Magnetic resonance imaging biomarkers for chronic kidney disease: a position paper from the European Cooperation in Science and Technology Action PARENCHIMA

Nicholas M Selby, Peter J Blankestijn, Peter Boor, Christian Combe, Kai-Uwe Eckardt, Eli Eikefjord, Nuria Garcia-Fernandez, Xavier Golay, Isky Gordon, Nicolas Grenier, Paul D Hockings, Jens D Jensen, Jaap A Joles, Philip A Kalra, Bernhard K Krämer, Patrick B Mark, Iosif A Mendichovszky, Olivera Nikolic, Aghogho Odudu, Albert C M Ong, Alberto Ortiz, Menno Pruijm, Giuseppe Remuzzi, Jarle Rørvik, Sophie de Seigneux, Roslyn J Simms, Janka Slatinska, Paul Summers, Maarten W Taal, Harriet C Thoeny, Jean-Paul Vallée, Marcos Wolf, Anna Caroli, Steven Sourbron, Nicholas M Selby, Peter J Blankestijn, Peter Boor, Christian Combe, Kai-Uwe Eckardt, Eli Eikefjord, Nuria Garcia-Fernandez, Xavier Golay, Isky Gordon, Nicolas Grenier, Paul D Hockings, Jens D Jensen, Jaap A Joles, Philip A Kalra, Bernhard K Krämer, Patrick B Mark, Iosif A Mendichovszky, Olivera Nikolic, Aghogho Odudu, Albert C M Ong, Alberto Ortiz, Menno Pruijm, Giuseppe Remuzzi, Jarle Rørvik, Sophie de Seigneux, Roslyn J Simms, Janka Slatinska, Paul Summers, Maarten W Taal, Harriet C Thoeny, Jean-Paul Vallée, Marcos Wolf, Anna Caroli, Steven Sourbron

Abstract

Functional renal magnetic resonance imaging (MRI) has seen a number of recent advances, and techniques are now available that can generate quantitative imaging biomarkers with the potential to improve the management of kidney disease. Such biomarkers are sensitive to changes in renal blood flow, tissue perfusion, oxygenation and microstructure (including inflammation and fibrosis), processes that are important in a range of renal diseases including chronic kidney disease. However, several challenges remain to move these techniques towards clinical adoption, from technical validation through biological and clinical validation, to demonstration of cost-effectiveness and regulatory qualification. To address these challenges, the European Cooperation in Science and Technology Action PARENCHIMA was initiated in early 2017. PARENCHIMA is a multidisciplinary pan-European network with an overarching aim of eliminating the main barriers to the broader evaluation, commercial exploitation and clinical use of renal MRI biomarkers. This position paper lays out PARENCHIMA's vision on key clinical questions that MRI must address to become more widely used in patients with kidney disease, first within research settings and ultimately in clinical practice. We then present a series of practical recommendations to accelerate the study and translation of these techniques.

Figures

FIGURE 1
FIGURE 1
Summary of recommendations to progress renal MRI biomarkers. Technical validation should precede biological and clinical validation, although this process is likely to occur in parallel as well as sequentially; this bidirectional process is represented by the arrows. The labels with the prefix ‘R’ indicate the specific recommendation linked to each statement.

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