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

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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.