Dataset Information

Consensus-based technical recommendations for clinical translation of renal ASL MRI.

ABSTRACT:

Objectives

This study aimed at developing technical recommendations for the acquisition, processing and analysis of renal ASL data in the human kidney at 1.5 T and 3 T field strengths that can promote standardization of renal perfusion measurements and facilitate the comparability of results across scanners and in multi-centre clinical studies.

Methods

An international panel of 23 renal ASL experts followed a modified Delphi process, including on-line surveys and two in-person meetings, to formulate a series of consensus statements regarding patient preparation, hardware, acquisition protocol, analysis steps and data reporting.

Results

Fifty-nine statements achieved consensus, while agreement could not be reached on two statements related to patient preparation. As a default protocol, the panel recommends pseudo-continuous (PCASL) or flow-sensitive alternating inversion recovery (FAIR) labelling with a single-slice spin-echo EPI readout with background suppression and a simple but robust quantification model.

Discussion

This approach is considered robust and reproducible and can provide renal perfusion images of adequate quality and SNR for most applications. If extended kidney coverage is desirable, a 2D multislice readout is recommended. These recommendations are based on current available evidence and expert opinion. Nonetheless they are expected to be updated as more data become available, since the renal ASL literature is rapidly expanding.

SUBMITTER: Nery F

PROVIDER: S-EPMC7021752 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Consensus-based technical recommendations for clinical translation of renal ASL MRI.

Nery Fabio F Buchanan Charlotte E CE Harteveld Anita A AA Odudu Aghogho A Bane Octavia O Cox Eleanor F EF Derlin Katja K Gach H Michael HM Golay Xavier X Gutberlet Marcel M Laustsen Christoffer C Ljimani Alexandra A Madhuranthakam Ananth J AJ Pedrosa Ivan I Prasad Pottumarthi V PV Robson Philip M PM Sharma Kanishka K Sourbron Steven S Taso Manuel M Thomas David L DL Wang Danny J J DJJ Zhang Jeff L JL Alsop David C DC Fain Sean B SB Francis Susan T ST Fernández-Seara María A MA

Magma (New York, N.Y.) 20191212 1

<h4>Objectives</h4>This study aimed at developing technical recommendations for the acquisition, processing and analysis of renal ASL data in the human kidney at 1.5 T and 3 T field strengths that can promote standardization of renal perfusion measurements and facilitate the comparability of results across scanners and in multi-centre clinical studies.<h4>Methods</h4>An international panel of 23 renal ASL experts followed a modified Delphi process, including on-line surveys and two in-person mee ...[more]

PMID: 31833014

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Project description:BackgroundPhase-contrast (PC) MRI is a feasible and valid noninvasive technique to measure renal artery blood flow, showing potential to support diagnosis and monitoring of renal diseases. However, the variability in measured renal blood flow values across studies is large, most likely due to differences in PC-MRI acquisition and processing. Standardized acquisition and processing protocols are therefore needed to minimize this variability and maximize the potential of renal PC-MRI as a clinically useful tool.PurposeTo build technical recommendations for the acquisition, processing, and analysis of renal 2D PC-MRI data in human subjects to promote standardization of renal blood flow measurements and facilitate the comparability of results across scanners and in multicenter clinical studies.Study typeSystematic consensus process using a modified Delphi method.PopulationNot applicable.Sequence field/strengthRenal fast gradient echo-based 2D PC-MRI.AssessmentAn international panel of 27 experts from Europe, the USA, Australia, and Japan with 6 (interquartile range 4-10) years of experience in 2D PC-MRI formulated consensus statements on renal 2D PC-MRI in two rounds of surveys. Starting from a recently published systematic review article, literature-based and data-driven statements regarding patient preparation, hardware, acquisition protocol, analysis steps, and data reporting were formulated.Statistical testsConsensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60-74% agreement among the experts.ResultsAmong 60 statements, 57 (95%) achieved consensus after the second-round survey, while the remaining three showed a clear preference. Consensus statements resulted in specific recommendations for subject preparation, 2D renal PC-MRI data acquisition, processing, and reporting.Data conclusionThese recommendations might promote a widespread adoption of renal PC-MRI, and may help foster the set-up of multicenter studies aimed at defining reference values and building larger and more definitive evidence, and will facilitate clinical translation of PC-MRI.Level of evidence1 TECHNICAL EFFICACY STAGE: 1.

Project description:BackgroundCritics of systematic reviews have argued that these studies often fail to inform clinical decision making because their results are far too general, that the data are sparse, such that findings cannot be applied to individual patients or for other decision making. While there is some consensus on methods for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity. Clinical heterogeneity, true effect heterogeneity, can be defined as variability among studies in the participants, the types or timing of outcome measurements, and the intervention characteristics. The objective of this project was to develop recommendations for investigating clinical heterogeneity in systematic reviews.MethodsWe used a modified Delphi technique with three phases: (1) pre-meeting item generation; (2) face-to-face consensus meeting in the form of a modified Delphi process; and (3) post-meeting feedback. We identified and invited potential participants with expertise in systematic review methodology, systematic review reporting, or statistical aspects of meta-analyses, or those who published papers on clinical heterogeneity.ResultsBetween April and June of 2011, we conducted phone calls with participants. In June 2011 we held the face-to-face focus group meeting in Ann Arbor, Michigan. First, we agreed upon a definition of clinical heterogeneity: Variations in the treatment effect that are due to differences in clinically related characteristics. Next, we discussed and generated recommendations in the following 12 categories related to investigating clinical heterogeneity: the systematic review team, planning investigations, rationale for choice of variables, types of clinical variables, the role of statistical heterogeneity, the use of plotting and visual aids, dealing with outlier studies, the number of investigations or variables, the role of the best evidence synthesis, types of statistical methods, the interpretation of findings, and reporting.ConclusionsClinical heterogeneity is common in systematic reviews. Our recommendations can help guide systematic reviewers in conducting valid and reliable investigations of clinical heterogeneity. Findings of these investigations may allow for increased applicability of findings of systematic reviews to the management of individual patients.

Dataset Information

Consensus-based technical recommendations for clinical translation of renal ASL MRI.

Objectives

Methods

Results

Discussion

Publications

Consensus-based technical recommendations for clinical translation of renal ASL MRI.

Similar Datasets

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