Quantification of regional blood flow by monitoring of exogenous tracer via nuclear magnetic resonance spectroscopy

Label-Free Chemically and Molecularly Selective Magnetic Resonance Imaging

Biomedical imaging, especially molecular imaging, has been a driving force in scientific discovery, technological innovation, and precision medicine in the past two decades. While substantial advances and discoveries in chemical biology have been made to develop molecular imaging probes and tracers, translating these exogenous agents to clinical application in precision medicine is a major challenge. Among the clinically accepted imaging modalities, magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) exemplify the most effective and robust biomedical imaging tools. Both MRI and MRS enable a broad range of chemical, biological and clinical applications from determining molecular structures in biochemical analysis to imaging diagnosis and characterization of many diseases and image-guided interventions. Using chemical, biological, and nuclear magnetic resonance properties of specific endogenous metabolites and native MRI contrast-enhancing biomolecules, label-free molecular and cellular imaging with MRI can be achieved in biomedical research and clinical management of patients with various diseases. This review article outlines the chemical and biological bases of several label-free chemically and molecularly selective MRI and MRS methods that have been applied in imaging biomarker discovery, preclinical investigation, and image-guided clinical management. Examples are provided to demonstrate strategies for using endogenous probes to report the molecular, metabolic, physiological, and functional events and processes in living systems, including patients. Future perspectives on label-free molecular MRI and its challenges as well as potential solutions, including the use of rational design and engineered approaches to develop chemical and biological imaging probes to facilitate or combine with label-free molecular MRI, are discussed.

Deuterium oxide as a contrast medium for real-time MRI-guided endovascular neurointervention

Rationale: Endovascular intervention plays an important role in the treatment of various diseases, in which MRI-guidance can potentially improve precision. However, the clinical applications of currently available contrast media, including Gadolinium-based contrast agents and superparamagnetic iron oxide particles (SPIO), are hindered by safety concerns. In the present study, we sought to develop D2O as a novel contrast agent for guiding endovascular neurointervention. Methods: Animal studies were approved by institutional ACUC and conducted using an 11.7 T Bruker Biospec system and a 3T Siemens Trio clinical scanner for rodent and canine imaging, respectively. The locally selective blood brain barrier opening (BBBO) in rat brains was obtained by intraarterial (IA) injection of mannitol. The dynamic T2w* EPI MRI sequence was used to study the trans-catheter perfusion territory by IA administered SPIO before mannitol administration, whereas a dynamic T1w FLASH sequence was used to acquire Gd contrast-enhanced MRI for assessing BBBO after injection of mannitol. The contrast generated by D2O assessed by either EPI or FLASH methods was compared with the corresponding results assessed by SPIO or Gd. The utility of D2O MRI was also demonstrated to guide drug delivery to glioma in a mouse model. Finally, the clinical utility of D2O-MRI was demonstrated in a canine model. Results: Our study has shown that the contrast generated by D2O can be used to precisely delineate trans-catheter perfusion territory in both small and large animals. The perfusion territories determined by D2O-MRI show moderate correlation with those by SPIO-MRI (Spearman coefficient r = 0.5234, P < 0.001). Moreover, our results show that the perfusion territory determined by D2O-MRI can successfully predict the areas with BBBO after mannitol treatment similar to that assessed by Gd-MRI (Spearman coefficient r = 0.6923, P < 0.001). Using D2O-MRI as imaging guidance, the optimal infusion rate in the mouse brain was determined to be 150 µL/min to maximize the delivery efficacy to the tumor without serious off-target delivery to the brain parenchyma. The enhanced drug delivery of antibodies to the brain tumor was confirmed by fluorescence imaging. Conclusion: Our study demonstrated that D2O can be used as a negative MRI contrast medium to guide endovascular neurointervention. The established D2O -MRI method is safe and quantitative, without the concern of contrast accumulation. These qualities make it an attempting approach for a variety of endovascular procedures.

