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Angiomyolipoma (AML) are the most common benign solid renal mass. Differentiation from malignant tumours is essential. Imaging features in ultrasound may overlap between malignant lesions, especially between renal cell carcinoma (RCC) and AML. So far, sectional imaging has been necessary for reliable differentiation. The aim of this study is to evaluate the use of the ultrasound-guided attenuation parameter (UGAP), a recently established tool for assessing hepatic steatosis, in the differentiation of AMLs from other renal masses. Therefore, 27 patients with unknown solid renal masses were examined by ultrasound including UGAP. The attenuation was assessed qualitatively by attenuation map and quantitatively in comparison to the surrounding renal tissue. UGAP was applicable in 26/27 patients. Findings were compared with CT/MRI as the current imaging standard. A total of 18 AML and 9 other renal tumours were found. The diagnostic performance of B-Mode (hyperechogenic lesion) ultrasound was 77.8% in identifying AML. The diagnostic performance of the attenuation map showed a diagnostic performance of 92.6%, whereby UGAP measurements were successful in 76.9% of cases. Quantitatively, we found a significant difference (p < 0.034) in mean measured attenuation between AML (0.764 ± 0.162 dB/cm/MHz) vs. other renal tumours (0.658 ± 0.155 dB/cm/MHz). The best performance was found by a combined parameter of a hyperechogenic lesion with a positive attenuation map with an accuracy of 95.0%. In conclusion, UGAP may represent a possibility for differentiating solid renal lesions more accurately by ultrasound, especially classic hyperechoic AMLs from other renal lesions. Further studies are needed to increase the diagnostic reliability further. [ABSTRACT FROM AUTHOR]

Objective: Diffusion-weighted MRI is a technique that can infer microstructural and microcirculatory features from biological tissue, with particular application to renal tissue. There is extensive literature on diffusion tensor imaging (DTI) of anisotropy in the renal medulla, intravoxel incoherent motion (IVIM) measurements separating microstructural from microcirculation effects, and combinations of the two. However, interpretation of these features and adaptation of more specific models remains an ongoing challenge. One input to this process is a whole organ distillation of corticomedullary contrast of diffusion metrics, as has been explored for other renal biomarkers. Materials and methods: In this work, we probe the spatial dependence of diffusion MRI metrics with concentrically layered segmentation in 11 healthy kidneys at 3 T. The metrics include those from DTI, IVIM, a combined approach titled "REnal Flow and Microstructure AnisotroPy (REFMAP)", and a multiply encoded model titled "FC-IVIM" providing estimates of fluid velocity and branching length. Results: Fractional anisotropy decreased from the inner kidney to the outer kidney with the strongest layer correlation in both parenchyma (including cortex and medulla) and medulla with Spearman correlation coefficients and p-values (r, p) of (0.42, <0.001) and (0.37, <0.001), respectively. Also, dynamic parameters derived from the three models significantly decreased with a high correlation from the inner to the outer parenchyma or medulla with (r, p) ranges of (0.46–0.55, <0.001). Conclusions: These spatial trends might find implications for indirect assessments of kidney physiology and microstructure using diffusion MRI. [ABSTRACT FROM AUTHOR]

Background Hypertensive pregnancies are associated with an increased risk of cardiovascular and neurological diseases in the offspring during later life. However, less is known about the potential impact on multi‐organ phenotypes in offspring before disease symptoms occur. The objective of this systematic review was to determine the associations of fetal exposure to maternal hypertensive pregnancy with multi‐organ phenotypes across developmental stages. Methods and Results Ovid MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), WoS, Scopus, CINAHL, and ClinicalTrials.gov were systematically searched until February 2024. Records were independently screened by 2 authors. Studies reporting on the structure or function of the heart, blood vessels, brain, liver, and kidneys in offspring of hypertensive pregnancies compared with a normotensive control population were included. Risk of bias was assessed using the Newcastle‐Ottawa Scale. Extracted data were presented using harvest plots. Seventy‐three studies including 7091 offspring of hypertensive pregnancies and 42 164 controls were identified that met the inclusion criteria. Thirty‐two studies were investigations in fetuses, 24 in neonates and infants, 12 in children, 2 in adolescents, and 3 in adults. Offspring of hypertensive pregnancies had structural and functional changes in the heart compared with controls in some studies across developmental stages. Offspring of hypertensive pregnancies also had smaller occipital and parietal vessels, higher aortic intima‐media thickness, and lower retinal arteriolar‐to‐venular ratio. Some conflicting evidence existed for other phenotypical alterations. Conclusions There is still inconsistent evidence of multi‐organ structural and functional differences in offspring of hypertensive pregnancies. The evidence base could therefore be further strengthened through well‐designed and conducted prospective studies. Registration Information www.crd.york.ac.uk. Unique Identifier: CRD42023387550.

