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Chen W, Chen Z, Ma L, Wang Y, Song X. Rapid and quantitative CEST-MRI sequence using water presaturation. Magn Reson Med 2024. [PMID: 39385344 DOI: 10.1002/mrm.30309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 08/07/2024] [Accepted: 09/03/2024] [Indexed: 10/12/2024]
Abstract
PURPOSE Despite the significant potential for in vivo metabolic imaging in preclinical and clinical applications, CEST MRI suffers from long scan time and inaccurate quantification. This study aims to suppress the contaminations among signals under different frequencies, which could shorten the TR and thereby facilitate CEST imaging acceleration and quantification. METHODS A novel sequence is proposed by applying a water-presaturation (WPS) module at the beginning of each TR. WPS CEST quickly knocks down the residual signal from previous TRs so that the magnetization of all TRs recovers from zero, which aligns well with the formula of quasi-steady-state theorem and enables accurate quantification within shorter TR. WPS CEST was assessed by simulations, creatine phantom, and healthy human brain scans at 3 T. RESULTS In simulation and phantom experiment, WPS CEST allows accurate estimation of exchange rate (ksw) using omega plot and using shorter delay time (Td) and saturation time (Ts) (e.g., 1 s/1 s) compared with the conventional CEST. Simulations further showed that WPS CEST could obtain consistent spin-lock relaxation (R1ρ) values over varied Tds and Tss. Six human scans indicated that R1ρ collected from conventional sequences showed significant differences between two groups with Td and Ts of (1 s/1 s) and (2 s/2 s) (amide: 1.721 ± 0.051 s-1 vs. 1.622 ± 0.050 s-1, p = 0.001; nuclear Overhauser enhancement: 1.792 ± 0.046 s-1 vs. 1.687 ± 0.053 s-1, p = 0.004), whereas WPS CEST scans using these 2 Td/Ts values obtained the same mean R1ρ (amide: 1.616 ± 0.053 s-1 vs. 1.616 ± 0.048 s-1, p = 0.862; nuclear Overhauser enhancement: 1.688 ± 0.064 s-1 vs. 1.684 ± 0.054 s-1, p = 0.544). CONCLUSION WPS CEST demonstrated accurate quantitation within shorter TR compared with conventional sequences, and thereby may allow rapid quantitative CEST scans in various situations.
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Affiliation(s)
- Wenxuan Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Zhensen Chen
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Ministry of Education, Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Shanghai, China
| | - Lele Ma
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Yi Wang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
- Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaolei Song
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
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2
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Xu X, Leforestier R, Xia D, Block KT, Feng L. MRI of GlycoNOE in the human liver using GraspNOE-Dixon. Magn Reson Med 2024. [PMID: 39367632 DOI: 10.1002/mrm.30270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 10/06/2024]
Abstract
PURPOSE The objective of this study was to develop a new MRI technique for non-invasive, free-breathing imaging of glycogen in the human liver using the nuclear Overhauser effect (NOE). METHODS The proposed method, called GraspNOE-Dixon, uses a novel MRI sequence that combines steady-state saturation-transfer preparation with multi-echo golden-angle radial stack-of-stars sampling. Multi-echo acquisition enables fat/water-separated imaging for quantification of water-specific NOE. Image reconstruction is performed using the improved golden-angle radial sparse parallel imaging (GRASP-Pro) technique to exploit spatiotemporal correlations in dynamic images. To evaluate the proposed technique, imaging experiments were first performed on glycogen phantoms, followed by in vivo studies involving healthy volunteers and patients with fatty liver disease. In addition, a comparative assessment of signal changes before and after a 12-h fasting period was performed. RESULTS Evaluation experiments on glycogen phantoms showed a robust linear correlation between the NOE signal and glycogen concentration. In vivo experiments demonstrated motion-robust NOE-weighted images, with potential for further acceleration. In subjects with varying liver fat content, the fat/water separation approach resulted in distortion-free Z-spectra, enabling the quantification of glycogen NOE. An approximately one-third reduction in the NOE signal was observed following a 12-h fasting period, consistent with a decrease in glycogen level. CONCLUSION This study introduces a clinically feasible imaging technique, GraspNOE-Dixon, for free-breathing volumetric multi-echo imaging of hepatic glycogen at 3 T. The motion robust imaging technique developed here may also have applications in other body areas beyond liver imaging.
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Affiliation(s)
- Xiang Xu
- BioMedical Engineering and Imaging Institute (BMEII), Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rodolphe Leforestier
- BioMedical Engineering and Imaging Institute (BMEII), Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ding Xia
- BioMedical Engineering and Imaging Institute (BMEII), Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kai Tobias Block
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Li Feng
- BioMedical Engineering and Imaging Institute (BMEII), Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Diagnostic, Molecular and Interventional Radiology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, New York, USA
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Gammaraccio F, Villano D, Irrera P, Anemone AA, Carella A, Corrado A, Longo DL. Development and Validation of Four Different Methods to Improve MRI-CEST Tumor pH Mapping in Presence of Fat. J Imaging 2024; 10:166. [PMID: 39057737 PMCID: PMC11277679 DOI: 10.3390/jimaging10070166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/28/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
CEST-MRI is an emerging imaging technique suitable for various in vivo applications, including the quantification of tumor acidosis. Traditionally, CEST contrast is calculated by asymmetry analysis, but the presence of fat signals leads to wrong contrast quantification and hence to inaccurate pH measurements. In this study, we investigated four post-processing approaches to overcome fat signal influences and enable correct CEST contrast calculations and tumor pH measurements using iopamidol. The proposed methods involve replacing the Z-spectrum region affected by fat peaks by (i) using a linear interpolation of the fat frequencies, (ii) applying water pool Lorentzian fitting, (iii) considering only the positive part of the Z-spectrum, or (iv) calculating a correction factor for the ratiometric value. In vitro and in vivo studies demonstrated the possibility of using these approaches to calculate CEST contrast and then to measure tumor pH, even in the presence of moderate to high fat fraction values. However, only the method based on the water pool Lorentzian fitting produced highly accurate results in terms of pH measurement in tumor-bearing mice with low and high fat contents.
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Affiliation(s)
- Francesco Gammaraccio
- Department of Molecular Biotechnology and Health Sciences, University of Turin, 10126 Torino, Italy
| | - Daisy Villano
- Department of Molecular Biotechnology and Health Sciences, University of Turin, 10126 Torino, Italy
| | - Pietro Irrera
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), 10126 Torino, Italy
| | - Annasofia A. Anemone
- Department of Molecular Biotechnology and Health Sciences, University of Turin, 10126 Torino, Italy
| | - Antonella Carella
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), 10126 Torino, Italy
| | - Alessia Corrado
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), 10126 Torino, Italy
| | - Dario Livio Longo
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), 10126 Torino, Italy
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Kim JY, Partridge SC. Non-contrast Breast MR Imaging. Radiol Clin North Am 2024; 62:661-678. [PMID: 38777541 PMCID: PMC11116814 DOI: 10.1016/j.rcl.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Considering the high cost of dynamic contrast-enhanced MR imaging and various contraindications and health concerns related to administration of intravenous gadolinium-based contrast agents, there is emerging interest in non-contrast-enhanced breast MR imaging. Diffusion-weighted MR imaging (DWI) is a fast, unenhanced technique that has wide clinical applications in breast cancer detection, characterization, prognosis, and predicting treatment response. It also has the potential to serve as a non-contrast MR imaging screening method. Standardized protocols and interpretation strategies can help to enhance the clinical utility of breast DWI. A variety of other promising non-contrast MR imaging techniques are in development, but currently, DWI is closest to clinical integration, while others are still mostly used in the research setting.
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Affiliation(s)
- Jin You Kim
- Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Savannah C Partridge
- Department of Radiology, University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Center, Seattle, WA, USA.
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Li Y, Zhang Y, Tian L, Li J, Li H, Wang X, Wang C. 3D amide proton transfer-weighted imaging may be useful for diagnosing early-stage breast cancer: a prospective monocentric study. Eur Radiol Exp 2024; 8:41. [PMID: 38584248 PMCID: PMC10999404 DOI: 10.1186/s41747-024-00439-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/17/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions. METHODS Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson's correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTRasym) and immunohistochemical characteristics. RESULTS The MTRasym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUCAPT+DCE and AUCDCE was significant (p < 0.010). When a threshold of MTRasym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTRasym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020). CONCLUSIONS 3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTRasym can imply the proliferation activities of early-stage BC. RELEVANCE STATEMENT 3D-APTWI can be an alternative diagnostic method for patients with early-stage BC who are not suitable for contrast injection. KEY POINTS • 3D-APTWI reflects the changes in the microenvironment of early-stage breast cancer. • Combined 3D-APTWI is superior to DCE-MRI alone for early-stage breast cancer diagnosis. • 3D-APTWI improves the diagnostic accuracy of early-stage breast cancer.
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Affiliation(s)
- Yeqin Li
- Department of Radiology, Shandong Province Hospital of Traditional Chinese Medicine, Jinan, 250014, China
| | - Yan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Liwen Tian
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
| | - Ju Li
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
- Binzhou Medical University, Yantai, 264003, China
| | - Huihua Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Cuiyan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China.
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Sheng L, Yuan E, Yuan F, Song B. Amide proton transfer-weighted imaging of the abdomen: Current progress and future directions. Magn Reson Imaging 2024; 107:88-99. [PMID: 38242255 DOI: 10.1016/j.mri.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/21/2024]
Abstract
The chemical exchange saturation transfer technique serves as a valuable tool for generating in vivo image contrast based on the content of various proton groups, including amide protons, amine protons, and aliphatic protons. Among these, amide proton transfer-weighted (APTw) imaging has seen extensive development as a means to assess the biochemical status of lesions. The exchange from saturated amide protons to bulk water protons during and following the saturation ratio frequency pulse contributes to detectable APT signals. While APTw imaging has garnered significant attention in the central nervous system, demonstrating noteworthy findings in cerebral neoplasia, stroke, and Alzheimer's disease over the past decade, its application in the abdomen has been a relatively recent progression. Notably, studies have explored its utility in hepatocellular carcinoma, prostate cancer, and cervical carcinoma within the abdominal context. Despite these advancements, there is a paucity of reviews on APTw imaging in abdominal applications. This paper aims to fill this gap by providing a concise overview of the fundamental theories underpinning APTw imaging. Additionally, we systematically summarize its diverse clinical applications in the abdomen, with a particular focus on the digestive and urogenital systems. Finally, the manuscript concludes by discussing technical limitations and factors influencing APTw imaging in abdominal applications, along with prospects for future research.
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Affiliation(s)
- Liuji Sheng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Enyu Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fang Yuan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Radiology, Sanya People's Hospital, Sanya, Hainan, China.
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7
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Donahue MJ, Donahue PMC, Jones RS, Garza M, Lee C, Patel NJ, Cooper A, De Vis JB, Meszoely I, Crescenzi R. In vivo lymph node CEST-Dixon MRI in breast cancer patients with metastatic lymph node involvement. Magn Reson Med 2024; 91:670-680. [PMID: 37684712 DOI: 10.1002/mrm.29858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
PURPOSE Axillary lymph nodes (LNs) often present a reservoir for metastatic breast cancer, yet metastatic LN involvement cannot be discerned definitively using diagnostic imaging. This study investigated whether in vivo CEST may discriminate LNs with versus without metastatic involvement. METHODS 3T MRI was performed in patients with breast cancer before clinically-indicated mastectomy or lumpectomy with LN removal, after which LN metastasic involvement was determined using histological evaluation. Non-contrast anatomical imaging, as well as B0 and B1 field maps, were acquired in sequence with three-point CEST-Dixon (3D turbo-gradient-echo; factor = 25; TR/TE1/ΔTE = 851/1.35/1.1 ms; spatial-resolution = 2.5 × 2.5 × 6 mm; slices = 10; four sinc-gauss pulses with duty-cycle = 0.5, total saturation duration = 701.7 ms; B1 = 1.5 μT; saturation offsets = -5.5 to +5.5 ppm; stepsize = 0.2 ppm; scan duration = 6 min 30 s). The mean z-spectrum from LNs with (n = 20) versus without (n = 22) metastatic involvement were analyzed and a Wilcoxon rank-sum test (significance: p < 0.05) was applied to evaluate differences in B0, B1 , and magnetization transfer ratio (MTR) in differing spectral regions of known proton exchange (nuclear Overhauser effect [NOE], amide, amine, and hydroxyl) between cohorts. RESULTS No difference in axillary B1 (p = 0.634) or B0 (p = 0.689) was observed between cohorts. Elevated MTR was observed for the NOE (-1.7 ppm; MTR = 0.285 ± 0.075 vs. 0.248 ± 0.039; p = 0.048), amine (+2.5 ppm; MTR = 0.284 ± 0.067 vs. 0.234 ± 0.31; p = 0.005), and hydroxyl (+1 ppm; MTR = 0.394 ± 0.075 vs. 0.329 ± 0.055; p = 0.002) protons in LNs from participants with versus without metastatic involvement. CONCLUSIONS Findings are consistent with a unique metastatic LN microenvironment detectable by CEST-Dixon and suggest that CEST MRI may have potential for mapping LN metastasis non-invasively in vivo.
