Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
GE Healthcare, Dallas, TX, USA.
Methods Mol Biol. 2021;2216:267-278. doi: 10.1007/978-1-0716-0978-1_16.
Existing clinical markers for renal disease are limited. Hyperpolarized (HP) C MRI is based on the technology of dissolution dynamic nuclear polarization (DNP) and provides new avenues for imaging kidney structure, function, and most notably, renal metabolism, addressing some of these prior limitations. Changes in kidney structure and function associated with kidney disease can be evaluated using [C]urea, a metabolically inert tracer. Metabolic changes can be assessed using [1-C]pyruvate and a range of other rapidly metabolized small molecules, which mainly probe central carbon metabolism. Results from numerous preclinical studies using a variety of these probes demonstrated that this approach holds great potential for monitoring renal disease, although more work is needed to bridge intelligently into clinical studies. Here we introduce the general concept of HP C MRI and review the most relevant probes and applications to renal disease, including kidney cancer, diabetic nephropathy and ischemic kidney injury.This chapter is based upon work from the PARENCHIMA COST Action, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by two separate chapters describing the experimental procedure and data analysis.
现有的肾脏疾病临床标志物有限。极化（HP）C 磁共振成像基于溶解动态核极化（DNP）技术，为肾脏结构、功能成像提供了新途径，尤其是肾脏代谢成像，解决了之前的一些局限性。可以使用[C]尿素，一种代谢惰性示踪剂，评估与肾脏疾病相关的肾脏结构和功能变化。可以使用[1-C]丙酮酸和一系列其他快速代谢的小分子来评估代谢变化，这些小分子主要探测中心碳代谢。使用各种探针进行的许多临床前研究的结果表明，这种方法在监测肾脏疾病方面具有很大的潜力，尽管需要做更多的工作才能将其智能地应用于临床研究。本文介绍了 HP C 磁共振成像的一般概念，并综述了与肾脏疾病相关的最相关的探针和应用，包括肾肿瘤、糖尿病肾病和缺血性肾损伤。这一章是基于 PARENCHIMA COST 行动的工作，这是一个由欧洲合作科学技术（COST）计划资助的、由社区驱动的网络，旨在提高肾脏 MRI 生物标志物的可重复性和标准化。本介绍章节由另外两章补充，分别描述了实验程序和数据分析。