Angiomyolipoma (AML) are the most common benign solid renal mass. Differentiation from malignant tumours is essential. Imaging features in ultrasound may overlap between malignant lesions, especially between renal cell carcinoma (RCC) and AML. So far, sectional imaging has been necessary for reliable differentiation. The aim of this study is to evaluate the use of the ultrasound-guided attenuation parameter (UGAP), a recently established tool for assessing hepatic steatosis, in the differentiation of AMLs from other renal masses. Therefore, 27 patients with unknown solid renal masses were examined by ultrasound including UGAP. The attenuation was assessed qualitatively by attenuation map and quantitatively in comparison to the surrounding renal tissue. UGAP was applicable in 26/27 patients. Findings were compared with CT/MRI as the current imaging standard. A total of 18 AML and 9 other renal tumours were found. The diagnostic performance of B-Mode (hyperechogenic lesion) ultrasound was 77.8% in identifying AML. The diagnostic performance of the attenuation map showed a diagnostic performance of 92.6%, whereby UGAP measurements were successful in 76.9% of cases. Quantitatively, we found a significant difference (p < 0.034) in mean measured attenuation between AML (0.764 ± 0.162 dB/cm/MHz) vs. other renal tumours (0.658 ± 0.155 dB/cm/MHz). The best performance was found by a combined parameter of a hyperechogenic lesion with a positive attenuation map with an accuracy of 95.0%. In conclusion, UGAP may represent a possibility for differentiating solid renal lesions more accurately by ultrasound, especially classic hyperechoic AMLs from other renal lesions. Further studies are needed to increase the diagnostic reliability further.

Numerous imaging modalities are available to the provider when diagnosing or surveilling kidney stones. The decision to order one over the other can be nuanced and especially confusing to non-urologic practitioners. This manuscript reviews the main modalities used to image stones in the modern era - renal bladder ultrasound, Kidney Ureter Bladder plain film radiography (KUB), magnetic resonance imaging (MRI), and non-contrast computerized tomography (NCCT). While NCCT has become the most popular and familiar modality for most practitioners, particularly in the acute setting, ultrasound is a cost-effective technology that is adept at monitoring interval stone development in patients and evaluating for the presence of hydronephrosis. KUB and MRI also occupy unique niches in the management of urolithiasis. In the correct clinical setting, each of these modalities has a role in the acute workup and management of suspected nephrolithiasis. [ABSTRACT FROM AUTHOR]

