Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI

Anneloes de Boer; Giulia Villa; Octavia Bane; Michael Bock; Eleanor F Cox; Ilona A Dekkers; Per Eckerbom; Maria A Fernández-Seara; Susan T Francis; Bryan Haddock; Michael E Hall; Pauline Hall Barrientos; Ingo Hermann; Paul D Hockings; Hildo J Lamb; Christoffer Laustsen; Ruth P Lim; David M Morris; Steffen Ringgaard; Suraj D Serai; Kanishka Sharma; Steven Sourbron; Yasuo Takehara; Andrew L Wentland; Marcos Wolf; Frank G Zöllner; Fabio Nery; Anna Caroli

doi:10.1002/jmri.27419

Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI

J Magn Reson Imaging. 2022 Feb;55(2):323-335. doi: 10.1002/jmri.27419. Epub 2020 Nov 2.

Authors

Anneloes de Boer¹, Giulia Villa², Octavia Bane³, Michael Bock⁴, Eleanor F Cox⁵, Ilona A Dekkers⁶, Per Eckerbom⁷, Maria A Fernández-Seara⁸, Susan T Francis⁵, Bryan Haddock⁹, Michael E Hall¹⁰, Pauline Hall Barrientos¹¹, Ingo Hermann¹², Paul D Hockings¹³, Hildo J Lamb⁶, Christoffer Laustsen¹⁴, Ruth P Lim^{15

16}, David M Morris¹⁷, Steffen Ringgaard¹⁴, Suraj D Serai¹⁸, Kanishka Sharma¹⁹, Steven Sourbron¹⁹, Yasuo Takehara²⁰, Andrew L Wentland²¹, Marcos Wolf²², Frank G Zöllner¹², Fabio Nery²³, Anna Caroli²

Affiliations

¹ Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
² Department of Bioengineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
³ Biomedical Engineering and Imaging Institute/Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁴ Department of Radiology - Medical Physics, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁵ Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.
⁶ Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
⁷ Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
⁸ Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain.
⁹ Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
¹⁰ Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
¹¹ Department of Clinical Physics and Bioengineering, NHS Greater Glasgow and Clyde, Glasgow, UK.
¹² Computer Assisted Clinical Medicine, Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹³ Antaros Medical, BioVenture Hub, Mölndal, Sweden.
¹⁴ Department of Clinical Medicine, MR Research Centre, Aarhus University, Aarhus, Denmark.
¹⁵ Departments of Radiology, Surgery and Medicine, The University of Melbourne, Parkville, Victoria, Australia.
¹⁶ Department of Radiology, Austin Health, Heidelberg, Victoria, Australia.
¹⁷ Centre for Inflammation Research, University of Edinburgh, Edinburgh Bioquarter, Edinburgh, UK.
¹⁸ Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
¹⁹ Department of Imaging, Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK.
²⁰ Department of Fundamental Development for Advanced Low Invasive Diagnostic Imaging, Nagoya University, Graduate School of Medicine, Nagoya, Japan.
²¹ Department of Radiology, Stanford University, Stanford, California, USA.
²² High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
²³ Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK.

Abstract

Background: Phase-contrast (PC) MRI is a feasible and valid noninvasive technique to measure renal artery blood flow, showing potential to support diagnosis and monitoring of renal diseases. However, the variability in measured renal blood flow values across studies is large, most likely due to differences in PC-MRI acquisition and processing. Standardized acquisition and processing protocols are therefore needed to minimize this variability and maximize the potential of renal PC-MRI as a clinically useful tool.

Purpose: To build technical recommendations for the acquisition, processing, and analysis of renal 2D PC-MRI data in human subjects to promote standardization of renal blood flow measurements and facilitate the comparability of results across scanners and in multicenter clinical studies.

Study type: Systematic consensus process using a modified Delphi method.

Population: Not applicable.

Sequence field/strength: Renal fast gradient echo-based 2D PC-MRI.

Assessment: An international panel of 27 experts from Europe, the USA, Australia, and Japan with 6 (interquartile range 4-10) years of experience in 2D PC-MRI formulated consensus statements on renal 2D PC-MRI in two rounds of surveys. Starting from a recently published systematic review article, literature-based and data-driven statements regarding patient preparation, hardware, acquisition protocol, analysis steps, and data reporting were formulated.

Statistical tests: Consensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60-74% agreement among the experts.

Results: Among 60 statements, 57 (95%) achieved consensus after the second-round survey, while the remaining three showed a clear preference. Consensus statements resulted in specific recommendations for subject preparation, 2D renal PC-MRI data acquisition, processing, and reporting.

Data conclusion: These recommendations might promote a widespread adoption of renal PC-MRI, and may help foster the set-up of multicenter studies aimed at defining reference values and building larger and more definitive evidence, and will facilitate clinical translation of PC-MRI.

Level of evidence: 1 TECHNICAL EFFICACY STAGE: 1.

Keywords: consensus; kidney; phase-contrast MRI; renal blood flow; standardization.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Consensus
Delphi Technique
Humans
Kidney*
Magnetic Resonance Imaging*
Multicenter Studies as Topic
Renal Circulation

Abstract

Publication types

MeSH terms

Grants and funding