Caroli, A. (Anna)

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    Technical recommendations for clinical translation of renal MRI: a consensus project of the Cooperation in Science and Technology Action PARENCHIMA
    (Springer, 2020) Alsop, D.C. (David C.); Sourbron, S. (Steven); Boer, A. (Anneloes) de; Golay, X. (Xavier); Dekkers, I. (Ilona); Laustsen, C. (Christoffer); Pedrosa, I. (Ivan); Pohlmann, A. (Andreas); Buchanan, C.E. (Charlotte E.); Nery, F. (Fabio); Harteveld, A.A. (Anita A.); Odudu, A. (Aghogho); Pullens, P. (Pim); Caroli, A. (Anna); Ljimani, A. (Alexandra); Bane, O. (Octavia); Fernández-Seara, M.A. (María A.); Fain, S.B. (Sean B.); Sharma, K. (Kanishka); Prasad, P.V. (Pottumarthi V.); Francis, S.T. (Susan T.); Mendichovszky, I.A. (Iosif A.); Sigmund, E. (Eric)
    Purpose The potential of renal MRI biomarkers has been increasingly recognised, but clinical translation requires more standardisation. The PARENCHIMA consensus project aims to develop and apply a process for generating technical recommendations on renal MRI. Methods A task force was formed in July 2018 focused on fve methods. A draft process for attaining consensus was distributed publicly for consultation and fnalised at an open meeting (Prague, October 2018). Four expert panels completed surveys between October 2018 and March 2019, discussed results and refned the surveys at a face-to-face meeting (Aarhus, March 2019) and completed a second round (May 2019). Results A seven-stage process was defned: (1) formation of expert panels; (2) defnition of the context of use; (3) literature review; (4) collection and comparison of MRI protocols; (5) consensus generation by an approximate Delphi method; (6) reporting of results in vendor-neutral and vendor-specifc terms; (7) ongoing review and updating. Application of the process resulted in 166 consensus statements. Conclusion The process generated meaningful technical recommendations across very diferent MRI methods, while allowing for improvement and refnement as open issues are resolved. The results are likely to be widely supported by the renal MRI community and thereby promote more harmonisation.
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    Consensus-based technical recommendations for clinical translation of renal phase contrast MRI
    (Wiley, 2020) Serai, S.D. (Suraj D.); Morris, D.M. (David M.); Ringgaard, S. (Sreffen); Sourbron, S. (Steven); Zöllner, F.G. (Frank G.); Hermann, I. (Ingo); Boer, A. (Anneloes) de; Dekkers, I. (Ilona); Laustsen, C. (Christoffer); Nery, F. (Fabio); Lim, R.P. (Ruth P.); Cox, E.F. (Eleanor F.); Hall, M.E. (Michael E.); Caroli, A. (Anna); Bock, M. (Michael); Eckerbom, P. (Per); Wentland, A.L. (Andrew L.); Hockings, P.D. (Paul D.); Bane, O. (Octavia); Fernández-Seara, M.A. (María A.); Lamb, H.J. (Hildo J.); Haddock, B. (Bryan); Takehara, Y. (Yasuo); Wolf, M. (Marcos); Sharma, K. (Kanishka); Villa, G. (Giula); Francis, S.T. (Susan T.); Hall-Barrientos, P. (Pauline)
    Background: Phase-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 PCMRI as a clinically useful tool. Purpose: To 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 Type: Systematic consensus process using a modified Delphi method. Population: Not applicable. Sequence Field/Strength: Renal fast gradient echo-based 2D PC-MRI. Assessment: An 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 Tests: Consensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60–74% agreement among the experts. Results: Among 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 Conclusion: These 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 Evidence: 1 Technical Efficacy Stage: 1
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    Magnetic resonance imaging biomarkers for chronic kidney disease: a position paper from the European Cooperation in Science and Technology Action PARENCHIMA
    (Oxford University Press, 2018) Joles, J.A. (Jaap A.); Taal, M. (Maarten W.); Sourbron, S. (Steven); Ortiz, A. (Alberto); Gordon, I. (Isky); Pruijm, M. (Menno); Golay, X. (Xavier); Blankestijn, P.J. (Peter J.); Grenier, N. (Nicolas); Eckardt, K.U. (Kai-Uwe); Seigneux, S. (Sophie); Combe, C. (Christian); Mark, P.B. (Patrick B.); Kalra, P.A.(Philip A.); Odudu, A. (Aghogho); Rorvik, J. (Jarle); Caroli, A. (Anna); Jensen, J.D. (Jens D.); Vallée, J.P. (Jean-Paul); Remuzzi, G. (Giuseppe); Krämer, B.K. (Bernhard K.); Nikolic, O. (Olivera); Thoeny, H.C. (Harriet C.); Hockings, P.D. (Paul D.); Selby, N.M. (Nicholas M.); Eikefjord, E. (Eli); Garcia-Fernandez, N. (Nuria); Boor, P. (Peter); Ong, A.C.M. (Albert C. M.); Simms, R.J. (Roslyn J.); Wolf, M. (Marcos); Slatinska, J. (Janka); Summers, P. (Paul); Mendichovszky, I.A. (Iosif A.)
    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.