Real-time renal imaging is indispensable for monitoring kidney-related disease processes and evaluating the nephrotoxicity of nanoprobes. Owing to their small size, tunable photoluminescence properties, and low biotoxicity, carbon dots (CDs) are widely employed as nanoprobes for imaging-guided disease diagnosis. However, the preparation of near-infrared CDs is a stupendous challenging. Here, CDs with near-infrared fluorescence (NIR-CDs) were prepared by one-pot pyrolysis and were comprehensively evaluated for real-time renal imaging. The NIR-CDs possessed super-small size (1.8 ± 0.2 nm) and high quantum yield (14.3% in aqueous solution) at 696 nm. NIR-CDs exhibited high-efficiency renal clearance at 24 h post-treatment (97.47–99.27% ID) via glomerular filtration. The irreversible clearance of NIR-CDs enables effective real-time monitoring of kidney function in the normal and acute kidney injury (AKI) mouse models. Consequently, NIR-CDs can be utilized for imaging analyses of impaired kidney function, pioneering a serviceable guideline for neoapplications of NIR-CDs. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction: [99mTc]Tc-MAG3 is one of the routine renal radiopharmaceuticals being used in nuclear medicine centers, throughout the world. This study investigated the synthesis and 99mTc-labeling of MAG3, as well as the synthesis of the S-acetyl-MAG3-NHS complexing agent, which was used for labeling bovine serum albumin (BSA) as a protein model using technetium-99m. Methods: S-acetyl-MAG3 was prepared by the reaction of S-acetyl thioglycolic acid and triglycine. It was also activated to its N-hydroxysuccinimide counterpart which was used for preparation of biomolecule conjugates. All compounds and intermediates were characterized by ¹H NMR and LC/Mass spectroscopy. Labeling of MAG3 with 99m-technetium was also well performed. The radiochemical purity and stability of labeled products was done by thin-layer chromatography. Also, biodistribution studies in mice was performed. Results: The spectroscopic results confirmed the structure of compounds. The stability of [99mTc]Tc-MAG3 and [99mTc]Tc-MAG3-BSA was determined over 24h .It was found to drop from 90% to 60% and 99% to 80%, respectively. There was no difference between serum and buffer results. Biodistribution studies for [99mTc]Tc-MAG3 confirmed renal excretion with injected dose per gram (%ID/g) kidney of 41.28 ± 4.70, 45.63 ± 6.36 and 12.22 ± 2.83 after 1, 4 and 24h respectively. Conclusion: In this work, the rigorous purification processes were simplified through adjustment of molar ratios of reactants and the crude product obtained with higher yield was directly used for 99mTc labeling. The prepared labeled biomolecules conjugates showed acceptable radiochemical purity and stability. MAG3 was applicable for renal imaging according to biodistribution results. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of respiratory motion and cardiac driven pulsation in renal DWI and to examine asymmetrical velocity‐compensated diffusion encoding waveforms for robust ADC mapping in the kidneys. Methods: The standard monopolar Stejskal‐Tanner pulsed gradient spin echo (pgse) and the asymmetric bipolar velocity‐compensated (asym‐vc) diffusion encoding waveforms were used for coronal renal DWI at 3T. The robustness of the ADC quantification in the kidneys was tested with the aforementioned waveforms in respiratory‐triggered and breath‐held cardiac‐triggered scans at different trigger delays in 10 healthy subjects. Results: The pgse waveform showed higher ADC values in the right kidney at short trigger delays in comparison to longer trigger delays in the respiratory triggered scans when the diffusion gradient was applied in the feet‐head (FH) direction. The coefficient of variation over all respiratory trigger delays, averaged over all subjects was 0.15 for the pgse waveform in the right kidney when diffusion was measured in the FH direction; the corresponding coefficient of variation for the asym‐vc waveform was 0.06. The effect of cardiac driven pulsation was found to be small in comparison to the effect of respiratory motion. Conclusion: Short trigger delays in respiratory‐triggered scans can cause higher ADC values in comparison to longer trigger delays in renal DWI, especially in the right kidney when diffusion is measured in the FH direction. The asym‐vc waveform can reduce ADC variation due to respiratory motion in respiratory‐triggered scans at the cost of reduced SNR compared to the pgse waveform. [ABSTRACT FROM AUTHOR]

Background: Hypertensive pregnancies are associated with an increased risk of cardiovascular and neurological diseases in the offspring during later life. However, less is known about the potential impact on multi-organ phenotypes in offspring before disease symptoms occur. The objective of this systematic review was to determine the associations of fetal exposure to maternal hypertensive pregnancy with multi-organ phenotypes across developmental stages., Methods and Results: Ovid MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), WoS, Scopus, CINAHL, and ClinicalTrials.gov were systematically searched until February 2024. Records were independently screened by 2 authors. Studies reporting on the structure or function of the heart, blood vessels, brain, liver, and kidneys in offspring of hypertensive pregnancies compared with a normotensive control population were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Extracted data were presented using harvest plots. Seventy-three studies including 7091 offspring of hypertensive pregnancies and 42 164 controls were identified that met the inclusion criteria. Thirty-two studies were investigations in fetuses, 24 in neonates and infants, 12 in children, 2 in adolescents, and 3 in adults. Offspring of hypertensive pregnancies had structural and functional changes in the heart compared with controls in some studies across developmental stages. Offspring of hypertensive pregnancies also had smaller occipital and parietal vessels, higher aortic intima-media thickness, and lower retinal arteriolar-to-venular ratio. Some conflicting evidence existed for other phenotypical alterations., Conclusions: There is still inconsistent evidence of multi-organ structural and functional differences in offspring of hypertensive pregnancies. The evidence base could therefore be further strengthened through well-designed and conducted prospective studies., Registration Information: www.crd.york.ac.uk. Unique Identifier: CRD42023387550.