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Affiliation(s)
- Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paula M C Donahue
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - R Sky Jones
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Maria Garza
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chelsea Lee
- Department of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Niral J Patel
- Department of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Jill B De Vis
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ingrid Meszoely
- Department of Surgery, Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rachelle Crescenzi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
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Tkotz K, Liebert A, Gast LV, Zeiger P, Uder M, Zaiss M, Nagel AM. Multi-echo-based fat artifact correction for CEST MRI at 7 T. Magn Reson Med 2024; 91:481-496. [PMID: 37753844 DOI: 10.1002/mrm.29863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE CEST MRI is influenced by fat signal, which can reduce the apparent CEST contrast or lead to pseudo-CEST effects. Our goal was to develop a fat artifact correction based on multi-echo fat-water separation that functions stably for 7 T knee MRI data. METHODS Our proposed algorithm utilizes the full complex data and a phase demodulation with an off-resonance map estimation based on the Z-spectra prior to fat-water separation to achieve stable fat artifact correction. Our method was validated and compared to multi-echo-based methods originally proposed for 3 T by Bloch-McConnell simulations and phantom measurements. Moreover, the method was applied to in vivo 7 T knee MRI examinations and compared to Gaussian fat saturation and a published single-echo Z-spectrum-based fat artifact correction method. RESULTS Phase demodulation prior to fat-water separation reduced the occurrence of fat-water swaps. Utilizing the complex signal data led to more stable correction results than working with magnitude data, as was proposed for 3 T. Our approach reduced pseudo-nuclear Overhauser effects compared to the other correction methods. Thus, the mean asymmetry contrast at 3.5 ppm in cartilage over five volunteers increased from -9.2% (uncorrected) and -10.6% (Z-spectrum-based) to -1.5%. Results showed higher spatial stability than with the fat saturation pulse. CONCLUSION Our work demonstrates the feasibility of multi-echo-based fat-water separation with an adaptive fat model for fat artifact correction for CEST MRI at 7 T. Our approach provided better fat artifact correction throughout the entire spectrum and image than the fat saturation pulse or Z-spectrum-based correction method for both phantom and knee imaging results.
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Affiliation(s)
- Katharina Tkotz
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrzej Liebert
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Paula Zeiger
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Moritz Zaiss
- Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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9
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Yu T, Li L, Shi J, Gong X, Cheng Y, Wang W, Cao Y, Cao M, Jiang F, Wang L, Wang X, Zhang J. Predicting histopathological types and molecular subtype of breast tumors: A comparative study using amide proton transfer-weighted imaging, intravoxel incoherent motion and diffusion kurtosis imaging. Magn Reson Imaging 2024; 105:37-45. [PMID: 37890802 DOI: 10.1016/j.mri.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/07/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE To evaluate the predictive performance of multiparameter and histogram features derived from amide proton transfer-weighted imaging (APTWI), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) for histopathological types of breast tumors. METHODS Region of interest (ROI) was delineated by outlining the largest slice of the tumor on the false-color images of the DKI, IVIM and APTWI parameters, and extracted the histogram features. Receiver operating characteristic (ROC) curve was used to evaluate the performance of parameters in predicting benign and malignant breast lesions, molecular prognostic biomarkers, lymph node status, and subtypes of breast lesions. The Spearman correlation coefficient was used to determine the correlations between each parameter and clinical-pathological factors. RESULTS All 52 breast lesions were enrolled in this prospective study, including 8 benign lesions and 44 breast cancers. To diagnose malignant and benign breast lesions, the value of APT (min) performed best, with the AUC reaching 0.983. According to the different imaging methods, the APTWI performed best. To predict the positive status of ER, PR, Ki67, the value of Dapp (uniformity), Dapp (uniformity), f (entropy) performed best, with the AUC values reaching 0.743, 0.770, 0.848, respectively. For the identification of Luminal B, HER2-enriched, and TNBC breast cancers, Kapp (max), f (kurtosis), and Dapp (uniformity) performed best, with AUC values reaching 0.679, 0.826, 0.771, respectively. CONCLUSION This study found the APTWI, IVIM and DKI parameters could diagnose breast cancer. The histogram features of DKI and IVIM, based on tumor heterogeneity, may help to predict breast cancer subtypes.
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Affiliation(s)
- Tao Yu
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Lan Li
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Jinfang Shi
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Xueqin Gong
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Yue Cheng
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Wei Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Ying Cao
- School of Medicine, Chongqing University, Chongqing 400030, China
| | - Meimei Cao
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Fujie Jiang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Lu Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing 400030, China.
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Wu L, Lu D, Sun PZ. Comparison of model-free Lorentzian and spinlock model-based fittings in quantitative CEST imaging of acute stroke. Magn Reson Med 2023; 90:1958-1968. [PMID: 37335834 PMCID: PMC10538953 DOI: 10.1002/mrm.29772] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/14/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE CEST MRI detects complex tissue changes following acute stroke. Our study aimed to test if spinlock model-based fitting of the quasi-steady-state (QUASS)-reconstructed equilibrium CEST MRI improves the determination of multi-pool signal changes over the commonly-used model-free Lorentzian fitting in acute stroke. THEORY AND METHODS Multiple three-pool CEST Z-spectra were simulated using Bloch-McConnell equations for a range of T1 , relaxation delay, and saturation times. The multi-pool CEST signals were solved from the simulated Z-spectra to test the accuracy of routine Lorentzian (model-free) and spinlock (model-based) fittings without and with QUASS reconstruction. In addition, multiparametric MRI scans were obtained in rat models of acute stroke, including relaxation, diffusion, and CEST Z-spectrum. Finally, we compared model-free and model-based per-pixel CEST quantification in vivo. RESULTS The spinlock model-based fitting of QUASS CEST MRI provided a nearly T1 -independent determination of multi-pool CEST signals, advantageous over the fittings of apparent CEST MRI (model-free and model-based). In vivo data also demonstrated that the spinlock model-based QUASS fitting captured significantly different changes in semisolid magnetization transfer (-0.9 ± 0.8 vs. 0.3 ± 0.8%), amide (-1.1 ± 0.4 vs. -0.5 ± 0.2%), and guanidyl (1.0 ± 0.4 vs. 0.7 ± 0.3%) signals over the model-free Lorentzian analysis. CONCLUSION Our study demonstrated that spinlock model-based fitting of QUASS CEST MRI improved the determination of the underlying tissue changes following acute stroke, promising further clinical translation of quantitative CEST imaging.
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Affiliation(s)
- Limin Wu
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dongshuang Lu
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Phillip Zhe Sun
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Emory National Primate Research Center, Emory University, Atlanta GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA
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11
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Sun PZ. Numerical simulation-based assessment of pH-sensitive chemical exchange saturation transfer MRI quantification accuracy across field strengths. NMR IN BIOMEDICINE 2023; 36:e5000. [PMID: 37401645 DOI: 10.1002/nbm.5000] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/27/2023] [Accepted: 06/12/2023] [Indexed: 07/05/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI detects dilute labile protons via their exchange with bulk water, conferring pH sensitivity. Based on published exchange and relaxation properties, a 19-pool simulation was used to model the brain pH-dependent CEST effect and assess the accuracy of quantitative CEST (qCEST) analysis across magnetic field strengths under typical scan conditions. First, the optimal B1 amplitude was determined by maximizing pH-sensitive amide proton transfer (APT) contrast under the equilibrium condition. Apparent and quasi-steady-state (QUASS) CEST effects were then derived under the optimal B1 amplitude as functions of pH, RF saturation duration, relaxation delay, Ernst flip angle, and field strength. Finally, CEST effects, particularly the APT signal, were isolated with spinlock model-based Z-spectral fitting to evaluate the accuracy and consistency of CEST quantification. Our data showed that QUASS reconstruction significantly improved the consistency between simulated and equilibrium Z-spectra. The residual difference between QUASS and equilibrium CEST Z-spectra was, on average, 30 times less than that of the apparent CEST Z-spectra across field strengths, saturation, and repetition times. Also, the spinlock fitting of the QUASS CEST effect significantly reduced the residual errors 9-fold. Furthermore, the isolated APT amplitude from QUASS reconstruction was consistent and higher than the apparent CEST analysis under nonequilibrium conditions. To summarize, this study confirmed that QUASS reconstruction facilitates accurate determination of the CEST system under different scan protocols across field strengths, with the potential to help standardize CEST quantification.
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Affiliation(s)
- Phillip Zhe Sun
- Primate Imaging Center, Emory National Primate Research Center, Emory University, Atlanta, Georgia, USA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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12
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Zhao Y, Sun C, Zu Z. Assignment of molecular origins of NOE signal at -3.5 ppm in the brain. Magn Reson Med 2023; 90:673-685. [PMID: 36929814 PMCID: PMC10644915 DOI: 10.1002/mrm.29643] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/15/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Nuclear Overhauser enhancemen mediated saturation transfer effect, termed NOE (-3.5 ppm), is a major source of CEST MRI contrasts at 3.5 ppm in the brain. Previous phantom experiments have demonstrated that both proteins and lipids, two major components in tissues, have substantial contributions to NOE (-3.5 ppm) signals. Their relative contributions in tissues are informative for the interpretation of NOE (-3.5 ppm) contrasts that could provide potential imaging biomarkers for relevant diseases, which remain incompletely understood. METHODS Experiments on homogenates and supernatants of brain tissues collected from healthy rats, that could isolate proteins from lipids, were performed to evaluate the relative contribution of lipids to NOE (-3.5 ppm) signals. On the other hand, experiments on ghost membranes with varied pH, and reconstituted phospholipids with different chemical compositions were conducted to study the dependence of NOE (-3.5 ppm) on physiological conditions. Besides, CEST imaging on rat brains bearing 9 L tumors and healthy rat brains was performed to analyze the causes of the NOE (-3.5 ppm) contrast variations between tumors and normal tissues, and between gray matter and white matter. RESULTS Our experiments reveal that lipids have dominant contributions to the NOE (-3.5 ppm) signals. Further analysis suggests that decreased NOE (-3.5 ppm) signals in tumors and higher NOE (-3.5 ppm) signals in white matter than in gray matter are mainly explained by changes in membrane lipids, rather than proteins. CONCLUSION NOE (-3.5 ppm) could be exploited as a highly sensitive MRI contrast for imaging membrane lipids in the brain.
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Affiliation(s)
- Yu Zhao
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Casey Sun
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Chemistry, University of Florida, Gainesville, US
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Nashville, US
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, US
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13
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Igarashi T, Kim H, Sun PZ. Detection of tissue pH with quantitative chemical exchange saturation transfer magnetic resonance imaging. NMR IN BIOMEDICINE 2023; 36:e4711. [PMID: 35141979 PMCID: PMC10249910 DOI: 10.1002/nbm.4711] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 05/12/2023]
Abstract
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) has emerged as a novel means for sensitive detection of dilute labile protons and chemical exchange rates. By sensitizing to pH-dependent chemical exchange, CEST MRI has shown promising results in monitoring tissue statuses such as pH changes in disorders like acute stroke, tumor, and acute kidney injury. This article briefly reviews the basic principles for CEST imaging and quantitative measures, from the simplistic asymmetry analysis to multipool Lorentzian decoupling and quasi-steady-state reconstruction. In particular, the advantages and limitations of commonly used quantitative approaches for CEST applications are discussed.
