DEVELOPMENT AND CLINICAL TRANSLATION OF MRI METHODS FOR QUANTITATIVE ASSESSMENT OF ORGAN PHYSIOLOGY AND TISSUE STRUCTURE
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Graduate group
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Flow
Kidney
MRI
Oxygenation
Skull
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Abstract
This dissertation presents the development and clinical translation of MRI techniques for physiological and structural imaging, with applications in renal and bone assessment. The first half focuses on the technical development and validation of a non-invasive MRI-oximetry method for evaluating renal metabolism. In early kidney disease, tissue hypoxia occurs due to an imbalance between ATP supply and demand. Renal metabolic rate of oxygen (rMRO2) reflects the kidney’s metabolic efficiency, making it a potential biomarker for early-stage kidney disease. Whole-organ rMRO2 is quantified by invoking Fick’s Principle, requiring measurements of renal venous oxygen saturation (SvO2) and blood flow rate (BFR). The K-MOTIVE sequence (Kidney Metabolism of Oxygen via T2 and Interleaved Velocity Encoding) was developed for simultaneous measurements of SvO2 and BFR at the renal vein. This work optimized K-MOTIVE to facilitate free-breathing acquisition by increasing its robustness to respiratory motion. Free-breathing K-MOTIVE yielded comparable metabolic parameters compared to its breath-hold counterpart, demonstrating the method’s potential to improve image quality when subjects cannot hold their breath. Furthermore, K-MOTIVE’s sensitivity to within-subject changes in metabolic parameters was evaluated in response to hypoxic gas challenges, providing experimental insight into the kidney’s physiological response to transient hypoxemia. The second half of this dissertation focuses on validation and clinical translation of bone-selective MRI for craniofacial imaging in pediatric patients as a radiation-free alternative to CT. The emergence of low-dose protocols for CT imaging has mitigated pediatric radiation exposure, yet ionizing radiation remains a concern for children with complex craniofacial conditions requiring repeated radiologic monitoring. In this work, the DURANDE sequence (dual-radiofrequency, dual-echo ultrashort echo time) was quantitatively compared to other craniofacial-imaging techniques. Furthermore, DURANDE’s clinical feasibility was investigated in pediatric patients with craniofacial abnormalities. The bone-selective images were evaluated for their ability to resolve thin bone structures from soft tissue and air, as well as the agreement of the binary bone images and craniometric measurements derived from 3D skull renderings compared to those obtained from CT. DURANDE’s bone-selective images were demonstrated to have good bone contrast and soft tissue suppression, yielding comparable skull craniometry to those obtained from CT.
Advisor
Rajapakse, Chamith, S