Deuterium MR Spectroscopy at 4.7 T

Deuterium MR spectroscopy was used for the determination of tissue blood flow (TBF). The tracer D2O was injected into the tissue of interest, and tracer washout was followed using a 4.7 T spectroscopy/imaging unit. Normal subcutaneous tissue in rats was studied, as well as tissue influenced by vasoactive agents (papaverine and adrenaline). The vasoactive agents introduced changes of 40% in TBF, compared with normal tissue. Normal tissue measurements were repeated using various D2O injection volumes (5–400 μl). The injection volume 5 μl gave TBF 11.7 ± 2.0 ml/100 g·min (mean ± 1 SD). This value was 40% higher than corresponding values observed at larger injection volumes (200–400 μl). This injection volume effect is probably partly due to a capillary dilution caused by tracer administration, and partly related to the non-physiological deuterium signal decrease observed in dead rats. Blood flow measurements in human colon tumours implanted in nude mice showed a rather poor reproducibility, not improved by the use of a multiple site injection technique.

Calabadion

Introduction:

To evaluate whether calabadion 1, an acyclic member of the Cucurbit[n]uril family of molecular containers, reverses benzylisoquinoline and steroidal neuromuscular-blocking agent effects.

Methods:

A total of 60 rats were anesthetized, tracheotomized, and instrumented with IV and arterial catheters. Rocuronium (3.5 mg/kg) or cisatracurium (0.6 mg/kg) was administered and neuromuscular transmission quantified by acceleromyography. Calabadion 1 at 30, 60, and 90 mg/kg (for rocuronium) or 90, 120, and 150 mg/kg (for cisatracurium), or neostigmine/glycopyrrolate at 0.06/0.012 mg/kg were administered at maximum twitch depression, and renal calabadion 1 elimination was determined by using a 1H NMR assay. The authors also measured heart rate, arterial blood gas parameters, and arterial blood pressure.

Results:

After the administration of rocuronium, resumption of spontaneous breathing and recovery of train-of-four ratio to 0.9 were accelerated from 12.3 ± 1.1 and 16.2 ± 3.3 min with placebo to 4.6 ± 1.8 min with neostigmine/glycopyrrolate to 15 ± 8 and 84 ± 33 s with calabadion 1 (90 mg/kg), respectively. After the administration of cisatracurium, recovery of breathing and train-of-four ratio of 0.9 were accelerated from 8.7 ± 2.8 and 9.9 ± 1.7 min with placebo to 2.8 ± 0.8 and 7.6 ± 2.1 min with neostigmine/glycopyrrolate to 47 ± 13 and 87 ± 16 s with calabadion 1 (150 mg/kg), respectively. Calabadion 1 did not affect heart rate, mean arterial blood pressure, pH, carbon dioxide pressure, and oxygen tension. More than 90% of the IV administered calabadion 1 appeared in the urine within 1 h.

Conclusion:

Calabadion 1 is a new drug for rapid and complete reversal of the effects of steroidal and benzylisoquinoline neuromuscular-blocking agents.

In vivo measurement of CBF using ¹⁷O NMR signal of metabolically produced H₂¹⁷O as a perfusion tracer

The cerebral metabolic rate of oxygen of small animals can be reliably imaged using the in vivo (17) O magnetic resonance approach at high field. However, a separate measurement is required for imaging the cerebral blood flow in the same animal. In this study, we demonstrate that the (17) O NMR signal of metabolically produced H2 (17) O in the rat brain following an (17) O2 inhalation can serve as a perfusion tracer and its decay rate can be used to determine the absolute values of cerebral blood flow across a wide range of animal conditions. This finding suggests that the in vivo (17) O magnetic resonance approach is capable of imaging both cerebral metabolic rate of oxygen and cerebral blood flow simultaneously and noninvasively; and it provides new utilities for studying the cerebral oxygen metabolism and perfusion commonly associated with brain function and diseases.

Longitudinal functional magnetic resonance imaging in animal models

Functional magnetic resonance imaging (fMRI) has had an essential role in furthering our understanding of brain physiology and function. fMRI techniques are nowadays widely applied in neuroscience research, as well as in translational and clinical studies. The use of animal models in fMRI studies has been fundamental in helping elucidate the mechanisms of cerebral blood-flow regulation, and in the exploration of basic neuroscience questions, such as the mechanisms of perception, behavior, and cognition. Because animals are inherently non-compliant, most fMRI performed to date have required the use of anesthesia, which interferes with brain function and compromises interpretability and applicability of results to our understanding of human brain function. An alternative approach that eliminates the need for anesthesia involves training the animal to tolerate physical restraint during the data acquisition. In the present chapter, we review these two different approaches to obtaining fMRI data from animal models, with a specific focus on the acquisition of longitudinal data from the same subjects.

