Xiaoxi Liu, Ying-Chieh Lai, Di Cui, Shiang-Cheng Kung, Meyeon Park, Zoltan Laszik, Peder E Z Larson, Zhen J Wang
{"title":"肾移植患者使用超极化[1-13C]丙酮酸核磁共振成像进行代谢成像的初步经验。","authors":"Xiaoxi Liu, Ying-Chieh Lai, Di Cui, Shiang-Cheng Kung, Meyeon Park, Zoltan Laszik, Peder E Z Larson, Zhen J Wang","doi":"10.1002/jmri.29580","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant is the treatment of choice for patients with end-stage renal disease. Early detection of allograft injury is important to delay or prevent irreversible damage.</p><p><strong>Purpose: </strong>To investigate the feasibility of hyperpolarized (HP) [1-<sup>13</sup>C]pyruvate MRI for assessing kidney allograft metabolism.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>Six participants (mean age, 45.2 ± 12.4 years, two females) scheduled for kidney allograft biopsy and five patients (mean age, 59.6 ± 10.4 years, two females) with renal cell carcinoma (RCC).</p><p><strong>Field strength/sequence: </strong>Three Tesla, T2-weighted fast spin echo, multi-echo gradient echo, single shot diffusion-weighted echo-planar imaging, and time-resolved HP <sup>13</sup>C metabolite-selective imaging.</p><p><strong>Assessment: </strong>Five of the six kidney allograft participants underwent biopsy after MRI. Estimated glomerular filtration rate (eGFR) and urine protein-to-creatine ratio (uPCR) were collected within 4 weeks of MRI. Kidney metabolism was quantified from HP [1-<sup>13</sup>C]pyruvate MRI using the lactate-to-pyruvate ratio in allograft kidneys and non-tumor bearing kidneys from RCC patients.</p><p><strong>Statistical tests: </strong>Descriptive statistics (mean ± SD).</p><p><strong>Results: </strong>Biopsy was performed a mean of 9 days (range 5-19 days) after HP [1-<sup>13</sup>C]pyruvate MRI. Three biopsies were normal, one showed low-grade fibrosis and one showed moderate microvascular inflammation. All had stable functioning allografts with eGFR >60 mL/min/1.73 m<sup>2</sup> and normal uPCR. One participant who did not undergo biopsy had reduced eGFR of 49 mL/min/1.73 m<sup>2</sup> and elevated uPCR. The mean lactate-to-pyruvate ratio was 0.373 in participants with normal findings (N = 3) and 0.552 in participants with abnormal findings (N = 2). The lactate-to-pyruvate ratio was highest (0.847) in the participant with reduced eGFR and elevated uPRC. Native non-tumor bearing kidneys had a mean lactate-to-pyruvate ratio of 0.309.</p><p><strong>Data conclusion: </strong>Stable allografts with normal findings at biopsy showed lactate-to-pyruvate ratios similar to native non-tumor bearing kidneys, whereas allografts with abnormal findings showed higher lactate-to-pyruvate ratios.</p><p><strong>Evidence level: </strong>2 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Initial Experience of Metabolic Imaging With Hyperpolarized [1-<sup>13</sup>C]pyruvate MRI in Kidney Transplant Patients.\",\"authors\":\"Xiaoxi Liu, Ying-Chieh Lai, Di Cui, Shiang-Cheng Kung, Meyeon Park, Zoltan Laszik, Peder E Z Larson, Zhen J Wang\",\"doi\":\"10.1002/jmri.29580\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Kidney transplant is the treatment of choice for patients with end-stage renal disease. Early detection of allograft injury is important to delay or prevent irreversible damage.</p><p><strong>Purpose: </strong>To investigate the feasibility of hyperpolarized (HP) [1-<sup>13</sup>C]pyruvate MRI for assessing kidney allograft metabolism.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>Six participants (mean age, 45.2 ± 12.4 years, two females) scheduled for kidney allograft biopsy and five patients (mean age, 59.6 ± 10.4 years, two females) with renal cell carcinoma (RCC).</p><p><strong>Field strength/sequence: </strong>Three Tesla, T2-weighted fast spin echo, multi-echo gradient echo, single shot diffusion-weighted echo-planar imaging, and time-resolved HP <sup>13</sup>C metabolite-selective imaging.