The introduction of ultrafast ultrasound and spatiotemporal filtering has significantly improved the sensitivity of Doppler ultrasound imaging. This work describes the development of a 3D power Doppler imaging technique which uses a 1D-array ultrasound probe that mechanically translates at a constant speed. The continuous translation allows for a fast scan of a large 3D volume without requiring complex hardware. The technique was realized in a prototype and its feasibility illustrated using phantom and in vivo kidney and breast lesion experiments. Although this 3D Doppler imaging technique is limited in some aspects, it enables power Doppler imaging of a large volume in a short acquisition time with less computational costs. [ABSTRACT FROM AUTHOR]

Objective: Diffusion-weighted MRI is a technique that can infer microstructural and microcirculatory features from biological tissue, with particular application to renal tissue. There is extensive literature on diffusion tensor imaging (DTI) of anisotropy in the renal medulla, intravoxel incoherent motion (IVIM) measurements separating microstructural from microcirculation effects, and combinations of the two. However, interpretation of these features and adaptation of more specific models remains an ongoing challenge. One input to this process is a whole organ distillation of corticomedullary contrast of diffusion metrics, as has been explored for other renal biomarkers., Materials and Methods: In this work, we probe the spatial dependence of diffusion MRI metrics with concentrically layered segmentation in 11 healthy kidneys at 3 T. The metrics include those from DTI, IVIM, a combined approach titled "REnal Flow and Microstructure AnisotroPy (REFMAP)", and a multiply encoded model titled "FC-IVIM" providing estimates of fluid velocity and branching length., Results: Fractional anisotropy decreased from the inner kidney to the outer kidney with the strongest layer correlation in both parenchyma (including cortex and medulla) and medulla with Spearman correlation coefficients and p-values (r, p) of (0.42, <0.001) and (0.37, <0.001), respectively. Also, dynamic parameters derived from the three models significantly decreased with a high correlation from the inner to the outer parenchyma or medulla with (r, p) ranges of (0.46-0.55, <0.001)., Conclusions: These spatial trends might find implications for indirect assessments of kidney physiology and microstructure using diffusion MRI., (© 2024. The Author(s), under exclusive licence to European Society for Magnetic Resonance in Medicine and Biology (ESMRMB).)

The kidneys are vital organs performing several essential functions. Their primary function is the filtration of blood and the removal of metabolic waste products as well as fluid homeostasis. Renal filtration is the main pathway for drug removal, highlighting the importance of this organ to the growing field of nanomedicine. The kidneys (i) have a key role in the transport and clearance of nanoparticles (NPs), (ii) are exposed to potential NPs' toxicity, and (iii) are the targets of diseases that nanomedicine can study, detect, and treat. In this review, we aim to summarize the latest research on kidney-nanoparticle interaction. We first give a brief overview of the kidney's anatomy and renal filtration, describe how nanoparticle characteristics influence their renal clearance, and the approaches taken to image and treat the kidney, including drug delivery and tissue engineering. Finally, we discuss the future and some of the challenges faced by nanomedicine. [ABSTRACT FROM AUTHOR]

Renal imaging is widely used in the assessment of surrogate markers of nephron mass correlated to renal function. Autopsy studies have tested the validity of various imaging modalities in accurately estimating "true" nephron mass. However, in vivo assessment of nephron mass has been largely limited to kidney volume determination by ultrasonography (US) in pediatric populations. Practical limitations and risks create challenges in incorporating more precise 3D volumetric imaging, like magnetic resonance imaging (MRI), and computed tomography (CT) technologies, compared to US for routine kidney volume assessment in children. Additionally, accounting for structural anomalies such as hydronephrosis when estimating renal parenchymal area in congenital anomalies of the kidney and urinary tract (CAKUT) is important, as it correlates with chronic kidney disease (CKD) progression. 3D imaging using CT and MRI has been shown to be superior to US, which has traditionally relied on 2D measurements to estimate kidney volume using the ellipsoid calculation. Recent innovations using 3D and contrast-enhanced US (CEUS) provide improved accuracy with low risk. Indexing kidney volume to body surface area in children is an important standard that may allow early detection of CKD progression in high-risk populations. This review highlights current understanding of various imaging modalities in assessing nephron mass, discusses applications and limitations, and describes recent advances in the field of imaging and kidney disease. Although renal imaging has been a long-standing, essential tool in assessing kidney disease, innovation and new applications of established technologies provide important tools in the study and management of kidney disease in children. [ABSTRACT FROM AUTHOR]

