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J Magn Reson Imaging. 2008 Apr;27(4):925-31. doi: 10.1002/jmri.21313.

How accurate is dynamic contrast-enhanced MRI in the assessment of renal glomerular filtration rate? A critical appraisal.

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  • 1Institute of Child Health, University College London, Guilford Street, London, United Kingdom.

Abstract

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.

(c) 2008 Wiley-Liss, Inc.

PMID:
18302200
[PubMed - indexed for MEDLINE]
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