Liam Timms1, Tianyi Zhou1, Yue Lyu1, Ju Qiao1, Vishala Mishra2, Rita Maria Lahoud2, Gayatri Veeramani Jayaraman3,4, Andrew S Allegretti3, David Drew5, Ravi T Seethamraju6, Mukesh Harisinghani2, Srinivas Sridhar7,8,9. 1. Northeastern University, Boston, MA, USA. 2. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. 3. Department of Nephrology, Massachusetts General Hospital, Boston, MA, USA. 4. Department of Nephrology, Brigham and Women's Hospital, Boston, MA, USA. 5. Tufts Medical Center, Boston, MA, USA. 6. Siemens Medical Solutions, Boston, MA, USA. 7. Northeastern University, Boston, MA, USA. s.sridhar@northeastern.edu. 8. Theranano LLC, Newton, MA, USA. s.sridhar@northeastern.edu. 9. 435 Egan Research Center, 120 Forsyth Street, Boston, MA, 02115, USA. s.sridhar@northeastern.edu.
Abstract
PURPOSE: To evaluate the feasibility of Quantitative Ultrashort-Time-to-Echo Contrast-Enhanced (QUTE-CE) MRA using ferumoxytol as a contrast agent for abdominal angiography in the kidney. METHODS: Four subjects underwent ferumoxytol-enhanced MRA with the 3D UTE Spiral VIBE WIP sequence at 3 T. Image quality metrics were quantified, specifically the blood Signal-to-Noise Ratio (SNR), blood-tissue Contrast-to-Noise Ratio (CNR) and Intraluminal Signal Heterogeneity (ISH) from both the aorta and inferior vena cava (IVC). Morphometric analysis of the vessels was performed using manual approach and semi-automatic approach using Vascular Modeling ToolKit (VMTK). Image quality and branching order were compared between QUTE-CE MRA and the Gadolinium (Gd) CEMRA reference image. RESULTS: QUTE-CE MRA provides a bright blood snapshot that delineates arteries and veins equally in the same scan. The maximum SNR and CNR values were 3,282 ± 1,218 and 1,295 ± 580, respectively - significantly higher than available literature values using other CEMRA techniques. QUTE-CE MRA had lower ISH and depicted higher vessel branching order (7th vs 3rd) within the kidney compared to a standard dynamic clinical Gd CEMRA scan. Morphometric analysis yielded quantitative results for the total kidney volume, total cyst volume and for diameters of the branching arterial network down to the 7th branch. Vessel curvature was significantly increased (p < 0.001) in the presence of a renal cyst compared to equivalent vessels in normal kidney regions. CONCLUSION: QUTE-CE MRA is feasible for kidney angiography, providing greater detail of kidney vasculature, enabling quantitative morphometric analysis of the abdominal and intra-renal vessels and yielding metrics relevant to vascular diseases while using a contrast agent ferumoxytol that is safe for CKD patients.
PURPOSE: To evaluate the feasibility of Quantitative Ultrashort-Time-to-Echo Contrast-Enhanced (QUTE-CE) MRA using ferumoxytol as a contrast agent for abdominal angiography in the kidney. METHODS: Four subjects underwent ferumoxytol-enhanced MRA with the 3D UTE Spiral VIBE WIP sequence at 3 T. Image quality metrics were quantified, specifically the blood Signal-to-Noise Ratio (SNR), blood-tissue Contrast-to-Noise Ratio (CNR) and Intraluminal Signal Heterogeneity (ISH) from both the aorta and inferior vena cava (IVC). Morphometric analysis of the vessels was performed using manual approach and semi-automatic approach using Vascular Modeling ToolKit (VMTK). Image quality and branching order were compared between QUTE-CE MRA and the Gadolinium (Gd) CEMRA reference image. RESULTS: QUTE-CE MRA provides a bright blood snapshot that delineates arteries and veins equally in the same scan. The maximum SNR and CNR values were 3,282 ± 1,218 and 1,295 ± 580, respectively - significantly higher than available literature values using other CEMRA techniques. QUTE-CE MRA had lower ISH and depicted higher vessel branching order (7th vs 3rd) within the kidney compared to a standard dynamic clinical Gd CEMRA scan. Morphometric analysis yielded quantitative results for the total kidney volume, total cyst volume and for diameters of the branching arterial network down to the 7th branch. Vessel curvature was significantly increased (p < 0.001) in the presence of a renal cyst compared to equivalent vessels in normal kidney regions. CONCLUSION: QUTE-CE MRA is feasible for kidney angiography, providing greater detail of kidney vasculature, enabling quantitative morphometric analysis of the abdominal and intra-renal vessels and yielding metrics relevant to vascular diseases while using a contrast agent ferumoxytol that is safe for CKD patients.
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