Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors Pre-nephrectomy and post-nephrectomy.

OBJECTIVES: Renal plasma flow (RPF) (derived from renal blood flow, RBF) and glomerular filtration rate (GFR) allow the determination of the filtration fraction (FF), which may have a role as a non-invasive renal biomarker. This is a hypothesis-generating pilot study assessing the effect of nephrectomy on renal function in healthy kidney donors. METHODS: Eight living kidney donors underwent arterial spin labelling (ASL) magnetic resonance imaging (MRI) and GFR measurement prior to and 1 year after nephrectomy. Chromium-51 labelled ethylenediamine tetraacetic acid ((51)Cr-EDTA) with multi-blood sampling was undertaken and GFR calculated. The RBF and GFR obtained were used to calculate FF. RESULTS: All donors showed an increase in single kidney GFR of 24 - 75 %, and all but two showed an increase in FF (-7 to +52 %) after nephrectomy. The increase in RBF, and hence RPF, post-nephrectomy was not as great as the increase in GFR in seven out of eight donors. As with any pilot study, the small number of donors and their relatively narrow age range are potential limiting factors. CONCLUSIONS: The ability to measure RBF, and hence RPF, non-invasively, coupled with GFR measurement, allows calculation of FF, a biomarker that might provide a sensitive indicator of loss of renal reserve in potential donors. KEY POINTS: • Non-invasive MRI measured renal blood flow and calculated renal plasma flow. • Effect of nephrectomy on blood flow and filtration in donors is presented. • Calculated filtration fraction may be a useful new kidney biomarker.

Comparison of ASL and DCE MRI for the non-invasive measurement of renal blood flow: quantification and reproducibility.

OBJECTIVES: To investigate the reproducibility of arterial spin labelling (ASL) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and quantitatively compare these techniques for the measurement of renal blood flow (RBF). METHODS: Sixteen healthy volunteers were examined on two different occasions. ASL was performed using a multi-TI FAIR labelling scheme with a segmented 3D-GRASE imaging module. DCE MRI was performed using a 3D-FLASH pulse sequence. A Bland-Altman analysis was used to assess repeatability of each technique, and determine the degree of correspondence between the two methods. RESULTS: The overall mean cortical renal blood flow (RBF) of the ASL group was 263 ± 41 ml min(-1) [100 ml tissue](-1), and using DCE MRI was 287 ± 70 ml min(-1) [100 ml tissue](-1). The group coefficient of variation (CVg) was 18 % for ASL and 28 % for DCE-MRI. Repeatability studies showed that ASL was more reproducible than DCE with CVgs of 16 % and 25 % for ASL and DCE respectively. Bland-Altman analysis comparing the two techniques showed a good agreement. CONCLUSIONS: The repeated measures analysis shows that the ASL technique has better reproducibility than DCE-MRI. Difference analysis shows no significant difference between the RBF values of the two techniques. KEY POINTS: Reliable non-invasive monitoring of renal blood flow is currently clinically unavailable. Renal arterial spin labelling MRI is robust and repeatable. Renal dynamic contrast-enhanced MRI is robust and repeatable. ASL blood flow values are similar to those obtained using DCE-MRI.

Precise measurement of renal filtration and vascular parameters using a two-compartment model for dynamic contrast-enhanced MRI of the kidney gives realistic normal values.

OBJECTIVE: To model the uptake phase of T(1)-weighted DCE-MRI data in normal kidneys and to demonstrate that the fitted physiological parameters correlate with published normal values. METHODS: The model incorporates delay and broadening of the arterial vascular peak as it appears in the capillary bed, two distinct compartments for renal intravascular and extravascular Gd tracer, and uses a small-vessel haematocrit value of 24%. Four physiological parameters can be estimated: regional filtration K ( trans ) (ml min(-1) [ml tissue](-1)), perfusion F (ml min(-1) [100 ml tissue](-1)), blood volume v ( b ) (%) and mean residence time MRT (s). From these are found the filtration fraction (FF; %) and total GFR (ml min(-1)). Fifteen healthy volunteers were imaged twice using oblique coronal slices every 2.5 s to determine the reproducibility. RESULTS: Using parenchymal ROIs, group mean values for renal biomarkers all agreed with published values: K ( trans ): 0.25; F: 219; v ( b ): 34; MRT: 5.5; FF: 15; GFR: 115. Nominally cortical ROIs consistently underestimated total filtration (by ~50%). Reproducibility was 7-18%. Sensitivity analysis showed that these fitted parameters are most vulnerable to errors in the fixed parameters kidney T(1), flip angle, haematocrit and relaxivity. CONCLUSIONS: These renal biomarkers can potentially measure renal physiology in diagnosis and treatment. KEY POINTS: • Dynamic contrast-enhanced magnetic resonance imaging can measure renal function. • Filtration and perfusion values in healthy volunteers agree with published normal values. • Precision measured in healthy volunteers is between 7 and 15%.

Repeatability of renal arterial spin labelling MRI in healthy subjects.