Renovascular hypertension (RVHTN) is an important contributor to secondary etiologies of hypertension in the pediatric population. Adelay in diagnosis can be associated with adverse outcomes. Theetiologies of renal artery stenosis (RAS) vary from anatomical, inflammatory, genetic syndromes, intra-luminal, external compression and idiopathic. Itis a silent disease with isolated hypertension as its primary clinical manifestation. Laboratoryvalues can be notable for electrolyts requires a high index of clinical suspicion and entails ruling out other secondary causes of hypertension while monitoring for target organ damage. Imagingof individuals with suspected RAS includes: renal ultrasound, computed tomography angiography, magnetic resonance angiography and renal scintigraphy, but angiography continues to be the gold standard. Variousfactor are used to determine the most appropriate method for ongoing care: anti-hypertensive therapy, with or without radiological or surgical intervention. Inall instances, a multi-disciplinary team approach should be used to provide optimal care to these children and adolescents. [ABSTRACT FROM AUTHOR]

Appropriate interpretation of changes in markers of kidney function is essential during the treatment of acute and chronic heart failure. Historically, kidney function was primarily assessed by serum creatinine and the calculation of estimated glomerular filtration rate. An increase in serum creatinine, also termed worsening renal function, commonly occurs in patients with heart failure, especially during acute heart failure episodes. Even though worsening renal function is associated with worse outcome on a population level, the interpretation of such changes within the appropriate clinical context helps to correctly assess risk and determine further treatment strategies. Additionally, it is becoming increasingly recognized that assessment of kidney function is more than just glomerular filtration rate alone. As such, a better evaluation of sodium and water handling by the renal tubules allows to determine the efficiency of loop diuretics (loop diuretic response and efficiency). Also, though neurohumoral blockers may induce modest deteriorations in glomerular filtration rate, their use is associated with improved long-term outcome. Therefore, a better understanding of the role of cardio-renal interactions in heart failure in symptom development, disease progression and prognosis is essential. Indeed, perhaps even misinterpretation of kidney function is a leading cause of not attaining decongestion in acute heart failure and insufficient dosing of guideline-directed medical therapy in general. This position paper of the Heart Failure Association Working Group on Cardio-Renal Dysfunction aims at improving insights into the interpretation of renal function assessment in the different heart failure states, with the goal of improving heart failure care. [ABSTRACT FROM AUTHOR]

Introduction: Multicystic dysplastic kidney (MCDK) is a relatively common developmental abnormality of the urinary tract. In most cases, it is an asymptomatic disease and rarely leads to problems emerging from the pressing effect of large MCDK kidneys on the adjacent organs. Nowadays, surgical intervention has mostly been replaced by a non-invasive approach with long-term follow-up. Aim of the study: Analysis of the diagnostic process, patients' clinical condition, treatment, and follow-up in neonatal patients with extreme MCDK. Material and methods: Retrospective analysis of medical records of four infants with extreme MCDK, who were hospitalised in the Department of Intensive Therapy and Neonatal Pathology in Independent Public Clinical Hospital No. 1 in Zabrze in 2014-2019. The study also includes data from an out-patient nephrological unit, where infants are checked up by paediatric nephrologists every 6 to 12 months. Results: All four patients involved in this study were diagnosed during the prenatal period. After birth, the initial diagnosis was confirmed by ultrasound, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and/or scintigraphy. All patients in their neonatal period presented the symptoms caused by the pressing effect of the large size of MCDK kidneys, such as abdominal or flank discomfort, digestive disturbances, or respiratory distress. The life-threatening clinical condition of two of our patients led to surgical intervention, which significantly improved their life functions. The stable clinical condition of another two infants enabled a non-invasive approach. All four infants still remain under long-term follow-up. They are not afflicted with any problems emerging from the urinary tract and they do not require any pharmacological treatment. Conclusions: Despite the currently proposed non-invasive approach to MCDK, there are cases when a nephrectomy should be a considered, especially regarding patients with extreme-sized kidneys. [ABSTRACT FROM AUTHOR]

