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Olorunsola OG, Kim SH, Chang R, et al. Imaging assessment of a portable hemodialysis device: detection of possible failure modes and monitoring of functional performance. Med Instrum (Luton). 2014;2(2)doi: 10.7243/2052-6962-2-2.
Olorunsola, O. G., Kim, S. H., Chang, R., Kuo, Y. C., Hetts, S. W., Heller, A., Kant, R., Saeed, M., Fissell, W. H., Roy, S., & Wilson, M. W. (2014). Imaging assessment of a portable hemodialysis device: detection of possible failure modes and monitoring of functional performance. Medical instrumentation (Luton, England), 2(2), . https://doi.org/10.7243/2052-6962-2-2
Olorunsola, Olufoladare G, et al. "Imaging assessment of a portable hemodialysis device: detection of possible failure modes and monitoring of functional performance." Medical instrumentation (Luton, England) vol. 2,2 (2014). doi: https://doi.org/10.7243/2052-6962-2-2
Olorunsola OG, Kim SH, Chang R, Kuo YC, Hetts SW, Heller A, Kant R, Saeed M, Fissell WH, Roy S, Wilson MW. Imaging assessment of a portable hemodialysis device: detection of possible failure modes and monitoring of functional performance. Med Instrum (Luton). 2014 Mar 27;2(2). doi: 10.7243/2052-6962-2-2. PMID: 25045526; PMCID: PMC4101171.
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Med Instrum (Luton). 2014 Mar 27;2(2). doi: 10.7243/2052-6962-2-2.

Imaging assessment of a portable hemodialysis device: detection of possible failure modes and monitoring of functional performance.

Medical instrumentation (Luton, England)

Olufoladare G Olorunsola, Steven H Kim, Ryan Chang, Yuo-Chen Kuo, Steven W Hetts, Alex Heller, Rishi Kant, Maythem Saeed, William H Fissell, Shuvo Roy, Mark W Wilson

Affiliations

  1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., Room 381, Box 0628, San Francisco, CA 94143, USA.
  2. Department of Medicine, Vanderbilt University Medical Center, USA.

PMID: 25045526 PMCID: PMC4101171 DOI: 10.7243/2052-6962-2-2

Abstract

BACKGROUND: The purpose of this study was to investigate the utility and limitations of various imaging modalities in the noninvasive assessment of a novel compact hemodialyzer under development for renal replacement therapy, with specific aim towards monitoring its functional performance.

METHODS: The prototype is a 4×3×6 cm aluminum cartridge housing "blood" and "dialysate" flow paths arranged in parallel. A sheet of semipermeable silicon nanopore membranes forms the blood-dialysate interface, allowing passage of small molecules. Blood flow was simulated using a peristaltic pump to instill iodinated contrast through the blood compartment, while de-ionized water was instilled through the dialysate compartment at a matched rate in the countercurrent direction. Images were acquired under these flow conditions using multi-detector computed tomography (MDCT), fluoroscopy, high-resolution quantitative computed tomography (HR-QCT), and magnetic resonance imaging (MRI). MDCT was used to monitor contrast diffusion efficiency by plotting contrast density as a function of position along the path of flow through the cartridge during steady state infusion at 1 and 20 mL/min. Both linear and exponential regressions were used to model contrast decay along the flow path.

RESULTS: Both linear and exponential models of contrast decay appeared to be reasonable approximations, yielding similar results for contrast diffusion during a single pass through the cartridge. There was no measurable difference in contrast diffusion when comparing 1 mL/min and 20 mL/min flow rates. Fluoroscopy allowed a gross qualitative assessment of flow within the device, and revealed flow inhomogeneity within the corner of the cartridge opposite the blood inlet port. MRI and HR-QCT were both severely limited due to the paramagnetic properties and high atomic number of the target material, respectively. During testing, we encountered several causes of device malfunction, including leak formation, trapped gas, and contrast-mediated nanopore clogging. We illustrate the imaging manifestations of each.

CONCLUSIONS: Despite the inherent challenges in imaging a predominantly metallic device, some modalities show potential in the non-invasive assessment of a novel compact hemodialyzer. The approaches described here could potentially be translated to device evaluation in the implanted setting.

Keywords: End-stage renal disease; hemodialysis device; multi-detector computed tomography; renal replacement therapy

References

  1. Ann Biomed Eng. 2011 Apr;39(4):1296-305 - PubMed
  2. JAMA. 2007 Sep 19;298(11):1291-9 - PubMed
  3. AJNR Am J Neuroradiol. 2011 Aug;32(7):1158-64 - PubMed
  4. Magn Reson Med. 2010 Oct;64(4):1039-46 - PubMed
  5. Kidney Int. 2006 Nov;70(10):1877; author reply 1877-8 - PubMed
  6. Acta Radiol. 1992 Nov;33(6):600-5 - PubMed
  7. Panminerva Med. 2011 Sep;53(3):155-66 - PubMed
  8. Nephrol Dial Transplant. 2009 Sep;24(9):2915-9 - PubMed
  9. J Memb Sci. 2009 Jan 5;326(1):58-63 - PubMed
  10. J Heart Lung Transplant. 2010 Jan;29(1):79-85 - PubMed
  11. J Thorac Imaging. 2005 Feb;20(1):32-40 - PubMed
  12. ASAIO J. 2011 Jan-Feb;57(1):32-7 - PubMed
  13. Semin Dial. 2009 Nov-Dec;22(6):665-70 - PubMed
  14. J Med Imaging Radiat Oncol. 2012 Aug;56(4):379-83 - PubMed
  15. N Engl J Med. 2010 Dec 9;363(24):2287-300 - PubMed

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