± 1.4; P<.001). The MTTT/K was significantly higher in the ATN group (mean, 83.2{\%} ± 9.2) than in the normal function group (mean, 72.4{\%} ± 10.2; P =.031) or in the acute rejection group (mean, 69.2{\%} ± 6.1; P =.003). Conclusion: Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.",
author = "Akira Yamamoto and Zhang, {Jeff L.} and Henry Rusinek and Hersh Chandarana and Vivier, {Pierre Hugues} and Babb, {James S.} and Thomas Diflo and John, {Devon G.} and Benstein, {Judith A.} and Laura Barisoni-Thomas and Stoffel, {David R.} and Lee, {Vivian S.}",
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AU - Yamamoto, Akira

AU - Zhang, Jeff L.

AU - Rusinek, Henry

AU - Chandarana, Hersh

AU - Vivier, Pierre Hugues

AU - Babb, James S.

AU - Diflo, Thomas

AU - John, Devon G.

AU - Benstein, Judith A.

AU - Barisoni-Thomas, Laura

AU - Stoffel, David R.

AU - Lee, Vivian S.

PY - 2011/9/1

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N2 - Purpose: To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance(MR) renography to help identify the cause of acute graft dysfunction. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years;age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate(GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTTA), the tubular compartment (MTTT), and the collecting system compartment (MTTC) were calculated. Also derived was MTT for the whole kidney (MTTK = MTTA + MTTT + MTTC) and fractional MTT of each compartment (MTTA/K = MTTA /MTTK, MTTT/K = MTTT /MTTK, MTTC/K = MTTC/MTTK). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance. Results: There were significant differences in GFR and MTTK between the acute dysfunction group(36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P<.001 and P =.004). The MTTA/K was significantly higher in the acute rejection group (mean, 12.7% ± 2.9) than in the normal function group (mean, 8.3% ± 2.2; P<.001) or in the ATN group (mean, 7.1% ± 1.4; P<.001). The MTTT/K was significantly higher in the ATN group (mean, 83.2% ± 9.2) than in the normal function group (mean, 72.4% ± 10.2; P =.031) or in the acute rejection group (mean, 69.2% ± 6.1; P =.003). Conclusion: Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.

AB - Purpose: To assess prospectively the ability of quantitative low-dose three-dimensional magnetic resonance(MR) renography to help identify the cause of acute graft dysfunction. Materials and Methods: This HIPAA-compliant study was approved by the institutional review board, and written informed consent was obtained. Between December 2001 and May 2009, sixty patients with transplanted kidneys (41 men and 19 women; mean age, 49 years;age range, 22-71 years) were included. Thirty-one patients had normal function and 29 had acute dysfunction due to acute rejection (n = 12), acute tubular necrosis (ATN) (n = 8), chronic rejection (n = 6), or drug toxicity (n = 3). MR renography was performed at 1.5 T with three-dimensional gradient-echo imaging. With use of a multicompartment renal model, the glomerular filtration rate(GFR) and the mean transit time (MTT) of the tracer for the vascular compartment (MTTA), the tubular compartment (MTTT), and the collecting system compartment (MTTC) were calculated. Also derived was MTT for the whole kidney (MTTK = MTTA + MTTT + MTTC) and fractional MTT of each compartment (MTTA/K = MTTA /MTTK, MTTT/K = MTTT /MTTK, MTTC/K = MTTC/MTTK). These parameters were compared in patients in the different study groups. Statistical analysis was performed by using analysis of covariance. Results: There were significant differences in GFR and MTTK between the acute dysfunction group(36.4 mL/min ± 20.8 [standard deviation] and 177.1 seconds ± 46.8, respectively) and the normal function group (65.9 mL/min ± 27.6 and 140.5 seconds ± 51.8, respectively) (P<.001 and P =.004). The MTTA/K was significantly higher in the acute rejection group (mean, 12.7% ± 2.9) than in the normal function group (mean, 8.3% ± 2.2; P<.001) or in the ATN group (mean, 7.1% ± 1.4; P<.001). The MTTT/K was significantly higher in the ATN group (mean, 83.2% ± 9.2) than in the normal function group (mean, 72.4% ± 10.2; P =.031) or in the acute rejection group (mean, 69.2% ± 6.1; P =.003). Conclusion: Low-dose MR renography analyzed by using a multicompartmental tracer kinetic renal model may help to differentiate noninvasively between acute rejection and ATN after kidney transplantation.

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