Validation of multiparametric MRI by histopathology after nephrectomy: a case study

Anneloes de Boer; Tobias T Pieters; Anita A Harteveld; Peter J Blankestijn; Clemens Bos; Martijn Froeling; Roel Goldschmeding; Hans J M Hoogduin; Jaap A Joles; Bart-Jeroen Petri; Marianne C Verhaar; Tim Leiner; Tri Q Nguyen; Arjan D van Zuilen

doi:10.1007/s10334-020-00887-9

Validation of multiparametric MRI by histopathology after nephrectomy: a case study

Anneloes de Boer, Tobias T Pieters, Anita A Harteveld, Peter J Blankestijn, Clemens Bos, Martijn Froeling, Roel Goldschmeding, Hans J M Hoogduin, Jaap A Joles, Bart-Jeroen Petri, Marianne C Verhaar, Tim Leiner, Tri Q Nguyen, Arjan D van Zuilen

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Abstract

OBJECTIVES: Renal multiparametric MRI (mpMRI) is a promising tool to monitor renal allograft health to enable timely treatment of chronic allograft nephropathy. This study aims to validate mpMRI by whole-kidney histology following transplantectomy.

MATERIALS AND METHODS: A patient with kidney transplant failure underwent mpMRI prior to transplantectomy. The mpMRI included blood oxygenation level-dependent (BOLD) MRI, T1 and T2 mapping, diffusion-weighted imaging (DWI), 2D phase contrast (2DPC) and arterial spin labeling (ASL). Parenchymal mpMRI measures were compared to normative values obtained in 19 healthy controls. Differences were expressed in standard deviations (SD) of normative values. The mpMRI measures were compared qualitatively to histology.

RESULTS: The mpMRI showed a heterogeneous parenchyma consistent with extensive interstitial hemorrhage on histology. A global increase in T1 (+ 3.0 SD) and restricted diffusivity (- 3.6 SD) were consistent with inflammation and fibrosis. Decreased T2 (- 1.8 SD) indicated fibrosis or hemorrhage. ASL showed diminished cortical perfusion (- 2.9 SD) with patent proximal arteries. 2DPC revealed a 69% decrease in renal perfusion. Histological evaluation showed a dense inflammatory infiltrate and fibrotic changes, consistent with mpMRI results. Most interlobular arteries were obliterated while proximal arteries were patent, consistent with ASL findings.

DISCUSSION: mpMRI findings correlated well with histology both globally as well as locally.

Original language	English
Pages (from-to)	377-387
Number of pages	11
Journal	Magma - Magnetic Resonance Materials In Physics Biology And Medicine
Volume	34
Issue number	3
Early online date	20 Sept 2020
DOIs	https://doi.org/10.1007/s10334-020-00887-9
Publication status	Published - Jun 2021

Keywords

Histology
Kidney
Kidney transplantation
Multiparametric magnetic resonance imaging

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de Boer, A., Pieters, T. T., Harteveld, A. A., Blankestijn, P. J., Bos, C., Froeling, M., Goldschmeding, R., Hoogduin, H. J. M., Joles, J. A., Petri, B.-J., Verhaar, M. C., Leiner, T., Nguyen, T. Q., & van Zuilen, A. D. (2021). Validation of multiparametric MRI by histopathology after nephrectomy: a case study. Magma - Magnetic Resonance Materials In Physics Biology And Medicine, 34(3), 377-387. https://doi.org/10.1007/s10334-020-00887-9

