2563: Non-contrast enhanced 7 tesla MR imaging for non-invasive monitoring of chronic rejection in reconstructive transplantation

Abstract

2563: Non-contrast enhanced 7 tesla MR imaging for non-invasive monitoring of chronic rejection in reconstructive transplantation Shailesh Raval, MS, Tiejun Zhao, PhD, Narayan Krishnamurthy, Tamer Ibrahim, PhD, and Vijay S. Gorantla, MD, PhD University of Pittsburgh, Pittsburgh, PA, USA; Siemens Healthineers, Malvern, PA, USA Introduction Chronic rejection (CR) in solid organ and reconstructive transplantation (RT) is associated with progressive, occlusive intimal hyperplasia (IH) resulting in ischemic graft loss Four hand transplants and 1 face transplant have been lost to CR Skin biopsies can detect acute rejection (AR) but miss CR changes Early detection is key to prevent CR graft loss Sequential vascular mapping with CT angiography is fraught with radiation/contrast risks and intravascular imaging is invasive or lead to graft ischemia For the first time, we developed a non-invasive, reliable and reproducible, non-radiation, contrast-free, ultra-high resolution (UHR) 3D vascular MRI imaging strategy for preoperative (surgical planning) and perioperative (graft viability) and post-transplant (CR monitoring) applications in RT. Results Our non-contrast technique allowed UHR luminal and vessel wall imaging in the CF and UE tissues Volume-rendering and post-processing allowed successful 3D-reconstruction and segmenting micro/macrovasculature of CF and UE without skeletonization or dilation Figure 1 summarizes T1-VIBE, T2-DESS and DSI revealing exquisite detail of soft tissue anatomy (vessels, muscles, nerve, fat, ligaments, and tendons). Conclusion Current state of the art imaging in RT includes conventional imaging (3D-CT, 15/3TMRI, CT-angio, intravascular-ultrasound, plain-radiography) and stereolithography for surgical planning with limitation like radiation, renal toxic contrast or are of sub-optimal resolution to map microvessels /other structures Our approach is renal-toxic-contrast and radiationfree, increasing its safety in RT (CF or UE) or even solid organ (eg renal transplant) applications for sequential non-invasive graft monitoring of CR In addition, UHR imaging can be used for monitoring of neuroregeneration after transection/repair or transplant related nerve outcomes as well as identifying precise localization of various structures for patient screening/selection, procedural planning and sequential monitoring of macro/microvascular parameters. CONTACT Shailesh Raval, MS rshailesh8504@gmail.com Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/kvca. © 2016 Shailesh Raval, Tiejun Zhao Tiejun Zhao, Narayan Krishnamurthy, Tamer Ibrahim, and Vijay S. Gorantla. Published with license by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted. VASCULARIZED COMPOSITE ALLOTRANSPLANTATION 2016, VOL. 3, NOS. 1–2, 21–22 http://dx.doi.org/10.1080/23723505.2016.1233014