Vascular perfusion of human lung cancer in a rat orthotopic model using dynamic contrast-enhanced magnetic resonance imaging

Lung cancer is the leading cause of death among cancers. Early detection and diagnosis present a major goal in the efforts to improve survival rates of lung cancer patients. Changes in angiogenic activity and microvascular perfusion properties in cancers can serve as markers of malignancy. The aim of this study was to employ MRI means to measure the microvascular perfusion parameters of orthotopic nonsmall cell lung cancer, using the experimental rat model. Anatomical and dynamic contrast-enhanced lung images were acquired at high spatial resolution, and registered and analyzed, pixel by pixel and globally, by means of a model-based algorithm. The MRI output yielded color-coded parametric images of the influx and efflux transcapillary transfer constants that indicated rapid microvascular perfusion. The transfer constants were about 1 order of magnitude higher than those found in other tumors or in nonorthotopic lung cancer, with the influx constant median value of 0.42 min(-1) and the efflux constant median value of 1.61 min(-1). The rapid perfusion was in accord with the immunostaining of the capillaries, which suggested the tumor exploitation of the existing alveolar vessels. The results showed that high resolution, dynamic, contrast-enhanced MRI is an effective tool for the quantitative measurement of spatial and temporal changes in lung cancer perfusion and vasculature.

Perfusion-based fMRI: insights from animal models

Modern functional neuroimaging techniques, including functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and optical imaging of intrinsic signals (OIS), rely on a tight coupling between neural activity and cerebral blood flow (CBF) to visualize brain activity using CBF as a surrogate marker. Because CBF is a uniquely defined physiological parameter, fMRI techniques based on CBF contrast have the advantage of being specific to tissue signal change, and the potential to provide more direct and quantitative measures of brain activation than blood oxygenation level-dependent (BOLD)- or cerebral blood volume (CBV)-based techniques. The changes in CBF elicited by increased neural activity are an excellent index of the magnitude of electrical activity. Increases in CBF are more closely localized to the foci of increased electrical activity, and occur more promptly to the stimulus than BOLD- or CBV-based contrast. In addition, CBF-based fMRI is less affected by confounds from venous drainage common to BOLD. Animal studies of brain activation have yielded considerable insights into the advantages of CBF-based fMRI. Based on results provided by animal studies, CBF fMRI may offer a means of better assessing the magnitude, spatial extent, and temporal response of neural activity, and may be more specific to tissue state. These properties are expected to be particularly useful for longitudinal and quantitative fMRI studies.

Methodology of brain perfusion imaging

Numerous techniques have been proposed in the last 15 years to measure various perfusion-related parameters in the brain. In particular, two approaches have proven extremely successful: injection of paramagnetic contrast agents for measuring cerebral blood volumes (CBV) and arterial spin labeling (ASL) for measuring cerebral blood flows (CBF). This review presents the methodology of the different magnetic resonance imaging (MRI) techniques in use for CBV and CBF measurements and briefly discusses their limitations and potentials.

Non-invasive tumour blood perfusion measurement by 2H magnetic resonance

Deuterium uptake into foot-implanted C3H murine mammary carcinomas was measured non-invasively by 2H NMR spectroscopy at 46 MHz after i.v. injection. The arterial input function (AIF) was estimated from 2H NMR measurements with a second radiofrequency coil externally located over the heart. Tumour and heart data were acquired over the same time period by means of a switch automatically activated every 1.6-3.2 s. Although the AIF data were, in general, partly contaminated by signals from adjacent tissue, a mathematical fitting procedure involving simultaneous fitting of the AIF and the tumour kinetics gave robust results for tumour blood perfusion (TBP): up to four repeat TBP measurements were made in 14 out of 20 untreated animals and TBP could be measured before and after treatment in 14 out of 15 animals. The ability of this technique to measure changes in blood perfusion was assessed using hydralazine, which decreased TBP from 91 to 29 ml 100 g(-1) min(-1) and this was comparable to a 70% reduction in relative TBP measured by laser Doppler flowmetry.