</p><p><strong>Assessment: </strong>Five of the six kidney allograft participants underwent biopsy after MRI. Estimated glomerular filtration rate (eGFR) and urine protein-to-creatine ratio (uPCR) were collected within 4 weeks of MRI. Kidney metabolism was quantified from HP [1-<sup>13</sup>C]pyruvate MRI using the lactate-to-pyruvate ratio in allograft kidneys and non-tumor bearing kidneys from RCC patients.</p><p><strong>Statistical tests: </strong>Descriptive statistics (mean ± SD).</p><p><strong>Results: </strong>Biopsy was performed a mean of 9 days (range 5-19 days) after HP [1-<sup>13</sup>C]pyruvate MRI. Three biopsies were normal, one showed low-grade fibrosis and one showed moderate microvascular inflammation. All had stable functioning allografts with eGFR >60 mL/min/1.73 m<sup>2</sup> and normal uPCR. One participant who did not undergo biopsy had reduced eGFR of 49 mL/min/1.73 m<sup>2</sup> and elevated uPCR. The mean lactate-to-pyruvate ratio was 0.373 in participants with normal findings (N = 3) and 0.552 in participants with abnormal findings (N = 2). The lactate-to-pyruvate ratio was highest (0.847) in the participant with reduced eGFR and elevated uPRC. Native non-tumor bearing kidneys had a mean lactate-to-pyruvate ratio of 0.309.</p><p><strong>Data conclusion: </strong>Stable allografts with normal findings at biopsy showed lactate-to-pyruvate ratios similar to native non-tumor bearing kidneys, whereas allografts with abnormal findings showed higher lactate-to-pyruvate ratios.</p><p><strong>Evidence level: </strong>2 TECHNICAL EFFICACY: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29580\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29580","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Initial Experience of Metabolic Imaging With Hyperpolarized [1-13C]pyruvate MRI in Kidney Transplant Patients.
Background: Kidney transplant is the treatment of choice for patients with end-stage renal disease. Early detection of allograft injury is important to delay or prevent irreversible damage.
Purpose: To investigate the feasibility of hyperpolarized (HP) [1-13C]pyruvate MRI for assessing kidney allograft metabolism.
Study type: Prospective.
Subjects: Six participants (mean age, 45.2 ± 12.4 years, two females) scheduled for kidney allograft biopsy and five patients (mean age, 59.6 ± 10.4 years, two females) with renal cell carcinoma (RCC).
Field strength/sequence: Three Tesla, T2-weighted fast spin echo, multi-echo gradient echo, single shot diffusion-weighted echo-planar imaging, and time-resolved HP 13C metabolite-selective imaging.
Assessment: Five of the six kidney allograft participants underwent biopsy after MRI. Estimated glomerular filtration rate (eGFR) and urine protein-to-creatine ratio (uPCR) were collected within 4 weeks of MRI. Kidney metabolism was quantified from HP [1-13C]pyruvate MRI using the lactate-to-pyruvate ratio in allograft kidneys and non-tumor bearing kidneys from RCC patients.
Results: Biopsy was performed a mean of 9 days (range 5-19 days) after HP [1-13C]pyruvate MRI. Three biopsies were normal, one showed low-grade fibrosis and one showed moderate microvascular inflammation. All had stable functioning allografts with eGFR >60 mL/min/1.73 m2 and normal uPCR. One participant who did not undergo biopsy had reduced eGFR of 49 mL/min/1.73 m2 and elevated uPCR. The mean lactate-to-pyruvate ratio was 0.373 in participants with normal findings (N = 3) and 0.552 in participants with abnormal findings (N = 2). The lactate-to-pyruvate ratio was highest (0.847) in the participant with reduced eGFR and elevated uPRC. Native non-tumor bearing kidneys had a mean lactate-to-pyruvate ratio of 0.309.
Data conclusion: Stable allografts with normal findings at biopsy showed lactate-to-pyruvate ratios similar to native non-tumor bearing kidneys, whereas allografts with abnormal findings showed higher lactate-to-pyruvate ratios.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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