Chemical exchange saturation transfer imaging of phosphocreatine in the muscle

Whole-cerebrum guanidino and amide CEST mapping at 3 T by a 3D stack-of-spirals gradient echo acquisition

PURPOSE

To develop a 3D, high-sensitivity CEST mapping technique based on the 3D stack-of-spirals (SOS) gradient echo readout, the proposed approach was compared with conventional acquisition techniques and evaluated for its efficacy in concurrently mapping of guanidino (Guan) and amide CEST in human brain at 3 T, leveraging the polynomial Lorentzian line-shape fitting (PLOF) method.

METHODS

Saturation time and recovery delay were optimized to achieve maximum CEST time efficiency. The 3DSOS method was compared with segmented 3D EPI (3DEPI), turbo spin echo, and gradient- and spin-echo techniques. Image quality, temporal SNR (tSNR), and test-retest reliability were assessed. Maps of Guan and amide CEST derived from 3DSOS were demonstrated on a low-grade glioma patient.

RESULTS

The optimized recovery delay/saturation time was determined to be 1.4/2 s for Guan and amide CEST. In addition to nearly doubling the slice number, the gradient echo techniques also outperformed spin echo sequences in tSNR: 3DEPI (193.8 ± 6.6), 3DSOS (173.9 ± 5.6), and GRASE (141.0 ± 2.7). 3DSOS, compared with 3DEPI, demonstrated comparable GuanCEST signal in gray matter (GM) (3DSOS: [2.14%-2.59%] vs. 3DEPI: [2.15%-2.61%]), and white matter (WM) (3DSOS: [1.49%-2.11%] vs. 3DEPI: [1.64%-2.09%]). 3DSOS also achieves significantly higher amideCEST in both GM (3DSOS: [2.29%-3.00%] vs. 3DEPI: [2.06%-2.92%]) and WM (3DSOS: [2.23%-2.66%] vs. 3DEPI: [1.95%-2.57%]). 3DSOS outperforms 3DEPI in terms of scan-rescan reliability (correlation coefficient: 3DSOS: 0.58-0.96 vs. 3DEPI: -0.02 to 0.75) and robustness to motion as well.

CONCLUSION

The 3DSOS CEST technique shows promise for whole-cerebrum CEST imaging, offering uniform contrast and robustness against motion artifacts.

Improving standardization and accuracy of in vivo omega plot exchange parameter determination using rotating-frame model-based fitting of quasi-steady-state Z-spectra

PURPOSE

Although Ω-plot-driven quantification of in vivo amide exchange properties has been demonstrated, differences in scan parameters may complicate the fidelity of determination. This work systematically evaluated the use of quasi-steady-state (QUASS) Z-spectra reconstruction to standardize in vivo amide exchange quantification across acquisition conditions and further determined it in vivo.

METHODS

Simulation and in vivo rodent brain chemical exchange saturation transfer (CEST) data at 4.7 T were fit with and without QUASS reconstruction using both multi-Lorentzian and model-based fitting approaches. pH modulation was accomplished both in simulation and in vivo by inducing global ischemia via cardiac arrest. Amide parameters were determined via Ω-plots and compared across methods.

RESULTS

Simulation showed that Ω-plots using multi-Lorentzian fitting could underestimate the exchange rate, with error increasing as conditions diverged from the steady state. In comparison, model-based fitting using QUASS estimated the same exchange rate within 2%. These results aligned with in vivo findings where multi-Lorentzian fitting of native Z-spectra resulted in an exchange rate of 64 ± 13 s-1 (38 ± 16 s-1 after cardiac arrest), whereas model-based fitting of QUASS Z-spectra yielded an exchange rate of 126 ± 25 s-1 (49 ± 13 s-1).

CONCLUSION

The model-based fitting of QUASS CEST Z-spectra enables consistent and accurate quantification of exchange parameters through Ω-plot construction by reducing error due to signal overlap and nonequilibrium CEST effects.

Deep-learning-based super-resolution for accelerating chemical exchange saturation transfer MRI

Chemical exchange saturation transfer (CEST) MRI is a molecular imaging tool that provides physiological information about tissues, making it an invaluable tool for disease diagnosis and guided treatment. Its clinical application requires the acquisition of high-resolution images capable of accurately identifying subtle regional changes in vivo, while simultaneously maintaining a high level of spectral resolution. However, the acquisition of such high-resolution images is time consuming, presenting a challenge for practical implementation in clinical settings. Among several techniques that have been explored to reduce the acquisition time in MRI, deep-learning-based super-resolution (DLSR) is a promising approach to address this problem due to its adaptability to any acquisition sequence and hardware. However, its translation to CEST MRI has been hindered by the lack of the large CEST datasets required for network development. Thus, we aim to develop a DLSR method, named DLSR-CEST, to reduce the acquisition time for CEST MRI by reconstructing high-resolution images from fast low-resolution acquisitions. This is achieved by first pretraining the DLSR-CEST on human brain T1w and T2w images to initialize the weights of the network and then training the network on very small human and mouse brain CEST datasets to fine-tune the weights. Using the trained DLSR-CEST network, the reconstructed CEST source images exhibited improved spatial resolution in both peak signal-to-noise ratio and structural similarity index measure metrics at all downsampling factors (2-8). Moreover, amide CEST and relayed nuclear Overhauser effect maps extrapolated from the DLSR-CEST source images exhibited high spatial resolution and low normalized root mean square error, indicating a negligible loss in Z-spectrum information. Therefore, our DLSR-CEST demonstrated a robust reconstruction of high-resolution CEST source images from fast low-resolution acquisitions, thereby improving the spatial resolution and preserving most Z-spectrum information.