Global HDO uptake in human glioma xenografts is related to the perfused capillary distribution

The aim of this study is to evaluate the existence of a possible relationship between global deuterium-labeled water (HDO) uptake rates and the diffusion geometry of human glioma xenografts in nude mice. HDO diffusion times in the whole extravascular tumor volume were estimated by combining quantitative (1)H-MR diffusion imaging and morphometric analysis of intercapillary distances in two tumor lines with a different perfused vascular architecture. HDO uptake was measured independently using (2)H-magnetic resonance spectroscopy. Time constants of HDO-uptake curves (tau) were compared to estimations of maximum HDO diffusion times (t(difmax)). Tumors with a homogeneously perfused capillary distribution showed a mono-exponential HDO uptake. The t(difmax) was comparable to tau values of HDO uptake curves: t(difmax) varied between 74 and 368 sec and the range of tau values was 115-370 sec. Heterogeneously perfused tumors had a bi-exponential HDO uptake with t(difmax) in between the tau values of the fast and slow uptake phase. These findings indicate that the global HDO uptake is related to the perfused capillary distribution in human glioma xenografts. That HDO uptake rates indeed can depend on the perfused capillary distribution was substantiated in experiments with two-dimensional (2D) models. In these models with a diffusion-limited HDO uptake, HDO uptake curves could be approximated by curves derived from 2D HDO diffusion simulations. Magn Reson Med 42:479-489, 1999.

An adiabatic approximation to the tissue homogeneity model for water exchange in the brain: I. Theoretical derivation

Using the adiabatic approximation, which assumes that the tracer concentration in parenchymal tissue changes slowly relative to that in capillaries, we derived a time-domain, closed-form solution of the tissue homogeneity model. This solution, which is called the adiabatic solution, is similar in form to those of two-compartment models. Owing to its simplicity, the adiabatic solution can be used in CBF experiments in which kinetic data with only limited time resolution or signal-to-noise ratio, or both, are obtained. Using computer simulations, we investigated the accuracy and the precision of the parameters in the adiabatic solution for values that reflect 2H-labeled water (D2O) clearance from the brain (see Part II). It was determined that of the three model parameters, (1) the vascular volume (Vi), (2) the product of extraction fraction and blood flow (EF), and (3) the clearance rate constant (kadb), only the last one could be determined accurately, and therefore CBF must be determined from this parameter only. From the error analysis of the adiabatic solution, it was concluded that for the D2O clearance experiments described in Part II, the coefficient of variation of CBF was approximately 7% in gray matter and 22% in white matter.

A new method for imaging perfusion and contrast extraction fraction: input functions derived from reference tissues

This study describes a new method for analysis of dynamic MR contrast data that greatly increases the time available for data acquisition. The capillary input function, CB(t), is estimated from the rate of contrast agent uptake in a reference tissue such as muscle, based on literature values for perfusion rate, extraction fraction, and extracellular volume. The rate constant for contrast uptake (the product of perfusion rate, F, and extraction fraction, E; F x E) is then determined in each image pixel using CB(t), extracellular volume (relative to the reference tissue) measured from MR and the tissue concentration of contrast media as a function of time calculated from the MR data. The "reference tissue method" was tested using rats with mammary (n = 10) or prostate (n = 15) tumors implanted in the hindlimb. Dynamic MR images at 4.7 T were acquired before and after Gd-DTPA intravenous bolus injections to determine F x E(Gd-DTPA). Acquisition parameters were optimized for detection of the first pass of the contrast agent bolus, so that "first-pass analysis" could be used as the "gold standard" for determination of F x E. The accuracy of values of F x E determined using the reference tissue method was determined based on comparison with first-pass analysis. In some cases, deuterated water (D2O) was injected i.v. immediately after Gd-DTPA measurements, and the reference tissue method was used to calculate F, based on the rate of uptake of D2O. Comparison of rate constants for Gd-DTPA uptake and D2O uptake allowed calculation of E(Gd-DTPA). Values for F x E(Gd-DTPA), F, and E(Gd-DTPA) were determined for selected regions and on a pixel-by-pixel basis. Values for F x E and E(Gd-DTPA) measured using the reference tissue method correlated well (P = .90 with a standard error of +/- .016, n = 15) with values determined based on first-pass contrast media uptake. The reference tissue method has important advantages: (a) A large volume of reference tissue can be used to determine the contrast agent input function with high precision. (b) Data obtained for 20 minutes after injection are used to calculate F or F x E. The greatly increased acquisition time can be used to increase the spatial resolution, field of view or SNR of measurements. The reference tissue method is most useful when the volume of tissue that must be imaged and/or the spatial resolution required precludes use of traditional first-pass methods.

