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How bold is blood oxygenation level dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions

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Item Type:Review
Title:How bold is blood oxygenation level dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions
Creators Name:Niendorf, T. and Pohlmann, A. and Arakelyan, K. and Flemming, B. and Cantow, K. and Hentschel, J. and Grosenick, D. and Ladwig, M. and Reimann, H. and Klix, S. and Waiczies, S. and Seeliger, E.
Abstract:Renal tissue hypoperfusion and hypoxia are key elements in the pathophysiology of acute kidney injury and its progression to chronic kidney disease. Yet, in vivo assessment of renal haemodynamics and tissue oxygenation remains a challenge. Many of the established approaches are invasive, hence not applicable in humans. Blood oxygenation level dependent (BOLD) magnetic resonance imaging (MRI) offers an alternative. BOLD-MRI is non-invasive and indicative of renal tissue oxygenation. Nonetheless recent (pre-)clinical studies revived the question as to how bold renal BOLD-MRI really is. This review aims to deliver some answers. It is designed to inspire the renal physiology, nephrology, and imaging communities to foster explorations into the assessment of renal oxygenation and haemodynamics by exploiting the powers of MRI. For this purpose the specifics of renal oxygenation and perfusion are outlined. The fundamentals of BOLD-MRI are summarized. The link between tissue oxygenation and the oxygenation sensitive MR biomarker T2 * is outlined. The merits and limitations of renal BOLD-MRI in animal and human studies are surveyed together with their clinical implications. Explorations into detailing the relation between renal T2 * and renal tissue partial pressure of oxygen (pO2 ) are discussed with a focus on factors confounding the T2 * versus tissue pO2 relation. Multi-modality in vivo approaches suitable for detailing the role of the confounding factors that govern T2 * are considered. A schematic approach describing the link between renal perfusion, oxygenation, tissue compartments and renal T2 * is proposed. Future directions of MRI assessment of renal oxygenation and perfusion are explored.
Keywords:Magnetic Resonance Imaging BOLD, Acute Kidney Injury, Integrative Physiology, Renal Oxygenation, Renal Perfusion, Renal Vasculature, Tubular Compartment, MR-PHYSIOL, Animals
Source:Acta Physiologica
ISSN:1748-1708
Publisher:Wiley-Blackwell (U.K.)
Volume:213
Number:1
Page Range:19-38
Date:January 2015
Official Publication:https://doi.org/10.1111/apha.12393
PubMed:View item in PubMed

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