@article{73c5d95e545045a2a89dac2e6cecbf39,

title = "Validation of multiparametric MRI by histopathology after nephrectomy: a case study",

abstract = "OBJECTIVES: Renal multiparametric MRI (mpMRI) is a promising tool to monitor renal allograft health to enable timely treatment of chronic allograft nephropathy. This study aims to validate mpMRI by whole-kidney histology following transplantectomy.MATERIALS AND METHODS: A patient with kidney transplant failure underwent mpMRI prior to transplantectomy. The mpMRI included blood oxygenation level-dependent (BOLD) MRI, T1 and T2 mapping, diffusion-weighted imaging (DWI), 2D phase contrast (2DPC) and arterial spin labeling (ASL). Parenchymal mpMRI measures were compared to normative values obtained in 19 healthy controls. Differences were expressed in standard deviations (SD) of normative values. The mpMRI measures were compared qualitatively to histology.RESULTS: The mpMRI showed a heterogeneous parenchyma consistent with extensive interstitial hemorrhage on histology. A global increase in T1 (+ 3.0 SD) and restricted diffusivity (- 3.6 SD) were consistent with inflammation and fibrosis. Decreased T2 (- 1.8 SD) indicated fibrosis or hemorrhage. ASL showed diminished cortical perfusion (- 2.9 SD) with patent proximal arteries. 2DPC revealed a 69% decrease in renal perfusion. Histological evaluation showed a dense inflammatory infiltrate and fibrotic changes, consistent with mpMRI results. Most interlobular arteries were obliterated while proximal arteries were patent, consistent with ASL findings.DISCUSSION: mpMRI findings correlated well with histology both globally as well as locally.",

keywords = "Histology, Kidney, Kidney transplantation, Multiparametric magnetic resonance imaging",

author = "{de Boer}, Anneloes and Pieters, {Tobias T} and Harteveld, {Anita A} and Blankestijn, {Peter J} and Clemens Bos and Martijn Froeling and Roel Goldschmeding and Hoogduin, {Hans J M} and Joles, {Jaap A} and Bart-Jeroen Petri and Verhaar, {Marianne C} and Tim Leiner and Nguyen, {Tri Q} and {van Zuilen}, {Arjan D}",

note = "Funding Information: AB and TP were supported by an Alexandre Suerman stipend of the University Medical Center Utrecht, the Netherlands. CB and AH acknowledge funding from the Netherlands Organization for Scientific Research (14951). Publisher Copyright: {\textcopyright} 2020, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Funding Information: AB and TP were supported by an Alexandre Suerman stipend of the University Medical Center Utrecht, the Netherlands. CB and AH acknowledge funding from the Netherlands Organization for Scientific Research (14951). Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2021",

month = jun,

doi = "10.1007/s10334-020-00887-9",

language = "English",

volume = "34",

pages = "377--387",

journal = "Magma - Magnetic Resonance Materials In Physics Biology And Medicine",

issn = "0968-5243",

publisher = "Springer-Verlag",

number = "3",

}

de Boer, A, Pieters, TT, Harteveld, AA, Blankestijn, PJ, Bos, C , Froeling, M , Goldschmeding, R , Hoogduin, HJM , Joles, JA, Petri, B-J, Verhaar, MC , Leiner, T , Nguyen, TQ & van Zuilen, AD 2021, 'Validation of multiparametric MRI by histopathology after nephrectomy: a case study', Magma - Magnetic Resonance Materials In Physics Biology And Medicine, vol. 34, no. 3, pp. 377-387. https://doi.org/10.1007/s10334-020-00887-9

TY - JOUR

T1 - Validation of multiparametric MRI by histopathology after nephrectomy

T2 - a case study

AU - de Boer, Anneloes

AU - Pieters, Tobias T

AU - Harteveld, Anita A

AU - Blankestijn, Peter J

AU - Bos, Clemens

AU - Froeling, Martijn

AU - Goldschmeding, Roel

AU - Hoogduin, Hans J M

AU - Joles, Jaap A

AU - Petri, Bart-Jeroen

AU - Verhaar, Marianne C

AU - Leiner, Tim

AU - Nguyen, Tri Q

AU - van Zuilen, Arjan D

N1 - Funding Information: AB and TP were supported by an Alexandre Suerman stipend of the University Medical Center Utrecht, the Netherlands. CB and AH acknowledge funding from the Netherlands Organization for Scientific Research (14951). Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Funding Information: AB and TP were supported by an Alexandre Suerman stipend of the University Medical Center Utrecht, the Netherlands. CB and AH acknowledge funding from the Netherlands Organization for Scientific Research (14951). Publisher Copyright: © 2020, The Author(s).