The measurement of blood flow parameters with deuterium stable isotope MR imaging

METHODS

Because there are no radioactive hydrogen isotopes which can be used for clinical examinations, deuterium as a non-radioactive, freely diffusible tracer has some advantages compared with the radioactive tracers in the measurement of blood flow parameters. A non-invasive technique to estimate the mean tissue blood flow parameter in vivo was developed by using deuterium nuclear magnetic resonance (NMR) imaging in rat. We obtained the NMR signal changes from deuterium NMR images in nine male Wister rats after intravenous injection of D2O and applied exponential curve fitting analyses to calculate blood flow parameters of the brain, heart and skeletal muscle.

RESULTS

While fitting the reducing of the monoexponential function yielded a blood flow parameter of 27.9 +/- 1.6 ml/min/100 g tissue weight for the brain and 46.7 +/- 3.7 ml/min/100 g tissue weight for the heart, fitting the early reducing of the signal intensity of the biexponential function yielded a blood flow parameter of 95.6 +/- 10.9 ml/min/100 g tissue weight for the brain and 108.0 +/- 13.1 ml/min/100 g tissue weight for the heart. The mean muscle blood flow parameter determined by the monoexponential uptake function was 43.8 +/- 7.3 ml/min/100 g tissue weight.

CONCLUSIONS

The blood flow parameter measurement by means of an imaging coil for deuterium is less invasive and reflects the mean tissue blood flow parameter for the entire tissue sample more homogeneously than spectroscopic monitoring.

In vivo imaging of extraction fraction of low molecular weight MR contrast agents and perfusion rate in rodent tumors

Tissue uptake of a fully extractable MR detectable tracer, deuterated water (D2O), was compared with that of a less extractable contrast agent, Gadolinium-DTPA-dimeglumine (Gd-DTPA), in rodent tumor and muscle tissue. This dual tracer method allowed calculation of relative (to muscle) tissue perfusion and extraction fraction of Gd-DTPA in each image pixel in vivo. Solutions of Gd-DTPA and D2O were injected intravenously into Fisher female rats (n = 9) with R3230 mammary adenocarcinomas implanted in the hind limb. Perfusion rate was approximately two times greater (P < 0.005 by paired t test) in tumor than in muscle. Gd-DTPA extraction fraction at the interface between tumor and muscle was 2.0 times the extraction fraction in normal muscle (P < 0.005 by paired t test). Extraction fraction at the tumor center was 1.6 times the extraction fraction in muscle (P < 0.01 by paired t test). High extraction fraction of Gd-DTPA correlated with high capillary permeability determined from Evans Blue staining. Low molecular weight Gd-DTPA derivatives are widely used in clinical practice, and their extraction fractions are crucial determinants of image contrast during the first few passes of the contrast agent bolus. Therefore spatially resolved measurements of contrast agent extraction fractions obtained in vivo have significant clinical utility. The data demonstrate that extraction of low molecular weight tracers is sensitive to increased permeability in tumor vasculature and that this increased permeability can be imaged.

Perfusion imaging by a flow-sensitive alternating inversion recovery (FAIR) technique: application to functional brain imaging

Perfusion is a crucial physiological parameter for tissue function. To obtain perfusion-weighted images and consequently to measure cerebral blood flow (CBF), a newly developed flow-sensitive alternating inversion recovery (FAIR) technique was used. Dependency of FAIR signal on inversion times (TI) was examined; signal is predominantly located in large vessels at short TI, whereas it is diffused into gray matter areas at longer TI. CBF of gray matter areas in the human brain is 71 +/- 15 SD ml/100 g/min (n = 6). In fMRI studies, micro- and macrovessel inflow contributions can be obtained by adjusting TIs. Signal changes in large vessel areas including the scalp were seen during finger opposition at a TI of 0.4 s; however, these were not observed at a longer TI of 1.4 s. To compare with commonly used BOLD and slice selective inversion recovery techniques, FAIR and BOLD images were acquired at the same time during unilateral finger opposition. Generally, activation sites determined by three techniques are consistent. However, activation of some areas can be detected only by FAIR, not by BOLD, suggesting that the oxygen consumption increase couples with the CBF change completely. Relative and absolute CBF changes in the contralateral motor cortex are 53 +/- 17% SD (n = 9) and 27 +/- 11 SD ml/100 g/min (n = 9), respectively.

Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping

Relative cerebral blood flow changes can be measured by a novel simple blood flow measurement technique with endogenous water protons as a tracer based on flow-sensitive alternating inversion recovery (FAIR). Two inversion recovery (IR) images are acquired by interleaving slice-selective inversion and nonselective inversion. During the inversion delay time after slice-selective inversion, fully magnetized blood spins move into the imaging slice and exchange with tissue water. The signal enhancement (FAIR image) measured by the signal difference between two images is directly related to blood flow. For functional MR imaging studies, two IR images are alternatively and repeatedly acquired during control and task periods. Relative signal changes in the FAIR images during the task periods represent the relative regional cerebral blood flow changes. The FAIR technique has been successfully applied to functional brain mapping studies in humans during finger opposition movements. The technique is capable of generating microvascular-based functional maps.

Nuclear magnetic resonance spectroscopy: a review of neuropsychiatric applications

1. Magnetic resonance spectroscopy (MRS) is a powerful new neuropsychiatric research tool which allows for the noninvasive investigation of in vivo biochemistry. This review focuses on the recent applications of MRS to in vivo neuropsychiatric research. 2. The history of MRS as it has progressed from an in vitro method of biochemical analysis to its current in vivo research uses is presented. 3. A brief overview of the physical principles of MRS, including methods for spectral localization, is discussed. 4. Applications of the different MRS modalities (1H, 31P, 19F, 7Li, 13C and 23Na) to various neuropsychiatric disorders such as Alzheimer's disease, schizophrenia, affective disorders, acquired immunodeficiency disease, etc. are reviewed. The study of both fluorinated neuroleptics and the antidepressant fluoxetine using 19F MRS are discussed in greater detail. 5. Finally, potential future neuropsychiatric applications of MRS and specifically 19F MRS are presented.

The effects of successive high-energy shock-wave tumor administration on tumor blood flow

The effects of repeated high-energy shock wave (HESW) tumor administration on tumor blood flow (TBF) were studied in NU-1 human kidney cancer xenografts. Deuteriated water was used as a magnetic resonance spectroscopic detectable tracer for measuring tumor blood flow. Tumors were exposed twice to 800 electromagnetically generated HESW, with a 24-h interval or sham exposed. No changes in TBF occurred after sham exposure to HESW. TBF levels 2 h after the first and second HESW application were, respectively, 46% and 37% lower than the mean preexposure TBF value and returned to normal levels within 16 h. There was statistically no difference found between the effects on tumor blood flow after the first and second HESW exposure. These observations are in agreement with earlier studies and provide a rationale to shorten the time interval between HESW monotreatments to 2 to 3 h.

Atraumatic quantitation of cerebral perfusion in cats by 19F magnetic resonance imaging

We have noninvasively produced low-resolution, quantitative nuclear magnetic resonance images of cerebral blood flow in 2-ml voxels in eight cats. Typical signal-to-noise of 4 to 1 was obtained in cerebral voxels in 16.5-s epochs. Mean flow during normocapnia (paCO2 = 39 +/- 4 mm Hg) and hypercapnia (paCO2 = 62 +/- 4 mm Hg) was 53 +/- 20 ml/100 g-min and 140 +/- 36 ml/100 g-min, respectively. Fast flows in normocapnia were 94 +/- 13 and 182 +/- 39 ml/100 g-min in hypercapnia. These results suggest that an atraumatic quantitative imaging assessment of cerebral perfusion may be possible in humans using these techniques.

