Thread by @ERAEDTA

Time for a tweetorial on renal MRI! MRI is used to look at structure, but advanced sequences can measure function too. Multiple sequences in 1 session = multiparametric MRI = loads of data!

Could be used to triage risk in CKD, reduce invasive tests, or for translational research

An imaging biomarker is already being used in clinical practice. For which condition?

It's ADPKD! 🙌🙌🙌

Total kidney volume is approved by the FDA to identify patients at high risk of progressive renal impairment to treat with tolvaptan. TKV is best measured by kidney MRI and evaluated using the Mayo classification

Buchanan published landmark paper showing reproducibility of MRI measurements in CKD . eGFR correlated with multiple MRI measurements. Loads of sequences in a single short scan - looking at the kidney in so many different ways!

academic.oup.com/ndt/article/35…

Pruijm et al found that cortical R2* and R2* gradient across kidney predicted renal outcomes independently of eGFR and ACR. So image biomarkers might help risk stratify CKD patients to target more aggressive treatment

sciencedirect.com/science/articl…

Wang et al found ADC and BOLD to correlate with fibrosis, and ASL to correlate with capillary density on biopsy. Imaging biomarkers could therefore predict biopsy findings associated with outcome and response to treatment. A virtual biopsy! 😎

cjasn.asnjournals.org/content/14/9/1…

NDT had an issue dedicated to renal imaging in June 2020! Thanks @denisfouque1!

Increasing data suggest that diffusion and oxygenation measures correlate with biopsy and might predict CKD progression

academic.oup.com/ndt/issue/35/6

Multi parametric MRI provides huge amounts of measurements and data. Much work to be done to see how best to analyse and integrate.

Do you think we’ll see broader use of functional MRI in nephrology?

#tweetorial #tweetorialERA #medtwitter