A new technique with high reproducibility to estimate renal oxygenation using BOLD-MRI in chronic kidney disease

Magn Reson Imaging. 2015 Apr;33(3):253-61. doi: 10.1016/j.mri.2014.12.002. Epub 2014 Dec 15.


Objectives: To assess inter-observer variability of renal blood oxygenation level-dependent MRI (BOLD-MRI) using a new method of analysis, called the concentric objects (CO) technique, in comparison with the classical ROI (region of interest)-based technique.

Methods: MR imaging (3T) was performed before and after furosemide in 10 chronic kidney disease (CKD) patients (mean eGFR 43±24ml/min/1.73m(2)) and 10 healthy volunteers (eGFR 101±28ml/min1.73m(2)), and R2* maps were determined on four coronal slices. In the CO-technique, R2* values were based on a semi-automatic procedure that divided each kidney in six equal layers, whereas in the ROI-technique, all circles (ROIs) were placed manually in the cortex and medulla. The mean R2*values as assessed by two independent investigators were compared.

Results: With the CO-technique, inter-observer variability was 0.7%-1.9% across all layers in non-CKD, versus 1.6%-3.8% in CKD. With the ROI-technique, median variability for cortical and medullary R2* values was 3.6 and 6.8% in non-CKD, versus 4.7 and 12.5% in CKD; similar results were observed after furosemide.

Conclusion: The CO-technique offers a new, investigator-independent, highly reproducible alternative to the ROI-based technique to estimate renal tissue oxygenation in CKD.

Keywords: BOLD-MRI; Chronic kidney disease; Concentric objects; Furosemide; Imaging analysis; Onion peel technique; Region of interest; Reproducibility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Automation
  • Electronic Data Processing
  • Female
  • Furosemide / chemistry
  • Glomerular Filtration Rate
  • Healthy Volunteers
  • Humans
  • Image Processing, Computer-Assisted
  • Kidney / metabolism*
  • Kidney / physiopathology
  • Kidney Cortex
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Oxygen Consumption*
  • Prognosis
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / physiopathology
  • Reproducibility of Results
  • Software


  • Furosemide