UK Renal Imaging Network (UKRIN): Enabling clinical translation of functional MRI for kidney disease

肾脏疾病的全球负担是巨大的；世界上10%的人口患有慢性肾病（CKD）。CKD的病因包括急性肾损伤（AKI）、糖尿病和高血压。其他危险因素包括心血管疾病和肥胖。CKD会导致心血管事件、心血管死亡率或终末期肾脏疾病的大幅增加，在英国每年的估计成本为150亿英镑。由于缺乏有效的患者分层和治疗反应评估方法，治疗选择受到限制。磁共振成像（MRI）已成为一种有前途的评估、监测和管理肾脏疾病的新方法。然而，在临床实践和研究中，MRI肾脏生物标志物的潜力被低估和未开发。许多研究报告的患者数量较少，并且使用不同的MRI方法，使得不同研究的结果难以比较或外推到临床实践中。我们建议共同努力，解决将肾脏MRI应用于临床的挑战。该合作提案将利用英国肾脏成像网络（UKRIN），这是一个由13个英国肾脏MRI站点组成的现有网络。通过合作基金，我们的目标是开发一个肾脏MRI平台，分享专业知识，建设能力，并制定统一的方法，从而实现数据共享，并加速肾脏MRI的临床潜力。这将促进更大规模的队列研究，为肾脏疾病的理解和治疗提供独特的贡献。这是一项全球首创的倡议，汇集了患者、领先的科学家和临床研究人员、其他多学科专家、英国肾脏研究中心和行业扫描仪制造商。该伙伴关系将巩固英国在该领域的全球先锋地位；使这项新技术的临床应用成为可能；继续加速新技术的进步。这将作为未来合作研究项目的平台，包括多地点临床研究。我们为期三年的合作资助期的具体目标是开发一个平台，成为肾脏MRI的国家标准：1)我们将分享在英国各地建立的肾脏MRI经验。2)我们将组织一系列肾脏MRI研讨会和研讨会。3)我们将制定一套优化的肾脏成像扫描方案，可用于所有英国站点。这些将包括：(i)相对简单的结构和功能肾脏成像方法，可以快速应用；（ii）需要额外开发工作的更先进的尖端方法；（iii）可用于在所有站点保持高水平扫描仪性能的标准化质量保证协议。4)我们将开发一个国家图像共享和分析平台，以开发共享和汇总跨UKRIN站点获取的数据的能力，并开发针对肾脏MRI数据进行优化的分析管道。这将遵循英国痴呆症平台（DPUK）目前使用的模板，使用开源XNAT信息学软件。我们还将促进与英国肾脏登记处的联系。该提案将通过创建和验证一个平台来形成国家指南，从而建立肾脏MRI测量标准。这些新的功能性无创肾脏MRI方法将允许独立评估每个肾脏的各个不同方面，其结果反映瞬时肾脏功能，而不是随时间的代谢后果。利用MRI方法对肾脏进行成像，有可能通过更好的诊断、更好的预后评估和治疗效果来改善肾脏患者的管理，并加速新药的发现。伙伴关系赠款将解决治理、患者参与、业务发展和开发等关键领域的问题，所有这些都由综合通信计划提供支持。

The global burden of kidney disease is significant; 10% of the world's population have chronic kidney disease (CKD). Causes of CKD include acute kidney Injury (AKI), diabetes and high blood pressure. Other risk factors include cardiovascular disease and obesity. CKD confers a large increase in cardiovascular events, cardiovascular mortality or end-stage kidney disease, with an annual estimated cost in England of >£1.5 billion. Treatment options are limited by a lack of validated methods for patient stratification and assessment of response to therapy. Magnetic Resonance Imaging (MRI) has emerged as a promising new approach for assessing, monitoring and managing kidney disease. However, the potential of MRI kidney biomarkers is underestimated and unexplored in both clinical practice and research. Numerous research studies report small numbers of patients and use different MRI methods, making results from different studies difficult to compare or extrapolate into clinical practice. We propose to work together to tackle the challenges associated with moving renal MRI to clinical use. This Partnership proposal will capitalise on the UK Renal Imaging Network (UKRIN), an existing network of 13 UK renal MRI sites. Through the Partnership grant we aim to develop a renal MRI platform, share expertise, build capacity, and develop a harmonized approach thus enabling data sharing, and accelerating the clinical potential of renal MRI. This will facilitate larger cohort studies, providing a unique contribution to the understanding and treatment of kidney disease. This is a global 1st initiative bringing together patients, leading scientists and clinical researchers, other multidisciplinary experts, Kidney Research UK and industry scanner manufacturers. The Partnership will consolidate the UK's global pioneering role in this field; enable clinical translation of this novel technology; and continue to accelerate new technological advances. This will serve as a platform for future collaborative research programmes, including multi-site clinical studies. Our specific objectives for the three-year Partnership grant period are to develop a platform to become a national standard for renal MRI:1) We will share experience in renal MRI that has built up across UK sites.2) We will organise a series of renal MRI Symposia and Workshops.3) We will produce a set of optimised scanning protocols for renal imaging that can be used by all the UK sites. These will include: (i) relatively straightforward structural and functional renal imaging methods that can applied quickly; (ii) more advanced cutting-edge methods that require additional development work; (iii) standardised quality assurance protocols that can be used to maintain a high level of scanner performance at all sites.4) We will develop a national image sharing and analysis platform to develop the capability to share and aggregate data acquired across UKRIN sites, and to develop analysis pipelines that are optimised for renal MRI data. This will follow the template currently employed by the Dementias Platform UK (DPUK), using the open source XNAT informatics software. We will also facilitate links with the UK Renal Registry. This proposal will establish a standard of renal MRI measures by creating and validating a platform to form the national guide. These new functional non-invasive renal MRI methods will allow various different renal aspects of each kidney to be assessed independently, with results reflecting instantaneous kidney function, rather than the metabolic consequences over time. Imaging the kidney using MRI methods has the potential to improve the management of kidney patients through better diagnosis, better assessment of prognosis and the effect of therapy, and accelerating new drug discovery. The Partnership grant will address key areas of governance, patient engagement, business development and exploitation all supported by an integrated communications plan.