The detection of acute kidney injury with hyperpolarized 13C Urea and multi-exponential fitting

TL;DR

This study demonstrates that Laplacian fitting can effectively differentiate between healthy and ischemic rodent kidneys using hyperpolarized 13C urea T2 relaxation mapping, revealing significant differences in relaxation behavior.

Contribution

First to show differences in multi-exponential relaxation behavior of hyperpolarized 13C urea in healthy versus ischemic kidneys using Laplacian fitting.

Findings

Laplacian fitting is stable at SNR of 20.

Significant increase in mono-exponential pool in ischemic kidneys.

Significant decrease in bi-exponential pool in ischemic kidneys.

Abstract

Purpose: To assess the utility of Laplacian fitting to describe the differences in hyperpolarized 13C urea T2 relaxation in ischemic and healthy rodent kidneys. Theory and Methods: Six rats with unilateral renal ischemia were investigated. 13C urea T2 mapping was undertaken with a radial fast spin echo method, with subsequent post-processing performed with regularised Laplacian fitting. Results: Simulations showed that Laplacian fitting was stable down to a signal to noise ratio of 20. In vivo results showed a significant increase in the mono- and decrease in bi-exponential pools in IRI kidneys, in comparison to healthy (14+-10% vs 4+-2%, 85+-10% vs 95+-3%, p<0.05). Conclusion: We demonstrate, for the first time, the differences in multi-exponential behaviour of 13C,15N2-urea between the healthy and ischemic rodent kidney. The distribution of relaxation pools were found to be both visually and numerically significantly different. The ability to improve the information level in hyperpolarized MR, by utilizing the relaxation contrast mechanisms is an appealing option, that can easily be adopted in large animals and even in clinical studies in the near future.