OBJECT: Arterial spin labelling (ASL) can be used to measure renal perfusion non-invasively. The aim of this study was to determine the repeatability of this technique in healthy kidneys to vindicate its use in clinic. MATERIALS AND METHODS: Two groups of healthy volunteers were imaged two different days to assess intra- and inter-session repeatability. Oblique-coronal data volumes were acquired on a 1.5 T scanner with a dedicated abdominal 32-channel body phased array coil. ASL was performed using a multi-TI FAIR labelling scheme and 3D GRASE imaging module. Background suppression and respiratory triggering were used. T(1) maps of the kidney were acquired using the same sequence with background suppression disabled. RESULTS: For the group with multiple intra-session ASL measurements, the average cortical perfusion was 197 mL min(-1)100 g(-1) and average cortical T(1) was 1265 ms. For both perfusion and T(1) the variation shown by the within-subject standard deviation (SDws) (14.6 mL min(-1)100 g(-1) and 33.4 ms) and coefficient of variation (CVws) (7.52 and 2.69%, respectively) was small for all the analyses carried out. Bland-Altman plots were also used to visualise the variation between the same parameters collected from the different scanning sessions in both groups, and demonstrated good reproducibility. CONCLUSION: We have shown that in healthy volunteers, ASL parameters are repeatable over a short and long period. This supports the overall aim of using ASL in the clinic to assess longitudinal renal perfusion changes in patients.

Test-retest reliability and repeatability of renal diffusion tensor MRI in healthy subjects.

PURPOSE: This study assessed test-retest reliability and repeatability of diffusion tensor imaging (DTI) in the kidneys. MATERIALS AND METHODS: Seven healthy volunteers (age range, 19-31 years), were imaged three consecutive times on the same day (short-term reliability) and the same imaging protocol was repeated after a month (long-term reliability). Diffusion-weighted magnetic resonance imaging scans in the coronal-oblique projection of the kidney were acquired on a 1.5 T scanner using a multi-section echo-planar sequence; six contiguous slices each 5 mm thick, diffusion sensitisation along 20 non-collinear directions, TR=730 ms, TE=73 ms and 2 b-values (0 and 400 s mm(-2)). Volunteers were asked to hold their breath throughout each data acquisition (approx. 20 s). The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were obtained from maps generated using dedicated software MIStar (Apollo Medical Imaging, Melbourne, Australia). RESULTS: Statistical analyses of both short- and long-term repeats were carried out from which the within-subject coefficient of variation (wsCV) was calculated. The wsCV obtained for both the ADC and FA values were less than 10% in all the analyses carried out. In addition, paired (repeated measures) t-test was used to measure the variation between the diffusion parameters collected from the two scanning sessions a month apart. It showed no significant difference and the wsCV obtained after comparing the first and second scans were found to be smaller than 15% for both ADC and FA. CONCLUSION: Renal DTI produces reliable and repeatable results which make longitudinal investigation of patients viable.

Structure and NMR assignment in calcined and as-synthesized forms of AlPO-14: a combined study by first-principles calculations and high-resolution 27Al-31P MAS NMR correlation.

The high-resolution 27Al and 31P NMR spectra of two as-synthesized forms of the microporous aluminophosphate AlPO-14 and the corresponding calcined-dehydrated form were assigned using both "first-principles" calculations of NMR parameters (GIPAW, as implemented in NMR-CASTEP) and a 27Al-31P heteronuclear correlation NMR experiment (MQ-J-HETCOR) that exploits 27Al multiple-quantum coherences and J couplings to identify Al-O-P linkages. NMR parameters calculated from published AlPO-14 crystal structures, which are derived from powder X-ray diffraction (XRD) data, are in poor agreement with experiment and it was necessary to optimize the structure geometry using energy minimization before satisfactory agreement was obtained. Comparison of simulated powder XRD patterns from the experimental and the energy-minimized structures shows that the changes in relative atomic positions in the optimized structure are relatively small and yield only minor adjustments in the Bragg peak intensities. These results indicate that a combination of NMR spectroscopy and first-principles calculation of NMR parameters may soon be considered a generally useful step in the refinement of the structures of microporous materials derived from powder diffraction data.

Five-coordinate Pd(II) orthometallated triarylphosphite complexes.

The reaction of the orthopalladated triarylphosphite complexes [{Pd(mu-Cl){kappa(2)-P,C-P(OC(6)H(2)-2,4-R(2))(OC(6)H(3)-2,4-R(2))}(2)] (R = H, (t)Bu) with bis(2-diphenylphosphinoethyl)phenylphosphine leads to a five-coordinate palladium(II) (R = H) and a mixture containing four-and five-coordinate species (R = (t)Bu). The crystal structure of the five-coordinate species [Pd{kappa(2)-P,C-(P(OC(6)H(4))(OC(6)H(5))(2)}{bis(2-diphenylphosphinoethyl)phenylphosphine}][SbF(6)] is presented. This complex reacts with hydrogen peroxide or [AuCl(tht)] to give four-coordinate complexes in which the displaced phosphine residue is either oxidised or coordinated to gold chloride; this demonstrates that the five-coordinate complexes are labile in solution. By contrast, the reactions of the dimeric precursors with 1,1,1-tris(diphenylphosphinomethyl)ethane give four-coordinate complexes in the solid state, although evidence is presented that the smaller phosphite-containing system is five-coordinate at room temperature or higher in solution.