Feasibility of measuring renal blood flow by phase-contrast magnetic resonance imaging in patients with autosomal dominant polycystic kidney disease

OBJECTIVES: Renal blood flow (RBF) has been shown to predict disease progression in autosomal dominant polycystic kidney disease (ADPKD). We investigated the feasibility and accuracy of phase-contrast RBF by MRI (RBF(MRI)) in ADPKD patients with a wide range of estimated glomerular filtration rate (eGFR) values. METHODS: First, we validated RBF(MRI) measurement using phantoms simulating renal artery hemodynamics. Thereafter, we investigated in a test-set of 21 patients intra- and inter-observer coefficient of variation of RBF(MRI). After validation, we measured RBF(MRI) in a cohort of 91 patients and compared the variability explained by characteristics indicative for disease severity for RBF(MRI) and RBF measured by continuous hippuran infusion. RESULTS: The correlation in flow measurement using phantoms by phase-contrast MRI was high and fluid collection was high (CCC=0.969). Technical problems that precluded RBF(MRI) measurement occurred predominantly in patients with a lower eGFR (34% vs. 16%). In subjects with higher eGFRs, variability in RBF explained by disease characteristics was similar for RBF(MRI) compared to RBF(Hip,) whereas in subjects with lower eGFRs, this was significantly less for RBF(MRI). CONCLUSIONS: Our study shows that RBF can be measured accurately in ADPKD patients by phase-contrast, but this technique may be less feasible in subjects with a lower eGFR. KEY POINTS: • Renal blood flow (RBF) can be accurately measured by phase-contrast MRI in ADPKD patients. • RBF measured by phase-contrast is associated with ADPKD disease severity. • RBF measurement by phase-contrast MRI may be less feasible in patients with an impaired eGFR. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00330-015-3877-y) contains supplementary material, which is available to authorized users.