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E-book Preclinical MRI of the Kidney : Methods and Protocols
Renal MRI holds incredible promise for making a quantum leap in improving diagnosis and care of patientswith a multitude of diseases, by moving beyond the limitations and restrictions of current routine clinicalpractice. Clinical and preclinical renal MRI is advancing with ever increasing rapidity, and yet, aside from afew examples of renal MRI in routine use, it is still not good enough. Several roadblocks are still delayingthe pace of progress, particularly inefficient education of renal MR researchers, and lack of harmonization ofapproaches that limits the sharing of results among multiple research groups.Here we aim to address these limitations for preclinical renal MRI (predominantly in small animals), byproviding a comprehensive collection of more than 40 publications that will serve as a foundational resourcefor preclinical renal MRI studies. This includes chapters describing the fundamental principles underlying avariety of renal MRI methods, step-by-step protocols for executing renal MRI studies, and detailed guidesfor data analysis. This collection will serve as a crucial part of a roadmap toward conducting renal MRIstudies in a robust and reproducible way, that will promote the standardization and sharing of data.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven networkfunded by the European Cooperation in Science and Technology (COST) program of the EuropeanUnion, which aims to improve the reproducibility and standardization of renal MRI biomarkers. Magnetic resonance imaging (MRI) of the kidney is not brainsurgery—it’s better! It can save lives without invasive surgery,noninvasively. This statement—a play on Donald W McRobbie’s“MRI is not rocket science, it’s better” inMRI From Picture toProton—is one that Dr. Susan Back, radiologist and director ofPediatric Genitourinary Imaging at the Children’s Hospital ofPhiladelphia, would sign on to without hesitation. It’s Thursdayafternoon and she is just running an MRI scan on a 4-year-old boywith a left kidney urinary tract dilation, which was gradually increas-ing on ultrasound. This is the last sequence in the MRI protocol: acontrast-enhanced dynamic 3D T1-weighted GRE sequence with atemporal resolution of ~8 s, used for quantitative functional uro-graphy [1]. Before, an anatomic T2-weighted MR urogram [1] wasperformed to identify possible anatomic causes of obstruction(Fig.1), which are difficult to find with ultrasound. These renalMRI data play a key role in the diagnosis and treatment decisions.The configuration of the kidney on the MRI is concerning for anureteropelvic junction obstruction because there is an abrupt tran-sition from the renal pelvis to the proximal ureter.
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