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Affiliation(s)
- Takahiro Igarashi
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| | - Hahnsung Kim
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA
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14
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Vinogradov E, Keupp J, Dimitrov IE, Seiler S, Pedrosa I. CEST-MRI for body oncologic imaging: are we there yet? NMR IN BIOMEDICINE 2023; 36:e4906. [PMID: 36640112 PMCID: PMC10200773 DOI: 10.1002/nbm.4906] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI has gained recognition as a valuable addition to the molecular imaging and quantitative biomarker arsenal, especially for characterization of brain tumors. There is also increasing interest in the use of CEST-MRI for applications beyond the brain. However, its translation to body oncology applications lags behind those in neuro-oncology. The slower migration of CEST-MRI to non-neurologic applications reflects the technical challenges inherent to imaging of the torso. In this review, we discuss the application of CEST-MRI to oncologic conditions of the breast and torso (i.e., body imaging), emphasizing the challenges and potential solutions to address them. While data are still limited, reported studies suggest that CEST signal is associated with important histology markers such as tumor grade, receptor status, and proliferation index, some of which are often associated with prognosis and response to therapy. However, further technical development is still needed to make CEST a reliable clinical application for body imaging and establish its role as a predictive and prognostic biomarker.
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Affiliation(s)
- Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ivan E Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Philips Healthcare, Gainesville, FL, USA
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
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15
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Bo S, Stabinska J, Wu Y, Pavuluri K, Singh A, Mohanta Z, Choudhry R, Kates M, Sedaghat F, Bhujwalla Z, Pomper MG, McMahon MT. Exploring the potential of the novel imidazole-4,5-dicarboxyamide chemical exchange saturation transfer scaffold for pH and perfusion imaging. NMR IN BIOMEDICINE 2023; 36:e4894. [PMID: 36543742 PMCID: PMC10200726 DOI: 10.1002/nbm.4894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 05/23/2023]
Abstract
Here, we describe and assess the potential of 14 newly synthesized imidazole-4,5-dicarboxyamides (I45DCs) for pH and perfusion imaging. A number of these aromatic compounds possess large labile proton chemical shifts (up to 7.7 ppm from water) because of their intramolecular hydrogen bonds and a second labile proton to allow for chemical exchange saturation transfer (CEST) signal ratio-based pH measurements. We have found that the contrast produced is strong for a wide range of substitutions and that the inflection points in the CEST signal ratio versus pH plots used to generate concentration-independent pH maps can be adjusted based on these subsitutions to tune the pH range that can be measured. These I45DC CEST agents have advantages over the triiodobenzenes currently employed for tumor and kidney pH mapping, both preclinically and in initial human studies. Finally, as CEST MRI combined with exogenous contrast has the potential to detect functional changes in the kidneys, we evaluated our highest performing anionic compound (I45DC-diGlu) on a unilateral urinary obstruction mouse model and observed lower contrast uptake in the obstructed kidney compared with the unobstructed kidney and that the unobstructed kidney displayed a pH of ~ 6.5 while the obstructed kidney had elevated pH and an increased range in pH values. Based on this, we conclude that the I45DCs have excellent imaging properties and hold promise for a variety of medical imaging applications, particularly renal imaging.
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Affiliation(s)
- Shaowei Bo
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Julia Stabinska
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Yunkou Wu
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - KowsalyaDevi Pavuluri
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Aruna Singh
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Zinia Mohanta
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Rehan Choudhry
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Max Kates
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Farzad Sedaghat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zaver Bhujwalla
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Martin G. Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael T. McMahon
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
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16
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Zhou Y, Bie C, van Zijl PC, Yadav NN. The relayed nuclear Overhauser effect in magnetization transfer and chemical exchange saturation transfer MRI. NMR IN BIOMEDICINE 2023; 36:e4778. [PMID: 35642102 PMCID: PMC9708952 DOI: 10.1002/nbm.4778] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 05/23/2023]
Abstract
Magnetic resonance (MR) is a powerful technique for noninvasively probing molecular species in vivo but suffers from low signal sensitivity. Saturation transfer (ST) MRI approaches, including chemical exchange saturation transfer (CEST) and conventional magnetization transfer contrast (MTC), allow imaging of low-concentration molecular components with enhanced sensitivity using indirect detection via the abundant water proton pool. Several recent studies have shown the utility of chemical exchange relayed nuclear Overhauser effect (rNOE) contrast originating from nonexchangeable carbon-bound protons in mobile macromolecules in solution. In this review, we describe the mechanisms leading to the occurrence of rNOE-based signals in the water saturation spectrum (Z-spectrum), including those from mobile and immobile molecular sources and from molecular binding. While it is becoming clear that MTC is mainly an rNOE-based signal, we continue to use the classical MTC nomenclature to separate it from the rNOE signals of mobile macromolecules, which we will refer to as rNOEs. Some emerging applications of the use of rNOEs for probing macromolecular solution components such as proteins and carbohydrates in vivo or studying the binding of small substrates are discussed.
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Affiliation(s)
- Yang Zhou
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen University Town, Shenzhen, Guangdong 518055 (China)
| | - Chongxue Bie
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
- Department of Information Science and Technology, Northwest University, No.1 Xuefu Avenue, Xi’an, Shanxi 710127 (China)
| | - Peter C.M. van Zijl
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
| | - Nirbhay N. Yadav
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N. Broadway, Baltimore MD 21205 (USA)
- The Russell H. Morgan Department of Radiology, The Johns Hopkins University School of Medicine, 720 Rutland Ave, Baltimore, MD 21205 (USA)
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17
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Amide proton transfer (APT) imaging of breast cancers and its correlation with biological status. Clin Imaging 2023; 96:38-43. [PMID: 36773531 DOI: 10.1016/j.clinimag.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To assess the usefulness of amide proton transfer (APT) imaging to predict the biological status of breast cancers. METHOD Sixty-six patients (age range 31-85 years, mean 58.9 years) with histopathologically proven invasive ductal carcinomas of 2 cm or larger in diameter were included in this study. 3D APT weighted imaging was conducted on a 3 T scanner. Mean APT signal intensity (SI) was analyzed in relation to biological subtypes, Ki-67 labeling index, and nuclear grades (NGs). RESULTS The triple-negative (TN) cancers (n = 10; 2.75 ± 0.42%) showed significantly higher APT SI than the luminal type cancers (n = 48; 1.74 ± 0.83) and HER2 cancers (n = 8; 1.83 ± 0.21) (P = 0.0007, 0.03). APT SI had weakly positive correlation with the Ki-67 labeling index (r = 0.38, P = 0.002). The mean APT SIs were significantly higher for high-Ki-67 (>30%) (n = 31; 2.25 ± 0.70) than low-Ki-67 (≤30%) cancers (n = 35; 1.60 ± 0.79) (P = 0.0007). There was no significant difference in the APT SIs between NG 1-2 (n = 31; 1.71 ± 0.84) and NG 3 (n = 35; 2.08 ± 0.76%) cancers (P = 0.06). CONCLUSIONS TN and high-Ki-67 breast cancers showed high APT SIs. APT imaging can help to predict the biological status of breast cancers.
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18
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Liu Z, Wen J, Wang M, Ren Y, Yang Q, Qian L, Luo H, Feng S, He C, Liu X, Wu Y, Luo D. Breast Amide Proton Transfer Imaging at 3 T: Diagnostic Performance and Association With Pathologic Characteristics. J Magn Reson Imaging 2023; 57:824-833. [PMID: 35816177 DOI: 10.1002/jmri.28335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Amide proton transfer (APT) imaging has been increasingly applied in tumor characterization. However, its value in evaluating breast cancer remains undetermined. PURPOSE To assess the diagnostic performance of APT imaging in breast cancer and its association with prognostic histopathologic characteristics. STUDY TYPE Prospective. SUBJECTS Eighty-four patients with breast lesions. FIELD STRENGTH/SEQUENCE A 3.0 T/single-shot fast spin echo APT imaging. ASSESSMENT APTw signal in breast lesion was quantified. Lesion malignancy, T stage, grades, Ki-67 index, molecular biomarkers (estrogen receptor [ER] expression, progesterone receptor [PR] expression, human epidermal growth factor receptor [HER-2] expression), molecular subtypes (luminal A, luminal B, triple negative, and HER-2 enriched) were determined. STATISTICAL TESTS Student t-test, one-way analysis of variance, receiver operating characteristic analysis, and Pearson's correlation with P < 0.05 as statistical significance. RESULTS APTw signal was significantly higher in malignant lesions (1.55% ± 1.24%) than in benign lesions (0.54% ± 1.13%), and in grade III lesions than in grade II lesions (1.65% ± 0.84% vs. 0.96% ± 0.96%), and in T2- (1.57% ± 0.64%) and T3-stage lesions (1.54% ± 0.63%) than in T1-stage lesions (0.81% ± 0.64%) for invasive breast carcinoma of no special type. APTw signal significantly correlated with Ki-67 index (r = 0.364) but showed no significant difference in groups of ER (P = 0.069), PR (P = 0.069), HER-2 (P = 0.961), and among molecular subtypes (P = 0.073). DATA CONCLUSION APT imaging shows potential in differentiating breast lesion malignancy and associates with prognosis-related tumor grade, T stage, and proliferative activity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhou Liu
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jie Wen
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Meng Wang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ya Ren
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Qian Yang
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Long Qian
- MR Research, GE Healthcare, Beijing, China
| | - Honghong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Sha Feng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Cuiju He
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Dehong Luo
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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19
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Zhao Y, Sun C, Zu Z. Assignment of molecular origins of NOE signal at -3.5 ppm in the brain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.03.526979. [PMID: 36778370 PMCID: PMC9915742 DOI: 10.1101/2023.02.03.526979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose Nuclear Overhauser Enhancement mediated saturation transfer effect, termed NOE(-3.5 ppm), is a major source of chemical exchange saturation transfer (CEST) MRI contrasts at 3.5 ppm in the brain. Previous phantom experiments have demonstrated that both proteins and lipids, two major components in tissues, have substantial contributions to NOE(-3.5 ppm) signals. Their relative contributions in tissues are informative for the interpretation of NOE(-3.5 ppm) contrasts that could provide potential imaging biomarkers for relevant diseases, which remain incompletely understood. Methods Experiments on homogenates and supernatants of brain tissues collected from healthy rats, that could isolate proteins from lipids, were performed to evaluate the relative contribution of lipids to NOE(-3.5 ppm) signals. On the other hand, experiments on ghost membranes with varied pH, and reconstituted phospholipids with different chemical compositions were conducted to study the dependence of NOE(-3.5 ppm) on physiological conditions. Besides, CEST imaging on rat brains bearing 9L tumors and healthy rat brains was performed to analyze the causes of the NOE(-3.5 ppm) contrast variations between tumors and normal tissues, and between gray matter and white matter. Results Our experiments reveal that lipids have dominant contributions to the NOE (-3.5 ppm) signals. Further analysis suggests that decreased NOE(-3.5 ppm) signals in tumors and higher NOE(-3.5 ppm) signals in white matter than in gray matter are mainly explained by changes in membrane lipids, rather than proteins. Conclusion NOE(-3.5 ppm) could be exploited as a highly sensitive MRI contrast for imaging membrane lipids in the brain.