PY - 2021/6

Y1 - 2021/6

N2 - OBJECTIVES: Renal multiparametric MRI (mpMRI) is a promising tool to monitor renal allograft health to enable timely treatment of chronic allograft nephropathy. This study aims to validate mpMRI by whole-kidney histology following transplantectomy.MATERIALS AND METHODS: A patient with kidney transplant failure underwent mpMRI prior to transplantectomy. The mpMRI included blood oxygenation level-dependent (BOLD) MRI, T1 and T2 mapping, diffusion-weighted imaging (DWI), 2D phase contrast (2DPC) and arterial spin labeling (ASL). Parenchymal mpMRI measures were compared to normative values obtained in 19 healthy controls. Differences were expressed in standard deviations (SD) of normative values. The mpMRI measures were compared qualitatively to histology.RESULTS: The mpMRI showed a heterogeneous parenchyma consistent with extensive interstitial hemorrhage on histology. A global increase in T1 (+ 3.0 SD) and restricted diffusivity (- 3.6 SD) were consistent with inflammation and fibrosis. Decreased T2 (- 1.8 SD) indicated fibrosis or hemorrhage. ASL showed diminished cortical perfusion (- 2.9 SD) with patent proximal arteries. 2DPC revealed a 69% decrease in renal perfusion. Histological evaluation showed a dense inflammatory infiltrate and fibrotic changes, consistent with mpMRI results. Most interlobular arteries were obliterated while proximal arteries were patent, consistent with ASL findings.DISCUSSION: mpMRI findings correlated well with histology both globally as well as locally.

AB - OBJECTIVES: Renal multiparametric MRI (mpMRI) is a promising tool to monitor renal allograft health to enable timely treatment of chronic allograft nephropathy. This study aims to validate mpMRI by whole-kidney histology following transplantectomy.MATERIALS AND METHODS: A patient with kidney transplant failure underwent mpMRI prior to transplantectomy. The mpMRI included blood oxygenation level-dependent (BOLD) MRI, T1 and T2 mapping, diffusion-weighted imaging (DWI), 2D phase contrast (2DPC) and arterial spin labeling (ASL). Parenchymal mpMRI measures were compared to normative values obtained in 19 healthy controls. Differences were expressed in standard deviations (SD) of normative values. The mpMRI measures were compared qualitatively to histology.RESULTS: The mpMRI showed a heterogeneous parenchyma consistent with extensive interstitial hemorrhage on histology. A global increase in T1 (+ 3.0 SD) and restricted diffusivity (- 3.6 SD) were consistent with inflammation and fibrosis. Decreased T2 (- 1.8 SD) indicated fibrosis or hemorrhage. ASL showed diminished cortical perfusion (- 2.9 SD) with patent proximal arteries. 2DPC revealed a 69% decrease in renal perfusion. Histological evaluation showed a dense inflammatory infiltrate and fibrotic changes, consistent with mpMRI results. Most interlobular arteries were obliterated while proximal arteries were patent, consistent with ASL findings.DISCUSSION: mpMRI findings correlated well with histology both globally as well as locally.

KW - Histology

KW - Kidney

KW - Kidney transplantation

KW - Multiparametric magnetic resonance imaging

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U2 - 10.1007/s10334-020-00887-9

DO - 10.1007/s10334-020-00887-9

M3 - Article

C2 - 32954447

SN - 0968-5243

VL - 34

SP - 377

EP - 387

JO - Magma - Magnetic Resonance Materials In Physics Biology And Medicine

JF - Magma - Magnetic Resonance Materials In Physics Biology And Medicine

IS - 3

ER -

Validation of multiparametric MRI by histopathology after nephrectomy: a case study

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