The kidneys are vital organs performing several essential functions. Their primary function is the filtration of blood and the removal of metabolic waste products as well as fluid homeostasis. Renal filtration is the main pathway for drug removal, highlighting the importance of this organ to the growing field of nanomedicine. The kidneys (i) have a key role in the transport and clearance of nanoparticles (NPs), (ii) are exposed to potential NPs’ toxicity, and (iii) are the targets of diseases that nanomedicine can study, detect, and treat. In this review, we aim to summarize the latest research on kidney-nanoparticle interaction. We first give a brief overview of the kidney’s anatomy and renal filtration, describe how nanoparticle characteristics influence their renal clearance, and the approaches taken to image and treat the kidney, including drug delivery and tissue engineering. Finally, we discuss the future and some of the challenges faced by nanomedicine.

Horseshoe kidney is an inborn renal fusion anomaly. It is frequently associated with renal stones and infections. The diagnosis is made using imaging methods - ultrasound, X-ray of the abdomen and intravenous pyelography, computed tomography (CT), magnetic resonance imaging (MRI) and radionuclide investigations. The diagnosis sometimes is hard, especially when other abnormalities are present, i.e. hydronephrosis, nephrolithiasis, stenosis of the ureteropelvic junction, etc. The authors present a male patient with horseshoe kidney and unilateral hydronephrosis due to obstruction of the ureteropelvic junction and discuss the diagnosis of horseshoe kidney and the diagnostic approach in such patients.

Blayne Welk,1,2 Kuan Liu,2 Salimah Z Shariff,2 1Department of Surgery and Epidemiology and Biostatistics, Western University, ON, Canada; 2Institute for Clinical Evaluative Sciences – Western (ICES Western), London, ON, CanadaObjective: To assess the use of urologic investigations among traumatic spinal cord injury (TSCI) patients.Methods: This is a retrospective cohort study from Ontario, Canada. We included all adult TSCI patients injured between 2002 and 2012. The primary outcome was the frequency of urodynamic testing, renal imaging, and cystoscopy. Primary exposure was the year of injury. The impact of age, sex, comorbidity, socioeconomic status, and lesion level was assessed with Cox regression models.Results: One thousand five hundred and fifty one incident TSCI patients were discharged from a rehabilitation hospital. The median follow-up time of this cohort was 5.0 years (interquartile range =2.9–7.5). At least one urodynamics, renal imaging, or cystoscopy was performed during follow-up for 50%, 80%, and 48% of the cohort, respectively. The overall rate of these tests was 0.22, 0.60, and 0.22 per person-year of follow-up. The proportion of patients who had regular, yearly urodynamics (

A ligand of N-2-(furylmethyl iminodiacetic acid) (FMIDA) has been easily labeled by a tetradentate chelating agent of [Tc]. Factors like a stannous chloride solution as a reducing agent (100 μg), substrate amount (100 μg), pH (7), in vitro stability (8 h) and temperature (37 °C) have been systematically studied to optimize high radiochemical yield (98.0%). The radiochemical conversion was calculated on thin-layer chromatography, paper electrophoresis, and high performance liquid chromatography. Biodistribution study showed that this complex was removed from the kidneys and bladder path way during 1 h post injection. Therefore, [Tc]FMIDA may be used as renal function radiotracer. [ABSTRACT FROM AUTHOR]

Intrarenal splenosis is very rare and its management is not well established. We present a patient in whom an enhancing left renal mass was incidentally detected on a Computerized tomographic (CT) scan, concerning for renal cell carcinoma. However, the lesion was determined to represent intrarenal splenosis, confirmed by Technetium-99m (99mTc) sulfur colloid scan and percutaneous biopsy, which revealed splenic tissue. This multimodal approach to diagnosis of an unusual condition spared the patient an invasive procedure.

Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux. [ABSTRACT FROM PUBLISHER]

The introduction of dissolution dynamic nuclear polarization (d-DNP) technology has enabled a new paradigm for renal imaging investigations. It allows standard magnetic resonance imaging complementary renal metabolic and functional fingerprints within seconds without the use of ionizing radiation. Increasing evidence supports its utility in preclinical research in which the real-time interrogation of metabolic turnover can aid the physiological and pathophysiological metabolic and functional effects in ex vivo and in vivo models. The method has already been translated to humans, although the clinical value of this technology is unknown. In this paper, I review the potential benefits and pitfalls associated with dissolution dynamic nuclear polarization in preclinical research and its translation to renal patients.

