To investigate the effect of image registration on quantitative measurements of free breathing diffusion kurtosis imaging (DKI) in normal human kidney.

Twenty healthy volunteers were prospectively enrolled to undergo DKI imaging with a 3.0 T MR scanner. Three b values (0, 500, and 1 000 s/mm²) were adopted,with image registration performed after image acquisition. Acquired images were fitted using the DKI fitting model to generate the DKI metric maps,which were performed on both the pre-registration images and post-registration images. Image quality of the derived metric maps(before and after image registration,respectively) was assessed by two radiologists. Measurements of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (D_||), axial diffusivity (D_⊥), mean kurtosis(MK), radial kurtosis (K_||) and axial kurtosis (K_⊥) were conducted. The inter-observer reproducibility of the image quality assessment was analyzed using intra-class correlation coefficient(ICC). Wilcoxon signed-rank test was used to evaluate the difference in the subjective scores of the metric maps between those obtained before registration and those after registration. While pairedt test or Wilcoxon signed-rank test was performed to analyze the difference in the quantitative measurements of DKI metrics of the renal cortex and medulla between those obtained before registration and those after registration.

For the inter-observer reproducibility, satisfactory ICCs were obtained for the quantitative metric measurements(pre-registration: 0.784 to 0.821; post-registration:0.836 to 0.934). Significant difference was notice between subjective scores for the quality of metric maps (P<0.05 for each comparison). In both the renal cortex and medulla, significant difference was noticed between each metric value obtained with pre-registration images and that with post-registration images (P<0.05 for each comparison).

Image registration can not only offer higher quality DKI metric maps,but also has effect on the quantitative measurements of obtained metric maps.

Kidney; Magnetic resonance imaging; Image registration