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Liu R, Wang X, Zhao Z, Wen Q, Liu T, Wu D, Wen Z, Zhang Y. A comparative study of quantitative metrics in chemical exchange saturation transfer imaging for grading gliomas in adults. Magn Reson Imaging 2023; 96:50-59. [PMID: 36403863 DOI: 10.1016/j.mri.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/15/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the performance of different chemical exchange saturation transfer (CEST) metrics for grading gliomas with semiautomatically defined regions of interest (ROIs). METHODS Thirty-eight adult subjects were included, including 23 high-grade gliomas and 15 low-grade gliomas confirmed by histopathology. The B0-corrected CEST z-spectra were first calculated with magnetization transfer ratio asymmetry (MTRasym) analysis at frequency offsets of 3.5, 3, 2.5, 2, 1.5, and 1 ppm to obtain the fit-free metrics and subsequently fitted with three Lorentzian functions denoting direct water saturation (DS), amide proton transfer (APT), and combined semisolid magnetization transfer and nuclear Overhauser enhancement (MT & NOE) effects to derive the fit-based metrics. Wilcoxon rank-sum test was performed to determine if a statistically significant difference was present in the CEST metrics between low- and high-grade gliomas. Receiver operating characteristic (ROC) curves were used to evaluate the differentiation of CEST metrics between low- and high-grade gliomas. Pearson correlation coefficients were employed to evaluate the correlations of CEST metrics. RESULTS For the fit-free metrics, the highest areas under the curve (AUCs) of 0.85, 0.88, and 0.88, corresponding to MTRasym, MTRnormref (normalization by the reference scan), and MTRRex (subtraction of inverse z-spectra), respectively, were obtained at 3 ppm across various frequency offsets. In addition, the AUCs generated from the fit-based metrics (0.88-0.90) were higher than those generated from the fit-free metrics at 3 ppm. CONCLUSION The results of this preliminary study indicate that fit-free CEST metrics at 3 ppm are superior to the other frequency offsets for grading human brain gliomas. The fit-based metrics manifested improved differentiation between low- and high-grade gliomas compared to the fit-free CEST metrics.
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Affiliation(s)
- Ruibin Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xianlong Wang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qingqing Wen
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tingting Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China.
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21
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Rivlin M, Anaby D, Nissan N, Zaiss M, Deshmane A, Navon G, Sklair-Levy M. Breast cancer imaging with glucosamine CEST (chemical exchange saturation transfer) MRI: first human experience. Eur Radiol 2022; 32:7365-7373. [PMID: 35420304 DOI: 10.1007/s00330-022-08772-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study aims to evaluate the feasibility of imaging breast cancer with glucosamine (GlcN) chemical exchange saturation transfer (CEST) MRI technique to distinguish between tumor and surrounding tissue, compared to the conventional MRI method. METHODS Twelve patients with newly diagnosed breast tumors (median age, 53 years) were recruited in this prospective IRB-approved study, between August 2019 and March 2020. Informed consent was obtained from all patients. All MRI measurements were performed on a 3-T clinical MRI scanner. For CEST imaging, a fat-suppressed 3D RF-spoiled gradient echo sequence with saturation pulse train was applied. CEST signals were quantified in the tumor and in the surrounding tissue based on magnetization transfer ratio asymmetry (MTRasym) and a multi-Gaussian fitting. RESULTS GlcN CEST MRI revealed higher signal intensities in the tumor tissue compared to the surrounding breast tissue (MTRasym effect of 8.12 ± 4.09%, N = 12, p = 2.2 E-03) with the incremental increase due to GlcN uptake of 3.41 ± 0.79% (N = 12, p = 2.2 E-03), which is in line with tumor location as demonstrated by T1W and T2W MRI. GlcN CEST spectra comprise distinct peaks corresponding to proton exchange between free water and hydroxyl and amide/amine groups, and relayed nuclear Overhauser enhancement (NOE) from aliphatic groups, all yielded larger CEST integrals in the tumor tissue after GlcN uptake by an averaged factor of 2.2 ± 1.2 (p = 3.38 E-03), 1.4 ± 0.4 (p =9.88 E-03), and 1.6 ± 0.6 (p = 2.09 E-02), respectively. CONCLUSION The results of this initial feasibility study indicate the potential of GlcN CEST MRI to diagnose breast cancer in a clinical setup. KEY POINTS • GlcN CEST MRI method is demonstrated for its the ability to differentiate between breast tumor lesions and the surrounding tissue, based on the differential accumulation of the GlcN in the tumors. • GlcN CEST imaging may be used to identify metabolic active malignant breast tumors without using a Gd contrast agent. • The GlcN CEST MRI method may be considered for use in a clinical setup for breast cancer detection and should be tested as a complementary method to conventional clinical MRI methods.
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Affiliation(s)
- Michal Rivlin
- School of Chemistry, Tel-Aviv University, Levanon St., 6997801, Tel Aviv, Israel
| | - Debbie Anaby
- Department of Radiology, Sheba Medical Center, Sheba Tel Ha'shomer, Emek Ha Ella 1 St, 5265601, Ramat-Gan, Israel.,The Sackler School of Medicine, Tel-Aviv University, Levanon St., 6997801, Tel Aviv, Israel
| | - Noam Nissan
- Department of Radiology, Sheba Medical Center, Sheba Tel Ha'shomer, Emek Ha Ella 1 St, 5265601, Ramat-Gan, Israel.,The Sackler School of Medicine, Tel-Aviv University, Levanon St., 6997801, Tel Aviv, Israel
| | - Moritz Zaiss
- Departmnet of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anagha Deshmane
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Gil Navon
- School of Chemistry, Tel-Aviv University, Levanon St., 6997801, Tel Aviv, Israel.
| | - Miri Sklair-Levy
- The Sackler School of Medicine, Tel-Aviv University, Levanon St., 6997801, Tel Aviv, Israel.,Meirav High Risk Clinic, Department of Diagnostic Imaging, Sheba Medical Center, Emek Ha Ella 1 St, 5265601, Ramat Gan, Israel
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22
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Loi L, Goerke S, Zimmermann F, Korzowski A, Meissner JE, Breitling J, Schott S, Bachert P, Ladd ME, Schlemmer HP, Bickelhaupt S, Paech D. Assessing the influence of the menstrual cycle on APT CEST-MRI in the human breast. Magn Reson Imaging 2022; 91:24-31. [PMID: 35550841 DOI: 10.1016/j.mri.2022.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE In fibroglandular breast tissue, conventional dynamic contrast-enhanced MR-mammography is known to be affected by water content changes during the menstrual cycle. Likewise, amide proton transfer (APT) chemical exchange saturation transfer (CEST)-MRI might be inherently prone to the menstrual cycle, as CEST signals are indirectly detected via the water signal. The purpose of this study was to investigate the influence of the menstrual cycle on APT CEST-MRI in fibroglandular breast tissue. METHOD Ten healthy premenopausal women (19-34 years) were included in this IRB approved prospective study and examined twice during their menstrual cycle. Examination one and two were performed during the first half (day 2-8) and the second half (day 15-21) of the menstrual cycle, respectively. As a reference for the APT signal in malignant breast tumor tissue, previously reported data of nine breast cancer patients were included in this study. CEST-MRI (B1 = 0.7μT) was performed on a 7 T whole-body scanner followed by a multi-Lorentzian fit analysis. The APT signal was corrected for B0/B1-field inhomogeneities, fat signal contribution, and relaxation effects of the water signal and evaluated in the fibroglandular breast tissue. Intra-individual APT signal differences between examination one and two were compared using the Wilcoxon signed-rank test. The level of significance was set at p < 0.05. RESULTS The APT signal showed no significant difference in the fibroglandular breast tissue of healthy premenopausal volunteers throughout the menstrual cycle (p = 1.00) (examination 1 vs. examination 2: mean and standard deviation = 3.24 ± 0.68%Hz vs. 3.30 ± 0.73%Hz, median and IQR = 3.36%Hz and 0.87%Hz vs. 3.38%Hz and 0.71%Hz). CONCLUSION The present study provides an important basis for the clinical application of APT CEST-MRI as an additional contrast mechanism in MR-mammography, as menstrual cycle-related APT signal fluctuations seem to be negligible compared to the APT signal increase in breast cancer tissue.
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Affiliation(s)
- Lisa Loi
- German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Steffen Goerke
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Ferdinand Zimmermann
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Andreas Korzowski
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Jan-Eric Meissner
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Johannes Breitling
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Sarah Schott
- University Hospital Heidelberg, Department of Gynecology and Obstetrics, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Peter Bachert
- German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Im Neuenheimer Feld 226, 69120 Heidelberg, Germany
| | - Mark E Ladd
- Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany; German Cancer Research Center, Department of Medical Physics in Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Im Neuenheimer Feld 226, 69120 Heidelberg, Germany
| | - Heinz-Peter Schlemmer
- German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Sebastian Bickelhaupt
- German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; German Cancer Research Center, Junior Group Medical Imaging and Radiology - Cancer Prevention, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Daniel Paech
- German Cancer Research Center, Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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23
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Stabinska J, Müller-Lutz A, Wittsack HJ, Tell C, Rump LC, Ertas N, Antoch G, Ljimani A. Two point Dixon-based chemical exchange saturation transfer (CEST) MRI in renal transplant patients on 3 T. Magn Reson Imaging 2022; 90:61-69. [PMID: 35476934 DOI: 10.1016/j.mri.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/30/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the performance of two point (2-pt) Dixon-based chemical exchange saturation transfer (CEST) imaging for fat suppression in renal transplant patients. METHODS The 2-pt Dixon-based CEST MRI was validated in an egg-phantom and in fourteen renal transplant recipients (5 females and 9 males; age range: 23-78 years; mean age: 51 ± 16.8). All CEST experiments were performed on a 3 T clinical MRI scanner using a dual-echo CEST sequence. The 2-pt Dixon technique was applied to generate water-only CEST images at different frequency offsets, which were further used to calculate the z-spectra. The magnetization transfer ratio asymmetry (MTRasym) values in the frequency ranges of hydroxyl, amine and amide protons were estimated in the renal cortex and medulla. RESULTS Results of the in vitro experiments suggest that the 2-pt Dixon technique enables effective fat peak removal and does not introduce additional asymmetries to the z-spectrum. Accordingly, our results in vivo show that the fat-corrected amide proton transfer (APT) effect in the kidney is significantly higher compared to that obtained from the CEST data acquired close to the in-phase condition both in the renal cortex (-0.1 [0.7] vs. -0.7 [1.2], P = 0.029) and medulla (0.3 [0.8] vs. 0.01 [1.3], P = 0.049), indicating that the 2-pt Dixon-based CEST method increases the specificity of the APT contrast by correcting the fat-induced artifacts. CONCLUSION Combination of the dual-echo CEST acquisition with Dixon post-processing provides effective water-fat separation, allowing more accurate quantification of the APT CEST effect in the transplanted kidney.
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Affiliation(s)
- Julia Stabinska
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Christian Tell
- Department of Nephrology, Medical Faculty, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Lars Christian Rump
- Department of Nephrology, Medical Faculty, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Neslihan Ertas
- Department of Vascular and Endovascular Surgery, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
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24
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Zhou J, Zaiss M, Knutsson L, Sun PZ, Ahn SS, Aime S, Bachert P, Blakeley JO, Cai K, Chappell MA, Chen M, Gochberg DF, Goerke S, Heo HY, Jiang S, Jin T, Kim SG, Laterra J, Paech D, Pagel MD, Park JE, Reddy R, Sakata A, Sartoretti-Schefer S, Sherry AD, Smith SA, Stanisz GJ, Sundgren PC, Togao O, Vandsburger M, Wen Z, Wu Y, Zhang Y, Zhu W, Zu Z, van Zijl PCM. Review and consensus recommendations on clinical APT-weighted imaging approaches at 3T: Application to brain tumors. Magn Reson Med 2022; 88:546-574. [PMID: 35452155 PMCID: PMC9321891 DOI: 10.1002/mrm.29241] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 12/16/2022]
Abstract
Amide proton transfer-weighted (APTw) MR imaging shows promise as a biomarker of brain tumor status. Currently used APTw MRI pulse sequences and protocols vary substantially among different institutes, and there are no agreed-on standards in the imaging community. Therefore, the results acquired from different research centers are difficult to compare, which hampers uniform clinical application and interpretation. This paper reviews current clinical APTw imaging approaches and provides a rationale for optimized APTw brain tumor imaging at 3 T, including specific recommendations for pulse sequences, acquisition protocols, and data processing methods. We expect that these consensus recommendations will become the first broadly accepted guidelines for APTw imaging of brain tumors on 3 T MRI systems from different vendors. This will allow more medical centers to use the same or comparable APTw MRI techniques for the detection, characterization, and monitoring of brain tumors, enabling multi-center trials in larger patient cohorts and, ultimately, routine clinical use.