Research in pathologies of the brain, heart and kidney have gained immensely from the plethora of studies that have helped shape new methods in magnetic resonance (MR) for characterizing preclinical disease models. Methodical probing into preclinical animal models by MR is invaluable since it allows a careful interpretation and extrapolation of data derived from these models to human disease. In this review we will focus on the applications of cryogenic radiofrequency (RF) coils in small animal MR as a means of boosting image quality (e.g., by supporting MR microscopy) and making data acquisition more efficient (e.g., by reducing measuring time); both being important constituents for thorough investigational studies on animal models of disease. This review attempts to make the (bio)medical imaging, molecular medicine, and pharmaceutical communities aware of this productive ferment and its outstanding significance for anatomical and functional MR in small rodents. The goal is to inspire a more intense interdisciplinary collaboration across the fields to further advance and progress non-invasive MR methods that ultimately support thorough (patho)physiological characterization of animal disease models. In this review, current and potential future applications for the RF coil technology in cardiovascular, neurovascular, and renal disease will be discussed. [ABSTRACT FROM AUTHOR]

Purpose: To propose a novel system based on segmental renal anatomy for objectively reporting location of clinical T1 masses for nephron-sparing surgery. Methods: The kidney was subdivided into 12 standard segments, based on the computed tomography images. In 103 patients (105 cT1 tumours), three blinded radiologists (A, B, and C) prospectively reported segmental tumour location, size, and tumour-feeding arteries. Baseline, peri-operative, and post-operative data of 98 patients who underwent partial nephrectomy (PN) were prospectively collected, and the correlation between segmental tumour location and peri-operative data was evaluated. Kappa statistics were used to measure the inter-observer agreements. Results: Tumour location could be assigned to the defined renal segment in all cases. Median tumour size was 2.8 cm (range 0.6-5.8). Inter-observer concordance was as follows: A versus B 0.82 (95 % CI 0.74-0.90); A versus C 0.89 (95 % CI 0.83-0.95); and B versus C 0.84 (95 % CI 0.76-0.92). First, second, third, and fourth segments were involved by the tumour in 23, 39, 17, and 21 % of cases, respectively. Number of segments involved by the tumour correlated with tumour size ( p = 0.007), number of tumour-feeding arteries ( p = 0.001), estimated blood loss during PN ( p = 0.03), and trended towards higher post-operative complication rate ( p = 0.07). Tumour-feeding arteries were identifiable in 80 patients (76 %). Conclusions: Kidney segmentation (KS) system is an objective and reproducible radiologic method of universally reporting tumour location according to 12 renal segments. By adding descriptive information on tumour characteristics in candidates for nephron-sparing surgery, this novel KS system could serve as an adjunct to current nephrometry systems. [ABSTRACT FROM AUTHOR]

Introduction In preclinical research, the growing number of transgenic models has led to the need for renal-function studies in mice. Many efforts have been made to develop dedicated SPECT systems for rodents, but their availability is limited due to high capital costs. The aim of this work is to demonstrate the feasibility of mouse renal imaging by using an inexpensive alternative based on clinical gamma-cameras. Methods A healthy mouse was scanned 3 h after injection of 6 mCi of Dimercaptosuccinic acid (DMSA) labeled with 99mTc by using a single-head gamma-camera in conjunction with a dedicated pinhole collimator. List-mode data were binned to emulate multiple injections of 1 mCi, 0.1 mCi and 0.01 mCi of 99mTc-DMSA and 6-min ventral and dorsal planar images were acquired and SPECT imaging (60 projection images acquired over 60 min) was performed. An optimization of the protocols in terms of injected activity, time scan, renal cortex uniformity and cortex-to-pelvis contrast was carried out. Results The appropriate protocols were an injected activity of 0.6 mCi, combined with duration of scanning of 1 min for planar and 60 min for SPECT imaging. Our results were validated through the relative quantification of renal function, which showed that both kidneys contributed equally to the total function. They showed that functional structures of the mouse kidneys can be visually distinguished as easily as in human studies. Conclusions Our findings showed the feasibility of conducting quantitative DMSA SPECT studies of anesthetized mice on clinical gamma cameras. [ABSTRACT FROM AUTHOR]