Consensus-based technical recommendations for clinical translation of renal diffusion-weighted MRI

Area of Science:

• Medical Imaging
• Biomarker Development
• Renal Disease Research

Background:

• Diffusion-weighted imaging (DWI) shows promise for assessing renal disease.
• Lack of standardization hinders the validation of DWI-based imaging biomarkers.
• Harmonization efforts are needed for reliable inter-site comparisons.

Purpose of the Study:

• To propose technical recommendations for renal DWI variants (monoexponential DWI, IVIM, DTI) and associated MRI biomarkers.
• To facilitate international efforts in methodological harmonization of renal DWI.
• To establish a framework for acquisition protocols in future renal DWI studies.

Main Methods:

• Literature review of 194 renal DWI studies to extract reported biomarkers.
• Pearson correlations computed between diffusion biomarkers and protocol parameters.
• Delphi consensus process via surveys to build agreement on renal DWI best practices.

Main Results:

• Correlations identified between diffusion biomarkers and protocol parameters.
• Consensus (≥75% agreement) reached on 57 out of 87 survey questions.
• Recommendations provided for renal DWI preparation, acquisition, processing, and reporting.

Conclusions:

• Consensus-based technical recommendations aim to harmonize renal DWI across sites.
• Standardization is expected to increase the clinical impact of renal DWI.
• An iterative process for updating recommendations is anticipated.