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Affiliation(s)
- Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Moritz Zaiss
- Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Institute of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Linda Knutsson
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medical Radiation Physics, Lund University, Lund, Sweden.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Silvio Aime
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Peter Bachert
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Jaishri O Blakeley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kejia Cai
- Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael A Chappell
- Mental Health and Clinical Neurosciences and Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK.,Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Daniel F Gochberg
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Physics, Vanderbilt University, Nashville, Tennessee, USA
| | - Steffen Goerke
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Hye-Young Heo
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tao Jin
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science and Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - John Laterra
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany.,Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Mark D Pagel
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ravinder Reddy
- Center for Advance Metabolic Imaging in Precision Medicine, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - A Dean Sherry
- Advanced Imaging Research Center and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Chemistry and Biochemistry, University of Texas at Dallas, Richardson, Texas, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Greg J Stanisz
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Pia C Sundgren
- Department of Diagnostic Radiology/Clinical Sciences Lund, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Osamu Togao
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yin Wu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter C M van Zijl
- Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
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25
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Someya Y, Iima M, Imai H, Yoshizawa A, Kataoka M, Isoda H, Le Bihan D, Nakamoto Y. Investigation of breast cancer microstructure and microvasculature from time-dependent DWI and CEST in correlation with histological biomarkers. Sci Rep 2022; 12:6523. [PMID: 35444193 PMCID: PMC9021220 DOI: 10.1038/s41598-022-10081-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/24/2022] [Indexed: 12/24/2022] Open
Abstract
We investigated the associations of time-dependent DWI, non-Gaussian DWI, and CEST parameters with histological biomarkers in a breast cancer xenograft model. 22 xenograft mice (7 MCF-7 and 15 MDA-MB-231) were scanned at 4 diffusion times [Td = 2.5/5 ms with 11 b-values (0–600 s/mm2) and Td = 9/27.6 ms with 17 b-values (0–3000 s/mm2), respectively]. The apparent diffusion coefficient (ADC) was estimated using 2 b-values in different combinations (ADC0–600 using b = 0 and 600 s/mm2 and shifted ADC [sADC200–1500] using b = 200 and 1500 s/mm2) at each of those diffusion times. Then the change (Δ) in ADC/sADC between diffusion times was evaluated. Non-Gaussian diffusion and intravoxel incoherent motion (IVIM) parameters (ADC0, the virtual ADC at b = 0; K, Kurtosis from non-Gaussian diffusion; f, the IVIM perfusion fraction) were estimated. CEST images were acquired and the amide proton transfer signal intensity (APT SI) were measured. The ΔsADC9–27.6 (between \documentclass[12pt]{minimal}
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\begin{document}$${\text{sADC}}_{{27.6\,{\text{ms}}}}^{200{-}1500}$$\end{document}sADC27.6ms200-1500 and ΔADC2.5_sADC27.6 (between \documentclass[12pt]{minimal}
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\begin{document}$${\text{ADC}}_{{2.5\, {\text{ms}}}}^{0{-}600}$$\end{document}ADC2.5ms0-600 and \documentclass[12pt]{minimal}
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\begin{document}$${\text{sADC}}_{{27.6\,{\text{ms}}}}^{200{-}1500}$$\end{document}sADC27.6ms200-1500) was significantly larger for MCF-7 groups, and ΔADC2.5_sADC27.6 was positively correlated with Ki67max and APT SI. ADC0 decreased significantly in MDA-MB-231 group and K increased significantly with Td in MCF-7 group. APT SI and cellular area had a moderately strong positive correlation in MDA-MB-231 and MCF-7 tumors combined, and there was a positive correlation in MDA-MB-231 tumors. There was a significant negative correlation between APT SI and the Ki-67-positive ratio in MDA-MB-231 tumors and when combined with MCF-7 tumors. The associations of ΔADC2.5_sADC27.6 and API SI with Ki-67 parameters indicate that the Td-dependent DW and CEST parameters are useful to predict the histological markers of breast cancers.
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Affiliation(s)
- Yuko Someya
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
| | - Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.,Department of Clinical Innovative Medicine, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, 606-8507, Japan
| | - Hirohiko Imai
- Department of Systems Science, Graduate School of Informatics, Kyoto University, Kyoto, 606-8501, Japan
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, 606-8507, Japan
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Denis Le Bihan
- NeuroSpin/Joliot, CEA-Saclay Center, Paris-Saclay University, 91191, Gif-sur-Yvette, France.,Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan.,National Institute for Physiological Sciences, Okazaki, 444-8585, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
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26
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Bougias H, Stogiannos N. Breast MRI: Where are we currently standing? J Med Imaging Radiat Sci 2022; 53:203-211. [DOI: 10.1016/j.jmir.2022.03.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/22/2022] [Accepted: 03/31/2022] [Indexed: 01/07/2023]
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27
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Gao T, Zou C, Li Y, Jiang Z, Tang X, Song X. A Brief History and Future Prospects of CEST MRI in Clinical Non-Brain Tumor Imaging. Int J Mol Sci 2021; 22:11559. [PMID: 34768990 PMCID: PMC8584005 DOI: 10.3390/ijms222111559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 02/08/2023] Open
Abstract
Chemical exchange saturation transfer (CEST) MRI is a promising molecular imaging tool which allows the specific detection of metabolites that contain exchangeable amide, amine, and hydroxyl protons. Decades of development have progressed CEST imaging from an initial concept to a clinical imaging tool that is used to assess tumor metabolism. The first translation efforts involved brain imaging, but this has now progressed to imaging other body tissues. In this review, we summarize studies using CEST MRI to image a range of tumor types, including breast cancer, pelvic tumors, digestive tumors, and lung cancer. Approximately two thirds of the published studies involved breast or pelvic tumors which are sites that are less affected by body motion. Most studies conclude that CEST shows good potential for the differentiation of malignant from benign lesions with a number of reports now extending to compare different histological classifications along with the effects of anti-cancer treatments. Despite CEST being a unique 'label-free' approach with a higher sensitivity than MR spectroscopy, there are still some obstacles for implementing its clinical use. Future research is now focused on overcoming these challenges. Vigorous ongoing development and further clinical trials are expected to see CEST technology become more widely implemented as a mainstream imaging technology.
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Affiliation(s)
- Tianxin Gao
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Chuyue Zou
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Yifan Li
- Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing 100084, China;
| | - Zhenqi Jiang
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Xiaoying Tang
- School of Life Science, Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; (T.G.); (C.Z.); (Z.J.)
| | - Xiaolei Song
- Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing 100084, China;
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Zhang N, Kang J, Wang H, Liu A, Miao Y, Ma X, Song Q, Zhang L, Wang J, Shen Z, Xu X. Differentiation of fibroadenomas versus malignant breast tumors utilizing three-dimensional amide proton transfer weighted magnetic resonance imaging. Clin Imaging 2021; 81:15-23. [PMID: 34597999 DOI: 10.1016/j.clinimag.2021.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To explore the value of amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI) for differential diagnosis of fibroadenomas and malignant breast tumors. MATERIALS AND METHODS This prospective study enrolled 56 patients with suspected breast tumors and performed APTw imaging. Based on the histopathology results, patients were divided into group 1 with malignant breast tumors (n = 41) and group 2 with fibroadenomas (n = 15). The measured image parameters (APTw value, ADC value, type of Time of Intensity Curve, maximum tumor diameter in image) and the maximal diameter of the tumors measured from surgical resection were compared between the two groups, and the diagnostic performance based on these parameters was quantified with ROC curve. Spearman's correlation coefficient was used to analyze the association between APTw or ADC values and ER, PR, HER2, and Ki-67 expressions. RESULTS The intraclass correlation coefficients (ICC = 0.87 and 0.91) indicated a good inter-observer agreement of the measured APTw values. APTw values of malignant lesions were significantly higher than those of fibroadenomas (3.21 ± 1.04% vs 1.50 ± 0.54%, p < 0.001). Area under the curve (AUC) obtained from APTw imaging, DWI, DCE, APTw imaging+DWI, APTw imaging+DWI, and APTw imaging+DWI + DCE was 0.959, 0.897, 0.976, 0.997, and 1 respectively. The APTw value showed a negative correlation with ER expression (r = -0.357). CONCLUSION APTw imaging yielded similar diagnosis performance in discriminating fibroadenomas and malignant breast tumors when compared to the DCE and better than DWI imaging, and provided supplement information on tumor cell activity to DWI images. The APTw value showed correlations with some prognostic factors for breast cancer.
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Affiliation(s)
- Nan Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Jianyun Kang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Huali Wang
- Department of Pathology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Yanwei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Xiaolu Ma
- Department of Clinical Laboratory, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China.
| | - Lina Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China.
| | - Jiazheng Wang
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
| | - Zhiwei Shen
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
| | - Xiaofang Xu
- MSC Clinical & Technical Solutions, Philips Healthcare, 16 Tianze Road, Beijing, PR China.
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Zhang S, Rauch GM, Adrada BE, Boge M, Mohamed RMM, Abdelhafez AH, Son JB, Sun J, Elshafeey NA, White JB, Musall BC, Miyoshi M, Wang X, Kotrotsou A, Wei P, Hwang KP, Ma J, Pagel MD. Assessment of Early Response to Neoadjuvant Systemic Therapy in Triple-Negative Breast Cancer Using Amide Proton Transfer-weighted Chemical Exchange Saturation Transfer MRI: A Pilot Study. Radiol Imaging Cancer 2021; 3:e200155. [PMID: 34477453 PMCID: PMC8489465 DOI: 10.1148/rycan.2021200155] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Purpose To determine if amide proton transfer-weighted chemical exchange saturation transfer (APTW CEST) MRI is useful in the early assessment of treatment response in persons with triple-negative breast cancer (TNBC). Materials and Methods In this prospective study, a total of 51 participants (mean age, 51 years [range, 26-79 years]) with TNBC were included who underwent APTW CEST MRI with 0.9- and 2.0-µT saturation power performed at baseline, after two cycles (C2), and after four cycles (C4) of neoadjuvant systemic therapy (NAST). Imaging was performed between January 31, 2019, and November 11, 2019, and was a part of a clinical trial (registry number NCT02744053). CEST MR images were analyzed using two methods-magnetic transfer ratio asymmetry (MTRasym) and Lorentzian line shape fitting. The APTW CEST signals at baseline, C2, and C4 were compared for 51 participants to evaluate the saturation power levels and analysis methods. The APTW CEST signals and their changes during NAST were then compared for the 26 participants with pathology reports for treatment response assessment. Results A significant APTW CEST signal decrease was observed during NAST when acquisition at 0.9-µT saturation power was paired with Lorentzian line shape fitting analysis and when the acquisition at 2.0 µT was paired with MTRasym analysis. Using 0.9-µT saturation power and Lorentzian line shape fitting, the APTW CEST signal at C2 was significantly different from baseline in participants with pathologic complete response (pCR) (3.19% vs 2.43%; P = .03) but not with non-pCR (2.76% vs 2.50%; P > .05). The APTW CEST signal change was not significant between pCR and non-pCR at all time points. Conclusion Quantitative APTW CEST MRI depended on optimizing acquisition saturation powers and analysis methods. APTW CEST MRI monitored treatment effects but did not differentiate participants with TNBC who had pCR from those with non-pCR. © RSNA, 2021 Clinical trial registration no. NCT02744053 Supplemental material is available for this article.Keywords Molecular Imaging-Cancer, Molecular Imaging-Clinical Translation, MR-Imaging, Breast, Technical Aspects, Tumor Response, Technology Assessment.
