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LONDON, ON – In a newly published study, scientists at Lawson Health Research Institute have adapted PET/MRI technology to accurately image salt within the kidneys of patients with kidney disease.  

“Salt is very difficult to image in an MRI because the signal is much weaker than water,” explains Dr. Christopher McIntyre, Lawson Scientist and Nephrologist at London Health Sciences Centre (LHSC). “We wanted to find a way to look at the fundamental role of the kidney in getting rid of salt and water by using a functional MRI.”

Imaging salt within the kidneys has never been accurately accomplished in patients with kidney disease, but Dr. McIntyre and his team developed new technology and software that was adaptable to a PET/MRI machine at St. Joseph’s Health Care London. The new technology allowed the machine to image salt and water levels within the kidney.

“Salt within the kidneys have only been imaged in pre-clinical models, and low weight, healthy volunteers,” says Dr. McIntyre. “Since the kidney is further away from the MRI coils, and the organ moves when a person breathes, it is definitely very hard to image.”

This was the first study to use MRI to look at salt within the kidneys with a wide range of participant with different body types (10 healthy volunteers), as well as patients with kidney disease (five patients). The research team also imaged patients who had a combination of kidney disease and heart failure, because it is especially important for those patients specifically to be able to release salt and water as part of their treatments.

Currently, clinicians rely on kidney biopsies to measure salt levels, but Dr. McIntyre says that method isn’t as accurate or effective as it could be.

 “The problem is that the biopsies are painful, they have risks, and because it is a small sample of the kidney, we don’t get an accurate perspective of the kidney as a whole,” Dr. McIntyre explains. 

The study, which is published in Radiology has now opened the door to new possibilities when it comes to clinical care for patients with kidney disease.

“Salt is very toxic in patients with kidney failure,” adds Dr. McIntyre. “This will now allow us to diagnose and manage both chronic and acute kidney disease. It is a significant step forward.”

The next steps for the research team will be to compare salt MRI’s to biopsies, while also examining potential new therapy developments. 

“We are hoping we will have a higher degree of certainty moving forward to predict what will happen within the kidneys of these patients, with the possibility of using new targeted and effective treatments in the future,” notes Dr. McIntyre.
 

It was a diagnosis that came as a shock for 28-year-old Mitch Kuska who found out he had Multiple Sclerosis (MS) at the age of 26.  “I went from being a young 26-year-old doing regular things, to having to learn about this disease and everything that goes along with it and how it will affect my life." Kuska, an avid cyclist, says knowing that one day he may not be able to physically do the things he loves has been the hardest part of his MS journey so far.  “The scariest part for sure is the uncertainty, because I don’t know what the future holds for me. Before I could look into the future and feel for the most part that I would be healthy.”

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From his doctors, Kuska learned about a study being conducted with London Health Sciences Centre (LHSC) patients by a group of hospital researchers from Lawson Health Research Institute, the research arm of London’s hospitals. They were examining the use of mindfulness as a possible tool for newly diagnosed relapsing MS (RMS) patients. Mindfulness is a type of meditation that focuses on being intensely aware of senses and feelings in the moment.

“It can be a stressful time for people as they have just been diagnosed with a chronic neurological disease that will last the rest of their life,” says Dr. Sarah Morrow, Neurologist and Associate Scientist at Lawson.

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“We do find that there is an increase in anxiety and depression for people with MS, especially depression. In fact, the rates are three times higher for people with MS compared to other neurological disease.” Dr. Morrow is also the Director of the London MS Clinic at LHSC.

As part of the study, 24 newly diagnosed RMS patients were recruited including Kuska. Participants were split up into two groups, either the treatment group or the control group. The treatment group took part in ten sessions of the Mindfulness Without Borders program.

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“Mindfulness is bringing people into the moment rather than worrying about what could happen in the future or thinking about what happened in the past,” says Dr. Arlene MacDougall, Psychiatrist and Lawson Scientist. “It’s about centering yourself and gaining a sense of control of how you will respond rather than react to what is happening inside or outside of you.” 

The participants were evaluated before the sessions and then six months later to see if there was a difference between the two groups. “Immediately after the sessions when we compared the two groups, those in the mindfulness were reporting better coping skills and less perceived stress, and their symptoms of depression had been reduced,” adds Dr. Morrow.

“During the study treatment, I definitely noticed myself being more mindful of my symptoms. Sensing little changes in my body and little feelings here and there,” explains Kuska. “I was more in tune with myself and I felt this mindfulness tool helped me get into the right mindset to start dealing with MS.”

Following these initial findings published in Multiple Sclerosis and Related Disorders, the London research team plans to examine them in a larger study. They are also working to examine if the use of mindfulness would be helpful for people who are in the more progressive stages of MS.