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Novel contrast mixture achieves contrast resolution of human bladder wall suitable for T1 mapping: applications in interstitial cystitis and beyond

  • Urology - Original Paper
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Abstract

Purpose

Instillation of novel contrast mixture (NCM) was recently shown to improve the contrast resolution of rat bladder wall with high contrast-to-noise ratio (CNR). Here, the clinical safety and the feasibility of NCM-enhanced MRI to achieve artifact-free visualization of human bladder wall suitable for quantitative measurement of the magnetic resonance (MR) longitudinal relaxation time (T1) was assessed.

Methods

Six female subjects [two controls and two with Hunner-type interstitial cystitis IC and two with non-Hunner-type IC] consented for MRI at 3 T before and after instillation of NCM [4 mM gadobutrol and 5 mM ferumoxytol in 50 mL of sterile water for injection]. Single breath-hold fast MR acquisition in large readout bandwidth for 5-mm-thick single slice with variable flip angle was applied to minimize the motion and chemical shift artifacts in measurements of bladder wall thickness (BWT), CNR and T1 from 20 pixels.

Results

NCM instillation in subjects did not evoke pain or discomfort. Fourfold increase in bladder wall CNR (*p < 0.02) and pixel size of 0.35 mm with minimal influence of artifacts allowed accurate determination of bladder wall thinning ~ 0.46 mm from 50 mL NCM (*p < 0.05). Pre-contrast bladder wall T1 of 1544 ± 34.2 ms was shortened to 860.09 ± 13.95 ms in Hunner-type IC (*p < 0.0001) relative to only 1257.42 ± 20.59 and 1258.16 ± 6.16 ms in non-Hunner-type IC and controls, respectively.

Conclusion

Findings demonstrate the safety and feasibility of NCM-enhanced MRI to achieve artifact-free differential contrast and spatial resolution of human bladder wall, which is suitable for measuring BWT and pixel-wise measurement of T1 in post-contrast setting.

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Funding

This project was funded by NIDDK Grant 1R41DK108397. Authors would also like to acknowledge the contribution of Janet Erickson and Anna Wecht in patient recruitment and for assistance during scanning.

Author information

Authors and Affiliations

  1. Department of Urology, University of Pittsburgh, E313 Montefiore Hospital, 3459 Fifth Ave, Pittsburgh, PA, 15213, USA

    Pradeep Tyagi & Christopher Chermansky

  2. Lipella Pharmaceuticals Inc, Pittsburgh, PA, USA

    Joseph Janicki & Jonathan Kaufman

  3. Department of Radiology, Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, PA, USA

    Chan-Hong Moon

Authors
  1. Pradeep Tyagi
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  2. Joseph Janicki
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  3. Chan-Hong Moon
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  4. Jonathan Kaufman
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Corresponding author

Correspondence to Pradeep Tyagi.

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Conflict of interest

Pradeep Tyagi, Chan-Hong Moon and Christopher Chermansky declare that they have no conflict of interest. Joseph Janicki and Jonathan Kaufman are the employees of Lipella Pharmaceuticals, and Jonathan Kaufman is the inventor of the novel contrast mixture.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the University of Pittsburgh Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Tyagi, P., Janicki, J., Moon, CH. et al. Novel contrast mixture achieves contrast resolution of human bladder wall suitable for T1 mapping: applications in interstitial cystitis and beyond. Int Urol Nephrol 50, 401–409 (2018). https://doi.org/10.1007/s11255-018-1794-0

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  • DOI: https://doi.org/10.1007/s11255-018-1794-0

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