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Sun PZ. Quasi-steady-state chemical exchange saturation transfer (QUASS CEST) MRI analysis enables T 1 normalized CEST quantification - Insight into T 1 contribution to CEST measurement. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2021; 329:107022. [PMID: 34144360 PMCID: PMC8316384 DOI: 10.1016/j.jmr.2021.107022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/29/2021] [Accepted: 06/07/2021] [Indexed: 05/26/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI depends not only on the labile proton concentration and exchange rate but also on relaxation rates, particularly T1 relaxation time. However, T1 normalization has shown to be not straightforward under non-steady-state conditions and in the presence of radiofrequency spillover effect. Our study aimed to test if the combined use of the new quasi-steady-state (QUASS) analysis and inverse CEST calculation facilitates T1 normalization for improved CEST quantification. The CEST signal was simulated with Bloch-McConnell equations, and the apparent CEST, QUASS CEST, and the inverse CEST effects were calculated. T1-normalized CEST effects were tested for their specificity to the underlying CEST system (i.e., labile proton ratio and exchange rate). CEST experiments were performed from a 9-vial phantom of independently varied concentrations of creatine (20, 40, and 60 mM) and manganese chloride (20, 30, and 40 µM) under a range of RF saturation amplitudes (0.5-4 µT) and durations (1-4 s). The simulation showed that while T1 normalization of the apparent CEST effect was subject to noticeable T1 contamination, the T1-normalized inverse QUASS CEST effect had little T1 dependence. The experimental data were analyzed using a multiple linear regression model, showing that T1-normalized inverse QUASS analysis significantly depended on creatine concentration and saturation power (P < 0.05), not on manganese chloride concentration and saturation duration, advantageous over other CEST indices. The QUASS CEST algorithm reconstructs the steady-state CEST effect, enabling T1-normalized inverse CEST effect calculation for improved quantification of the underlying CEST system.
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Affiliation(s)
- Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA, United States.
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von Knebel Doeberitz N, Maksimovic S, Loi L, Paech D. [Chemical exchange saturation transfer (CEST) : Magnetic resonance imaging in diagnostic oncology]. Radiologe 2021; 61:43-51. [PMID: 33337509 DOI: 10.1007/s00117-020-00786-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Contrast generation by chemical exchange saturation transfer (CEST) is a recently emerging magnetic resonance imaging (MRI) research field with high clinical potential. METHODS This review covers the methodological principles and summarizes the clinical experience of CEST imaging studies in diagnostic oncology performed to date. RESULTS AND CONCLUSION CEST enables the detection of lowly concentrated metabolites, such as peptides and glucose, through selective saturation of metabolite-bound protons and subsequent magnetization transfer to free water. This technology yields additional information about metabolic activity and the tissue microenvironment without the need for conventional contrast agents or radioactive tracers. Various studies, mainly conducted in patients with neuro-oncolgic diseases, suggest that this technology may aid to assess tumor malignancy as well as therapeutic response prior to and in the first follow-up after intervention. KEY POINTS CEST-MRI enables the indirect detection of metabolites without radioactive tracers or contrast agents. Clinical experience exists especially in the setting of neuro-oncologic imaging. In oncologic imaging, CEST-MRI may improve assessment of prognosis and therapy response.
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Affiliation(s)
- N von Knebel Doeberitz
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - S Maksimovic
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - L Loi
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland
| | - D Paech
- Abteilung Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
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Effectiveness of fat suppression using a water-selective binomial-pulse excitation in chemical exchange saturation transfer (CEST) magnetic resonance imaging. MAGMA (NEW YORK, N.Y.) 2020; 33:809-818. [PMID: 32462557 DOI: 10.1007/s10334-020-00851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/24/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to characterize the individual contribution of multiple fat peaks to the measured chemical exchange saturation transfer (CEST) signal when using water-selective binomial-pulse excitation and to determine the effects of multiple fat peaks in the presence of B0 inhomogeneity. METHODS The excitation profiles of multiple binomial pulses were simulated. A CEST sequence with binomial-pulse excitation and modified point-resolved spectroscopy localization was then applied to the in vivo lumbar spinal vertebrae to determine the signal contributions of three distinct groups of lipid resonances. These confounding signal contributions were measured as a function of the irradiation frequency offset to determine the effect of the multi-peak nature of the fat signal on CEST imaging of exchange sites (at 1.0, 2.0 and 3.5 ppm) and robustness in the presence of B0 inhomogeneity. RESULTS Numerical simulations and in vivo experiments showed that water excitation (WE) using a 1-3-3-1 (WE-4) pulse provided the broadest signal suppression, which provided partial robustness against B0 inhomogeneity effects. Confounding fat signal contributions to the CEST contrasts at 1.0, 2.0 and 3.5 ppm were unavoidable due to the multi-peak nature of the fat signal. However, these CEST sites only suffer from small lipid artifacts with ∆B0 spanning roughly from - 50 to 50 Hz. Especially for the CEST site at 3.5 ppm, the lipid artifacts are smaller than 1% with ∆B0 in this range. CONCLUSION In WE-4-based CEST magnetic resonance imaging, B0 inhomogeneity is the limiting factor for fat suppression. The CEST sites at 1.0, 2.0 ppm and 3.5 ppm unavoidably suffer from lipid artifacts. However, when the ∆B0 is confined to a limited range, these CEST sites are only affected by small lipid artifacts, which may be ignorable in some cases of clinical applications.
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Ercan E, Varma G, Dimitrov IE, Xi Y, Pinho MC, Yu FF, Zhang S, Wang X, Madhuranthakam AJ, Lenkinski RE, Alsop DC, Vinogradov E. Combining inhomogeneous magnetization transfer and multipoint Dixon acquisition: Potential utility and evaluation. Magn Reson Med 2020; 85:2136-2144. [PMID: 33107146 PMCID: PMC7821205 DOI: 10.1002/mrm.28571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/08/2020] [Accepted: 10/06/2020] [Indexed: 11/08/2022]
Abstract
PURPOSE The recently introduced inhomogeneous magnetization transfer (ihMT) method has predominantly been applied for imaging the central nervous system. Future applications of ihMT, such as in peripheral nerves and muscles, will involve imaging in the vicinity of adipose tissues. This work aims to systematically investigate the partial volume effect of fat on the ihMT signal and to propose an efficient fat-separation method that does not interfere with ihMT measurements. METHODS First, the influence of fat on ihMT signal was studied using simulations. Next, the ihMT sequence was combined with a multi-echo Dixon acquisition for fat separation. The sequence was tested in 9 healthy volunteers using a 3T human scanner. The ihMT ratio (ihMTR) values were calculated in regions of interest in the brain and the spinal cord using standard acquisition (no fat saturation), water-only, in-phase, and out-of-phase reconstructions. The values obtained were compared with a standard fat suppression method, spectral presaturation with inversion recovery. RESULTS Simulations showed variations in the ihMTR values in the presence of fat, depending on the TEs used. The IhMTR values in the brain and spinal cord derived from the water-only ihMT multi-echo Dixon images were in good agreement with values from the unsuppressed sequence. The ihMT-spectral presaturation with inversion recovery combination resulted in 24%-35% lower ihMTR values compared with the standard non-fat-suppressed acquisition. CONCLUSION The presence of fat within a voxel affects the ihMTR calculations. The IhMT multi-echo Dixon method does not compromise the observable ihMT effect and can potentially be used to remove fat influence in ihMT.
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Affiliation(s)
- Ece Ercan
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gopal Varma
- Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Radiology, Boston, MA, USA
| | - Ivan E Dimitrov
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA.,Philips Healthcare, Gainesville, FL, USA
| | - Yin Xi
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Marco C Pinho
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Fang F Yu
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Shu Zhang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Department of Cancer Systems Imaging, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Xinzeng Wang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Global MR Application and Workflow, GE Healthcare, Houston, TX, USA
| | - Ananth J Madhuranthakam
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Robert E Lenkinski
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - David C Alsop
- Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Radiology, Boston, MA, USA
| | - Elena Vinogradov
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA.,Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
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Ceramic resonators for targeted clinical magnetic resonance imaging of the breast. Nat Commun 2020; 11:3840. [PMID: 32737293 PMCID: PMC7395080 DOI: 10.1038/s41467-020-17598-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 06/25/2020] [Indexed: 12/02/2022] Open
Abstract
Currently, human magnetic resonance (MR) examinations are becoming highly specialized with a pre-defined and often relatively small target in the body. Conventionally, clinical MR equipment is designed to be universal that compromises its efficiency for small targets. Here, we present a concept for targeted clinical magnetic resonance imaging (MRI), which can be directly integrated into the existing clinical MR systems, and demonstrate its feasibility for breast imaging. The concept comprises spatial redistribution and passive focusing of the radiofrequency magnetic flux with the aid of an artificial resonator to maximize the efficiency of a conventional MR system for the area of interest. The approach offers the prospect of a targeted MRI and brings novel opportunities for high quality specialized MR examinations within any existing MR system. Here, the authors present a concept for targeted clinical magnetic resonance imaging for relatively small targets in the body. They use an artificial resonator for spatial redistribution and passive focusing of the radiofrequency magnetic flux and demonstrate feasibility for targeted breast imaging.
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Loi L, Zimmermann F, Goerke S, Korzowski A, Meissner JE, Deike-Hofmann K, Stieber A, Bachert P, Ladd ME, Schlemmer HP, Bickelhaupt S, Schott S, Paech D. Relaxation-compensated CEST (chemical exchange saturation transfer) imaging in breast cancer diagnostics at 7T. Eur J Radiol 2020; 129:109068. [PMID: 32574936 DOI: 10.1016/j.ejrad.2020.109068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To investigate whether fat-corrected and relaxation-compensated amide proton transfer (APT) and guanidyl CEST-MRI enables the detection of signal intensity differences between breast tumors and normal-appearing fibroglandular tissue in patients with newly-diagnosed breast cancer. METHOD Ten patients with newly-diagnosed breast cancer and seven healthy volunteers were included in this prospective IRB-approved study. CEST-MRI was performed on a 7 T-whole-body scanner followed by a multi-Lorentzian fit analysis. APT and guanidyl CEST signal intensities were quantified in the tumor and in healthy fibroglandular tissue after correction of B0/B1-field inhomogeneities, fat signal contribution, T1- and T2-relaxation; signal intensity differences of APT and guanidyl resonances were compared using Mann-Whitney-U-tests. Pearson correlations between tumor CEST signal intensities and the proliferation index Ki-67 were performed. RESULTS APT CEST signal in tumor tissue (6.70 ± 1.38%Hz) was increased compared to normal-appearing fibroglandular tissue of patients (3.56 ± 0.54%Hz, p = 0.001) and healthy volunteers (3.70 ± 0.68%Hz, p = 0.001). Further, a moderate positive correlation was found between the APT signal and the proliferation index Ki-67 (R2 = 0.367, r = 0.606, p = 0.11). Guanidyl CEST signal was also increased in tumor tissue (5.24 ± 1.85%Hz) compared to patients' (2.42 ± 0.45%Hz, p = 0.006) and volunteers' (2.36 ± 0.54%Hz, p < 0.001) normal-appearing fibroglandular tissue and a positive correlation with the Ki-67 level was observed (R2 = 0.365, r = 0.604, p = 0.11). APT and guanidyl CEST signal in normal-appearing fibroglandular tissue was not different between patients and healthy volunteers (p = 0.88; p = 0.93). CONCLUSION Relaxation-compensated and fat-corrected CEST-MRI allowed a non-invasive differentiation of breast cancer and normal-appearing breast tissue. Thus, this approach represents a contrast agent-free method that may help to increase diagnostic accuracy in MR-mammography.
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Affiliation(s)
- Lisa Loi
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany.
| | - Ferdinand Zimmermann
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Im Neuenheimer Feld 226, 69120 Heidelberg, Germany.
| | - Steffen Goerke
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Andreas Korzowski
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Jan-Eric Meissner
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Katerina Deike-Hofmann
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Anne Stieber
- Department of Clinical and Interventional Radiology, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Peter Bachert
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Im Neuenheimer Feld 226, 69120 Heidelberg, Germany.
| | - Mark Edward Ladd
- Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany; Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Im Neuenheimer Feld 226, 69120 Heidelberg, Germany.
| | - Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Sebastian Bickelhaupt
- Junior Group Medical Imaging and Radiology - Cancer Prevention, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany.
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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MRI monitoring of energy storage in vivo using magnetization pathways. Proc Natl Acad Sci U S A 2020; 117:5092-5094. [PMID: 32111689 DOI: 10.1073/pnas.2001048117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Abstract
Non-invasive magnetic resonance imaging (MRI) techniques are increasingly applied in the clinic with a fast growing body of evidence regarding its value for clinical decision making. In contrast to biochemical or histological markers, the key advantages of imaging biomarkers are the non-invasive nature and the spatial and temporal resolution of these approaches. The following chapter focuses on clinical applications of novel MR biomarkers in humans with a strong focus on oncologic diseases. These include both clinically established biomarkers (part 1-4) and novel MRI techniques that recently demonstrated high potential for clinical utility (part 5-7).
