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How accurate is dynamic contrast‐enhanced MRI in the assessment of renal glomerular filtration rate? A critical appraisal
Author(s) -
Mendichovszky Iosif,
Pedersen Michael,
Frøkiær Jørgen,
Dissing Thomas,
Grenier Nicolas,
Anderson Peter,
McHugh Kieran,
Yang Qing,
Gordon Isky
Publication year - 2008
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21313
Subject(s) - renal function , dynamic contrast enhanced mri , dynamic contrast , medicine , magnetic resonance imaging , clinical practice , nuclear medicine , radiology , computer science , family medicine
Purpose To evaluate the current literature to see if the published results of MRI‐glomerular filtration rate (GFR) stand up to the claim that MRI‐GFR may be used in clinical practice. Claims in the current literature that Gadolinium (Gd) DTPA dynamic contrast enhanced (DCE) MRI clearance provides a reliable estimate of glomerular filtration are an overoptimistic interpretation of the results obtained. Before calculating absolute GFR from Gd‐enhanced MRI, numerous variables must be considered. Materials and Methods We examine the methodology in the published studies on absolute quantification of MRI‐GFR. The techniques evaluated included the dose and volume of Gd‐DTPA used, the speed of injection, acquisition sequences, orientation of the subject, re‐processing, conversion of signal to concentration and the model used for analysis of the data as well as the MRI platform. Results Claims in the current literature that using DCE MRI “Gd DTPA clearance provides a good estimate of glomerular filtration” are not supported by the data presented and a more accurate conclusion should be that “no MRI approach used provides a wholly satisfactory measure of renal GFR function.” Conclusion This study suggests that DCE MRI‐GFR results are not yet able to be used as a routine clinical or research tool. The published literature does not show what change in DCE MRI‐GFR is clinically significant, nor do the results in the literature allow a single DCE MRI‐GFR measurement to be correlated directly with a multiple blood sampling technique. J. Magn. Reson. Imaging 2008. © 2008 Wiley‐Liss, Inc.