Concurrent quantification of tissue metabolism and blood flow via 2H/31P NMR in vivo. II. Validation of the deuterium NMR washout method for measuring organ perfusion

The deuterium washout technique of measuring tissue blood flow is based upon NMR detection of HOD (administered as D2O saline, but typically detected as HOD because of rapid proton-deuteron exchange) as a freely diffusible tracer. Though this method is coming into more general use, it has not yet been rigorously validated in vivo against an accepted, independent measure of tissue blood flow. To this end, simultaneous radiolabeled microsphere and HOD washout blood flow measurements were made in rat gastrocnemius muscle. D2O saline was administered either intramuscularly or intraarterially (near the aortic bifurcation), and the sciatic nerve was electrically stimulated to increase the muscle blood flow rate. Over a range of flows of 2 to 80 ml/(100 g.min), comparison of microsphere and HOD washout measurements showed good agreement, with r = 0.92 (n = 16) for intramuscular administration and r = 0.91 (n = 12) for intraarterial administration. These data strongly suggest that the HOD washout technique provides accurate blood flow measurements in skeletal muscle.

Magnetic resonance spectroscopy studies on experimental murine and human tumors: comparison of changes in phosphorus metabolism with induced changes in vascular volume

The responses of two experimental murine tumors and two human tumor xenografts to the vasodilator hydralazine were compared using two magnetic resonance spectroscopy endpoints. Changes in tumor metabolism were determined using 31P MRS where inorganic phosphate levels relative to total phosphate (Pi/total) were measured, and alteration in tumor blood volume was examined using 19F MRS with perfluorooctylbromide (PFOB) as tracer. The integrated 19F signal from PFOB is dose dependent and stable for at least 2 hr after injection. The murine tumors SCCVII/Ha and KHT both showed changes in tumor metabolism after hydralazine, as an increase in Pi/total. However, hydralazine reduced vascular volume in the KHT tumor, demonstrated by reduced 19F signal from PFOB, but no such reduction was seen in the SCCVII/Ha tumor. In contrast, hydralazine had no effect on phosphorus metabolism in the HT29 and HX118 human tumor xenografts, but reduced vascular volume in both tumors. These results demonstrate that the effects of vasoactive agents such as hydralazine on tumor phosphorus metabolism are only partially consistent with changes in vascular volume, measured by the 19F MRS technique.

Proton NMR imaging of cerebral blood flow using H2(17)O

Cerebral blood flow was quantitatively mapped by monitoring the cerebral washout of H2(17)O using rapid, single-shot proton NMR imaging. H2(17)O acts as a freely diffusible contrast agent for proton imaging via its scalar-coupled term, enhancing T2 relaxation. Measured values for CBF ranged from 29 to 106 ml/min/100 g over a range of arterial pCO2 between 23 and 81 Torr.

New developments in cardiovascular magnetic resonance imaging and spectroscopy

Methodological improvements in nuclear magnetic resonance (NMR) imaging and spectroscopy have enabled the application of these techniques to the study of functional or dynamic biological processes. Because the techniques are non-invasive, repeated measurements can be made in the same animal at different time points, allowing disease progression and regression to be followed during drug therapy. In this review, Markus Rudin, Wolfgang Zierhut, André Sauter and Nigel Cook illustrate this concept by the use of NMR to evaluate cardiovascular function in the rat in various physiological and pathological situations. The possibility of using NMR to perform similar studies in both animals and humans should lead to the design of preclinical models with an improved clinical predictability.

The validation of freely diffusible tracer methods with NMR detection for measurement of blood flow

While the general theory of measuring organ perfusion using exogenously administered freely diffusible tracers was originally formulated over 40 years ago, the application of NMR techniques for tracer detection is a recent development. A brief theoretical review and discussion of the literature validating the use of deuterium and fluorine as NMR-detectable tracers is provided.

Brain magnetic resonance imaging with contrast dependent on blood oxygenation

Paramagnetic deoxyhemoglobin in venous blood is a naturally occurring contrast agent for magnetic resonance imaging (MRI). By accentuating the effects of this agent through the use of gradient-echo techniques in high fields, we demonstrate in vivo images of brain microvasculature with image contrast reflecting the blood oxygen level. This blood oxygenation level-dependent (BOLD) contrast follows blood oxygen changes induced by anesthetics, by insulin-induced hypoglycemia, and by inhaled gas mixtures that alter metabolic demand or blood flow. The results suggest that BOLD contrast can be used to provide in vivo real-time maps of blood oxygenation in the brain under normal physiological conditions. BOLD contrast adds an additional feature to magnetic resonance imaging and complements other techniques that are attempting to provide positron emission tomography-like measurements related to regional neural activity.