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Affiliation(s)
- Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
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Crescenzi R, Donahue PMC, Mahany H, Lants SK, Donahue MJ. CEST MRI quantification procedures for breast cancer treatment-related lymphedema therapy evaluation. Magn Reson Med 2019; 83:1760-1773. [PMID: 31631410 DOI: 10.1002/mrm.28031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/14/2019] [Accepted: 09/16/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To quantify chemical exchange saturation transfer contrast in upper extremities of participants with lymphedema before and after standardized lymphatic mobilization therapy using correction procedures for B0 and B1 heterogeneity, and T1 relaxation. METHODS Females with (n = 12) and without (n = 17) breast cancer treatment-related lymphedema (BCRL) matched for age and body mass index were scanned at 3.0T MRI. B1 efficiency and T1 were calculated in series with chemical exchange saturation transfer in bilateral axilla (B1 amplitude = 2µT, Δω = ±5.5 ppm, slices = 9, spatial resolution = 1.8 × 1.47 × 5.5 mm3 ). B1 dispersion measurements (B1 = 1-3 µT; increment = 0.5 µT) were performed in controls (n = 6 arms in 3 subjects). BCRL participants were scanned pre- and post-manual lymphatic drainage (MLD) therapy. Chemical exchange saturation transfer amide proton transfer (APT) and nuclear Overhauser effect (NOE) metrics corrected for B1 efficiency were calculated, including proton transfer ratio (PTR'), magnetization transfer ratio asymmetry ( M T R asymmetry ' ) , and apparent exchange-dependent relaxation (AREX'). Nonparametric tests were used to evaluate relationships between metrics in BCRL participants pre- versus post-MLD (two-sided P < 0.05 required for significance). RESULTS B1 dispersion experiments showed nonlinear dependence of Z-values on B1 efficiency in the upper extremities; PTR' showed < 1% mean fractional difference between subject-specific and group-level correction procedures. PTR'APT significantly correlated with T1 (Spearman's rho = 0.57, P < 0.001) and body mass index (Spearman's rho = -0.37, P = 0.029) in controls and with lymphedema stage (Spearman's rho = 0.48, P = 0.017) in BCRL participants. Following MLD therapy, PTR'APT significantly increased in the affected arm of BCRL participants (pre- vs. post-MLD: 0.41 ± 0.05 vs. 0.43 ± 0.03, P = 0.02), consistent with treatment effects from mobilized lymphatic fluid. CONCLUSION Chemical exchange saturation transfer metrics, following appropriate correction procedures, respond to lymphatic mobilization therapies and may have potential for evaluating treatments in participants with secondary lymphedema.
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Affiliation(s)
- Rachelle Crescenzi
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paula M C Donahue
- Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee.,Vanderbilt Dayani Center for Health and Wellness, Nashville, Tennessee
| | - Helen Mahany
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sarah K Lants
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Manus J Donahue
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
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Chen W, Karampinos DC. Chemical-shift encoding-based water-fat separation with multifrequency fat spectrum modeling in spin-lock MRI. Magn Reson Med 2019; 83:1608-1624. [PMID: 31592557 DOI: 10.1002/mrm.28026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/18/2019] [Accepted: 09/09/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE Chemical exchange saturation transfer is used commonly to generate MRI contrast based on the chemical exchange effect. The spin-lock techniques can also be used to probe the chemical exchange and other molecular motion processes in tissues. The presence of fat can cause errors in spin-lock MRI. Signals from fat are typically suppressed based on spectral selectivity or T1 nulling approaches in spin-lock imaging. However, these methods cannot be used to suppress fat signals from multiple fat peaks. To address this problem, we report chemical-shift encoding-based water-fat separation approaches with multifrequency fat spectrum modeling. METHODS Both the conventional spin-lock and the adiabatic continuous-wave constant-amplitude spin lock (ACCSL) with multi-echo acquisitions are investigated for chemical-shift encoding-based water-fat separation in spin-lock imaging. A comparison is made of reconstructions based on 3 models: a single-peak fat spectrum model, a standard precalibrated proton density 6-peak fat spectrum model, and the self-calibrated relaxation-dependent 3-peak fat spectrum model. Comparisons were performed using Bloch simulations, phantom, and in vivo experiments at 3 T. RESULTS Conventional spin-lock acquisitions cannot be used for reliable water-fat separation with a multipeak fat spectrum model. Water-fat separation based on ACCSL acquisitions achieves superior performance compared with the use of conventional spin-lock acquisitions. The best result is achieved from ACCSL acquisition with self-calibrated relaxation-dependent multipeak fat spectrum modeling. CONCLUSION The ACCSL acquisition can be used for chemical-shift encoding-based water-fat separation with multipeak fat spectrum modeling. This approach has the potential to improve quantitative analysis using spin-lock MRI for assessing the biochemical properties of tissues.
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Affiliation(s)
- Weitian Chen
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
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Evans VS, Torrealdea F, Rega M, Brizmohun Appayya M, Latifoltojar A, Sidhu H, Kim M, Kujawa A, Punwani S, Golay X, Atkinson D. Optimization and repeatability of multipool chemical exchange saturation transfer MRI of the prostate at 3.0 T. J Magn Reson Imaging 2019; 50:1238-1250. [PMID: 30770603 PMCID: PMC6767527 DOI: 10.1002/jmri.26690] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Chemical exchange saturation transfer (CEST) can potentially support cancer imaging with metabolically derived information. Multiparametric prostate MRI has improved diagnosis but may benefit from additional information to reduce the need for biopsies. PURPOSE To optimize an acquisition and postprocessing protocol for 3.0 T multipool CEST analysis of prostate data and evaluate the repeatability of the technique. STUDY TYPE Prospective. SUBJECTS Five healthy volunteers (age range: 24-47 years; median age: 28 years) underwent two sessions (interval range: 7-27 days; median interval: 20 days) and two biopsy-proven prostate cancer patients were evaluated once. Patient 1 (71 years) had a Gleason 3 + 4 transition zone (TZ) tumor and patient 2 (55 years) had a Gleason 4 + 3 peripheral zone (PZ) tumor. FIELD STRENGTH 3.0 T. Sequences run: T2 -weighted turbo-spin-echo (TSE); diffusion-weighted imaging; CEST; WASABI (for B0 determination). ASSESSMENT Saturation, readout, and fit-model parameters were optimized to maximize in vivo amide and nuclear Overhauser effect (NOE) signals. Repeatability (intrasession and intersession) was evaluated in healthy volunteers. Subsequently, preliminary evaluation of signal differences was made in patients. Regions of interest were drawn by two post-FRCR board-certified readers, both with over 5 years of experience in multiparametric prostate MRI. STATISTICAL TESTS Repeatability was assessed using Bland-Altman analysis, coefficient of variation (CV), and 95% limits of agreement (LOA). Statistical significance of CEST contrast was calculated using a nonparametric Mann-Whitney U-test. RESULTS The optimized saturation scheme was found to be 60 sinc-Gaussian pulses with 40 msec pulse duration, at 50% duty-cycle with continuous-wave pulse equivalent B1 power (B1CWPE ) of 0.92 μT. The magnetization transfer (MT) contribution to the fit-model was centered at -1.27 ppm. Intersession coefficients of variation (CVs) of the amide, NOE, and magnetization transfer (MT) and asymmetric magnetization transfer ratio (MTRasym ) signals of 25%, 23%, 18%, and 200%, respectively, were observed. Fit-metric and MTRasym CVs agreed between readers to within 4 and 10 percentage points, respectively. DATA CONCLUSION Signal differences of 0.03-0.10 (17-43%) detectable depending upon pool, with MT the most repeatable (signal difference of 17-22% detectable). LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1238-1250.
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Affiliation(s)
| | | | - Marilena Rega
- Institute of Nuclear Medicine, University College London Hospital NHS Foundation Trust, University College HospitalLondonUK
| | | | | | - Harbir Sidhu
- Centre for Medical ImagingUniversity College LondonLondonUK
- Radiology DepartmentUniversity College London Hospital NHS Foundation Trust, University College HospitalLondonUK
| | - Mina Kim
- Institute of NeurologyUniversity College LondonLondonUK
| | - Aaron Kujawa
- Institute of NeurologyUniversity College LondonLondonUK
| | - Shonit Punwani
- Centre for Medical ImagingUniversity College LondonLondonUK
| | - Xavier Golay
- Institute of NeurologyUniversity College LondonLondonUK
| | - David Atkinson
- Centre for Medical ImagingUniversity College LondonLondonUK
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Sonkar K, Ayyappan V, Tressler CM, Adelaja O, Cai R, Cheng M, Glunde K. Focus on the glycerophosphocholine pathway in choline phospholipid metabolism of cancer. NMR IN BIOMEDICINE 2019; 32:e4112. [PMID: 31184789 PMCID: PMC6803034 DOI: 10.1002/nbm.4112] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 04/16/2019] [Accepted: 04/20/2019] [Indexed: 05/02/2023]
Abstract
Activated choline metabolism is a hallmark of carcinogenesis and tumor progression, which leads to elevated levels of phosphocholine and glycerophosphocholine in all types of cancer tested so far. Magnetic resonance spectroscopy applications have played a key role in detecting these elevated choline phospholipid metabolites. To date, the majority of cancer-related studies have focused on phosphocholine and the Kennedy pathway, which constitutes the biosynthesis pathway for membrane phosphatidylcholine. Fewer and more recent studies have reported on the importance of glycerophosphocholine in cancer. In this review article, we summarize the recent literature on glycerophosphocholine metabolism with respect to its cancer biology and its detection by magnetic resonance spectroscopy applications.
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Affiliation(s)
- Kanchan Sonkar
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vinay Ayyappan
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Caitlin M. Tressler
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oluwatobi Adelaja
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ruoqing Cai
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Menglin Cheng
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristine Glunde
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Zimmermann F, Korzowski A, Breitling J, Meissner J, Schuenke P, Loi L, Zaiss M, Bickelhaupt S, Schott S, Schlemmer H, Paech D, Ladd ME, Bachert P, Goerke S. A novel normalization for amide proton transfer CEST MRI to correct for fat signal–induced artifacts: application to human breast cancer imaging. Magn Reson Med 2019; 83:920-934. [DOI: 10.1002/mrm.27983] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/24/2019] [Accepted: 08/14/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Ferdinand Zimmermann
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Physics and Astronomy University of Heidelberg Heidelberg Germany
| | - Andreas Korzowski
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Johannes Breitling
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Physics and Astronomy University of Heidelberg Heidelberg Germany
- Max‐Planck‐Institute for Nuclear Physics Heidelberg Germany
| | - Jan‐Eric Meissner
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Patrick Schuenke
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Lisa Loi
- Department of Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Medicine University of Heidelberg Heidelberg Germany
| | - Moritz Zaiss
- Department of High‐field Magnetic Resonance Max‐Planck‐Institute for Biological Cybernetics Tübingen Germany
| | - Sebastian Bickelhaupt
- Medical Imaging and Radiology ‐ Cancer Prevention German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Sarah Schott
- Department of Obstetrics and Gynecology University Hospital Heidelberg Heidelberg Germany
| | - Heinz‐Peter Schlemmer
- Department of Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Medicine University of Heidelberg Heidelberg Germany
| | - Daniel Paech
- Department of Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Mark E. Ladd
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Physics and Astronomy University of Heidelberg Heidelberg Germany
- Faculty of Medicine University of Heidelberg Heidelberg Germany
| | - Peter Bachert
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of Physics and Astronomy University of Heidelberg Heidelberg Germany
| | - Steffen Goerke
- Division of Medical Physics in Radiology German Cancer Research Center (DKFZ) Heidelberg Germany
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Vinogradov E. Imaging molecules. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2019; 306:145-149. [PMID: 31337563 DOI: 10.1016/j.jmr.2019.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/27/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
Molecular imaging using MRI is gaining momentum. While sensitivity of MR is limited compared to other molecular imaging modalities, the molecular specificity is high in comparison. Moreover, MRI offers contrast based on multitude of processes and scales, from intramolecular relaxation pathways to water diffusion. Living tissue offers abundance of potential molecular targets of interest in biology and medicine. In this short perspective we focus on some direct and indirect methods to visualize endogenous molecules. We briefly discuss Spectroscopic Imaging (MRSI), Chemical Exchange Saturation Transfer (CEST) and Magnetization Transfer Contrast (MTC). Imaging molecules with MRI is part of the larger universe of imaging methods. Moreover, it is part of ever increasing pool of data combining imaging with other modalities, biology and patient outcomes.
