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06-12-2022 | Magnetic Resonance Imaging | Original Article

Three Tesla magnetic resonance imaging detects oxalate osteopathy in patients with primary hyperoxaluria type I

Authors: Lisa-Marie Merz, Mark Born, Guido Kukuk, Alois M. Sprinkart, Ingrid Becker, Cristina Martin-Higueras, Bernd Hoppe

Published in: Pediatric Nephrology | Issue 7/2023

Abstract

Background

With declining kidney function and therefore increasing plasma oxalate, patients with primary hyperoxaluria type I (PHI) are at risk to systemically deposit calcium-oxalate crystals. This systemic oxalosis may occur even at early stages of chronic kidney failure (CKD) but is difficult to detect with non-invasive imaging procedures.

Methods

We tested if magnetic resonance imaging (MRI) is sensitive to detect oxalate deposition in bone. A 3 Tesla MRI of the left knee/tibial metaphysis was performed in 46 patients with PHI and in 12 healthy controls. In addition to the investigator’s interpretation, signal intensities (SI) within a region of interest (ROI, transverse images below the level of the physis in the proximal tibial metaphysis) were measured pixelwise, and statistical parameters of their distribution were calculated. In addition, 52 parameters of texture analysis were evaluated. Plasma oxalate and CKD status were correlated to MRI findings. MRI was then implemented in routine practice.

Results

Independent interpretation by investigators was consistent in most cases and clearly differentiated patients from controls. Statistically significant differences were seen between patients and controls (p < 0.05). No correlation/relation between the MRI parameters and CKD stages or Pox levels was found. However, MR imaging of oxalate osteopathy revealed changes attributed to clinical status which differed clearly to that in secondary hyperparathyroidism.

Conclusions

MRI is able to visually detect (early) oxalate osteopathy in PHI. It can be used for its monitoring and is distinguished from renal osteodystrophy. In the future, machine learning algorithms may aid in the objective assessment of oxalate deposition in bone.

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Title: Three Tesla magnetic resonance imaging detects oxalate osteopathy in patients with primary hyperoxaluria type I
Authors: Lisa-Marie Merz
Mark Born
Guido Kukuk
Alois M. Sprinkart
Ingrid Becker
Cristina Martin-Higueras
Bernd Hoppe
Publication date: 06-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Chronic Kidney Disease
Published in: Pediatric Nephrology / Issue 7/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-022-05836-3

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Springer Medicine

Three Tesla magnetic resonance imaging detects oxalate osteopathy in patients with primary hyperoxaluria type I

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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