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Affiliation(s)
- Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Yu L, Li C, Luo X, Zhou J, Zhang C, Zhang Y, Chen M. Differentiation of Malignant and Benign Head and Neck Tumors with Amide Proton Transfer-Weighted MR Imaging. Mol Imaging Biol 2019; 21:348-355. [PMID: 29987616 DOI: 10.1007/s11307-018-1248-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To prospectively evaluate the feasibility and capability of amide proton transfer-weighted (APTw) imaging for the characterization of head and neck tumors. PROCEDURES Twenty-nine consecutive patients with suspected head and neck tumors were enrolled in this study and underwent APTw magnetic resonance imaging (MRI) on a 3.0-T MRI scanner. The patients were divided into malignant (n = 16) and benign (n = 13) groups, based on pathological results. A map of magnetization transfer ratio asymmetry at 3.5 ppm [MTRasym (3.5 ppm)] was generated for each patient. Interobserver agreement was evaluated and comparisons of MTRasym (3.5 ppm) were made between the malignant and benign groups. Receiver operating characteristic analysis was used to determine the appropriate threshold value of MTRasym (3.5 ppm) for the differentiation of malignant from benign tumors. RESULTS The intraclass correlation coefficients of the malignant and benign groups were 0.96 and 0.90, respectively, which indicated a good interobserver agreement. MTRasym (3.5 ppm) was significantly higher for the malignant group (3.66 ± 1.15 %) than for the benign group (1.94 ± 0.93 %, P < 0.001). APTw MRI revealed an area under the curve of 0.904 in discriminating these two groups, with a sensitivity of 81.3 %, a specificity of 92.3 %, and an accuracy of 86.2 %, at the threshold of 2.62 % of MTRasym (3.5 ppm). CONCLUSIONS APTw MRI is feasible for use in the head and neck tumors and is a valuable imaging biomarker for distinguishing malignant from benign lesions.
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Affiliation(s)
- Lu Yu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing, 100730, China.,Graduate School of Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing, 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing, 100730, China
| | - Xiaojie Luo
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing, 100730, China
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, 600 N. Wolfe Street, Park 336, Baltimore, MD, 21287, USA
| | - Chen Zhang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing, 100730, China
| | - Yi Zhang
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, No. 388 Yuhangtang Road, Hangzhou, 310058, Zhejiang, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing, 100730, China. .,Graduate School of Peking Union Medical College, No. 9 Dong Dan San Tiao, Beijing, 100730, China.
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Zhao Y, Yan X, Zhang Z, Zhao W, Liu Z, Li J. Self-adapting multi-peak water-fat reconstruction for the removal of lipid artifacts in chemical exchange saturation transfer (CEST) imaging. Magn Reson Med 2019; 82:1700-1712. [PMID: 31241219 DOI: 10.1002/mrm.27859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/23/2019] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Artifacts caused by strong lipid signals pose challenges in body chemical exchange saturation transfer (CEST) imaging. This study aimed to develop an accurate water-fat reconstruction method based on the multi-echo Dixon technique to remove lipid artifacts in CEST imaging. THEORY AND METHODS It is well known that fat has multiple spectral peaks. Furthermore, RF pulses in CEST preparation saturate each fat peak at different levels, complicating fat modeling. Therefore, a self-adapting multi-peak model (SMPM) is proposed to update relative amplitudes of fat peaks using numerical calculation. With the SMPM-based updating, nonlinear least-squares fitting combined with IDEAL (Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation) algorithms was used for water-fat reconstruction and B0 mapping. The proposed method was compared with the reported 3-point Dixon method and the fixed multi-peak model in a phantom study using a fat-free Z-spectrum obtained from MR spectroscopy acquisition as the ground truth. This method was also validated by in vivo experiments on human breast. RESULTS In the phantom experiments, the Z-spectrum from the SMPM-based method agreed well with the fat-free Z-spectrum from CEST-PRESS (point-resolved spectroscopy), validating the effective removal of lipid artifacts, while a decrease or a rise that appeared at -3.5 ppm was observed in the Z-spectrum from the 3-point method and the FMPM-based method, respectively. In the in vivo experiments, no lipid artifacts were observed in the Z-spectrum or the amide CEST map from the SMPM-based method in the fibro-glandular region of the breast with high fat fractions. CONCLUSION The SMPM-based method successfully removes lipid artifacts and significantly improves the accuracy of CEST contrast.
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Affiliation(s)
- Yu Zhao
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China
| | | | - Weiwei Zhao
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
| | - Zhenzhi Liu
- Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, California
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
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Heo HY, Xu X, Jiang S, Zhao Y, Keupp J, Redmond KJ, Laterra J, van Zijl PCM, Zhou J. Prospective acceleration of parallel RF transmission-based 3D chemical exchange saturation transfer imaging with compressed sensing. Magn Reson Med 2019; 82:1812-1821. [PMID: 31209938 DOI: 10.1002/mrm.27875] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/07/2019] [Accepted: 05/30/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE To develop prospectively accelerated 3D CEST imaging using compressed sensing (CS), combined with a saturation scheme based on time-interleaved parallel transmission. METHODS A variable density pseudo-random sampling pattern with a centric elliptical k-space ordering was used for CS acceleration in 3D. Retrospective CS studies were performed with CEST phantoms to test the reconstruction scheme. Prospectively CS-accelerated 3D-CEST images were acquired in 10 healthy volunteers and 6 brain tumor patients with an acceleration factor (RCS ) of 4 and compared with conventional SENSE reconstructed images. Amide proton transfer weighted (APTw) signals under varied RF saturation powers were compared with varied acceleration factors. RESULTS The APTw signals obtained from the CS with acceleration factor of 4 were well-preserved as compared with the reference image (SENSE R = 2) both in retrospective phantom and prospective healthy volunteer studies. In the patient study, the APTw signals were significantly higher in the tumor region (gadolinium [Gd]-enhancing tumor core) than in the normal tissue (p < .001). There was no significant APTw difference between the CS-accelerated images and the reference image. The scan time of CS-accelerated 3D APTw imaging was dramatically reduced to 2:10 minutes (in-plane spatial resolution of 1.8 × 1.8 mm2 ; 15 slices with 4-mm slice thickness) as compared with SENSE (4:07 minutes). CONCLUSION Compressed sensing acceleration was successfully extended to 3D-CEST imaging without compromising CEST image quality and quantification. The CS-based CEST imaging can easily be integrated into clinical protocols and would be beneficial for a wide range of applications.
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Affiliation(s)
- Hye-Young Heo
- Divison of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Xiang Xu
- Divison of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Shanshan Jiang
- Divison of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Kristin J Redmond
- Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland
| | - John Laterra
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland.,Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Peter C M van Zijl
- Divison of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Jinyuan Zhou
- Divison of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
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Zaric O, Farr A, Poblador Rodriguez E, Mlynarik V, Bogner W, Gruber S, Asseryanis E, Singer CF, Trattnig S. 7T CEST MRI: A potential imaging tool for the assessment of tumor grade and cell proliferation in breast cancer. Magn Reson Imaging 2019; 59:77-87. [PMID: 30880110 DOI: 10.1016/j.mri.2019.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/03/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the feasibility of chemical exchange saturation transfer (CEST) MRI in patients with breast carcinomas and possible correlations between magnetization transfer asymmetry (MTRasym) values and histological features, such as tumor grade and the Ki-67 proliferation index. MATERIALS AND METHODS Nine healthy subjects and 18 female patients were enrolled for this study. The imaging protocol for the patients consisted of diffusion-weighted imaging (DWI), CEST imaging, and T1-weighted, contrast-enhanced (CE)-MRI. CEST was performed using a 3D gradient echo (GRE) sequence, employing eight pre-saturation pulses of a duration of 50 ms and a duty cycle (DC) of 80%, with a mean amplitude of the saturation pulse train of 1 μT. The Z-spectrum was plotted and MTRasym values calculated for the frequency of the maximum of MTRasym curve, were correlated with the Ki-67 proliferation index and apparent diffusion coefficient (ADC). Patient data were statistically assessed using the Games-Howell post-hoc and Pearson's correlation test. RESULTS Different tumor types had asymmetry peaks at different positions of Z-spectrum. MTRasym (mean ± SD) (%) calculated for G1 (3.0 ± 0.3; range: 2.70-3.50) was not significantly lower than for G2 (4.50 ± 1.30; range: 3.20-6.50; p = 0.066). In contrast, the increase in MTRasym between G1 and G3 (6.40 ± 1.70; range: 4.80-9.80) lesions was significant (p = 0.007). No significant difference was observed between G2 and G3 with regard to MTRasym (p = 0.089). There was a strong positive correlation between the MTRasym, and Ki-67 proliferation index (r = 0.890; p = 0.001), while there was a moderate negative correlation between MTRasym and ADC values (r = -0.506; p = 0.027). CONCLUSIONS Calculated MTRasym demonstrates a strong positive correlation with tumor proliferation and has the potential to become a valuable biomarker for breast tumor characterization.
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Affiliation(s)
- Olgica Zaric
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
| | - Esau Poblador Rodriguez
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Vladimir Mlynarik
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Gesellschaft, St. Pölten, Austria
| | - Wolfgang Bogner
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Gruber
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ella Asseryanis
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Christian F Singer
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria
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Deike-Hofmann K, Koenig F, Paech D, Dreher C, Delorme S, Schlemmer HP, Bickelhaupt S. Abbreviated MRI Protocols in Breast Cancer Diagnostics. J Magn Reson Imaging 2018; 49:647-658. [PMID: 30328180 DOI: 10.1002/jmri.26525] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/12/2022] Open
Abstract
Oncologic imaging focused on the detection of breast cancer is of increasing importance, with over 1.7 million new cases detected each year worldwide. MRI of the breast has been described to be one of the most sensitive imaging modalities in breast cancer detection; however, clinical use is limited due to high costs. In the past, the objective and clinical routine of oncologic imaging was to provide one extended imaging protocol covering all potential needs and clinical implications regardless of the specific clinical indication or question. Future protocols might be more focused according to a "keep it short and simple" approach, with a reduction of patient magnet time and a limited number of images to review. Rather than replacing conventional full-diagnostic breast MRI protocols, these approaches aim at introducing a new thinking in oncologic imaging using a diversification of available imaging approaches targeted to the dedicated clinical needs of the individual patient. Here we review current approaches on using abbreviated protocols that aim to increase the clinical availability and use of breast MRI for improved early detection of breast cancer. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:647-658.
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Affiliation(s)
| | - Franziska Koenig
- German Cancer Research Center (dkfz), Department of Radiology, Heidelberg, Germany
| | - Daniel Paech
- German Cancer Research Center (dkfz), Department of Radiology, Heidelberg, Germany
| | - Constantin Dreher
- German Cancer Research Center (dkfz), Department of Radiology, Heidelberg, Germany
| | - Stefan Delorme
- German Cancer Research Center (dkfz), Department of Radiology, Heidelberg, Germany
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Abstract
Magnetic resonance imaging (MRI) of the breast represents one of the most sensitive imaging modalities in breast cancer detection. Diffusion-weighted imaging (DWI) is a sequence variation introduced as a complementary MRI technique that relies on mapping the diffusion process of water molecules thereby providing additional information about the underlying tissue. Since water diffusion is more restricted in most malignant tumors than in benign ones owing to the higher cellularity of the rapidly proliferating neoplasia, DWI has the potential to contribute to the identification and characterization of suspicious breast lesions. Thus, DWI might increase the diagnostic accuracy of breast MRI and its clinical value. Future applications including optimized DWI sequences, technical developments in MR devices, and the application of radiomics/artificial intelligence algorithms may expand the potential of DWI in breast imaging beyond its current supplementary role.
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