Non-invasive mapping of brown adipose tissue activity with magnetic resonance imaging

Thermogenic brown adipose tissue (BAT) has a positive impact on whole-body metabolism. However, in vivo mapping of BAT activity typically relies on techniques involving ionizing radiation, such as [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) and computed tomography (CT). Here we report a noninvasive metabolic magnetic resonance imaging (MRI) approach based on creatine chemical exchange saturation transfer (Cr-CEST) contrast to assess in vivo BAT activity in rodents and humans. In male rats, a single dose of the β3-adrenoceptor agonist (CL 316,243) or norepinephrine, as well as cold exposure, triggered a robust elevation of the Cr-CEST MRI signal, which was consistent with the [18F]FDG PET and CT data and 1H nuclear magnetic resonance measurements of creatine concentration in BAT. We further show that Cr-CEST MRI detects cold-stimulated BAT activation in humans (both males and females) using a 3T clinical scanner, with data-matching results from [18F]FDG PET and CT measurements. This study establishes Cr-CEST MRI as a promising noninvasive and radiation-free approach for in vivo mapping of BAT activity.

Quantitative Assessment of Peripheral Oxidative Metabolism With a New Dynamic 1H MRI Technique: A Pilot Study in People With and Without Diabetes Mellitus

BACKGROUND

Type 2 diabetes mellitus (T2DM) is linked to impaired mitochondrial function. Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) is a gadolinium-contrast-free 1H method to assess mitochondrial function by measuring low-concentration metabolites. A CEST MRI-based technique may serve as a non-invasive proxy for assessing mitochondrial health.

HYPOTHESIS

A 1H CEST MRI technique may detect significant differences in in vivo skeletal muscle phosphocreatine (SMPCr) kinetics between healthy volunteers and T2DM patients undergoing standardized isometric exercise.

STUDY TYPE

Cross-sectional study.

SUBJECTS

Seven subjects without T2DM (T2DM-) and seven age, sex, and BMI-matched subjects with T2DM (T2DM+).

FIELD STRENGTH/SEQUENCE

Single-shot rapid acquisition with refocusing echoes (RARE) and single-shot gradient-echo sequences, 3 T.

ASSESSMENT

Subjects underwent a rest-exercise-recovery imaging protocol to dynamically acquire SMPCr maps in calf musculature. Medial gastrocnemius (MG) and soleus SMPCr concentrations were plotted over time, and SMPCr recovery time, τ , was determined. Mitochondrial function index was calculated as the ratio of resting SMPCr to τ . Participants underwent a second exercise protocol for imaging of skeletal muscle blood flow (SMBF), and its association with SMPCr was assessed.

STATISTICAL TESTS

Unpaired t-tests and Pearson correlation coefficient. A P value <0.05 was considered statistically significant.

RESULTS

SMPCr concentrations in MG and soleus displayed expected declines during exercise and returns to baseline during recovery. τ was significantly longer in the T2DM+ cohort (MG 83.5 ± 25.8 vs. 54.0 ± 21.1, soleus 90.5 ± 18.9 vs. 51.2 ± 14.5). The mitochondrial function index in the soleus was significantly lower in the T2DM+ cohort (0.33 ± 0.08 vs. 0.66 ± 0.19). SMBF was moderately correlated with the SMPCr in T2DM-; this correlation was not significant in T2DM+ (r = -0.23, P = 0.269).

CONCLUSION

The CEST MRI method is feasible for quantifying SMPCr in peripheral muscle tissue. T2DM+ individuals had significantly lower oxidative capacities than T2DM- individuals. In T2DM, skeletal muscle metabolism appeared to be decoupled from perfusion.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY: Stage 1.

A generalized QUCESOP method with evaluating CEST peak overlap

The overlapping peaks of the target chemical exchange saturation transfer (CEST) solutes and other unknown CEST solutes affect the quantification results and accuracy of the chemical exchange parameters-the fractional concentration, f b , exchange rate, k b , and transverse relaxation rate, R 2 b -for the target solutes. However, to date, no method has been established for assessing the overlapping peaks. This study aimed to develop a method for quantifying the f b , k b , and R 2 b values of a specific CEST solute, as well as assessing the overlap between the CEST peaks of the specific solute(s) and other unknown solutes. A simplified R 1 ρ model was proposed, assuming linear approximation of the other solutes' contributions to R 1 ρ . A CEST data acquisition scheme was applied with various saturation offsets and saturation powers. In addition to fitting the f b , k b , and R 2 b values of the specific solute, the overlapping condition was evaluated based on the root mean square error (RMSE) between the trajectories of the acquired and synthesized data. Single-solute and multi-solute phantoms with various phosphocreatine (PCr) concentrations and pH values were used to calculate the f b and k b of PCr and the corresponding RMSE. The feasibility of RMSE for evaluating the overlapping condition, and the accurate fitting of f b and k b in weak overlapping conditions, were verified. Furthermore, the method was employed to quantify the nuclear Overhauser effect signal in rat brains and the PCr signal in rat skeletal muscles, providing results that were consistent with those reported in previous studies. In summary, the proposed approach can be applied to evaluate the overlapping condition of CEST peaks and quantify the f b , k b , and R 2 b values of specific solutes, if the weak overlapping condition is satisfied.

Investigation of metabolite correlates of CEST in the human brain at 7 T

Metabolite-weighted chemical exchange saturation transfer MRI can be used to indirectly image metabolites such as creatine and glutamate. This study aims to further explore the contrast of CEST at 2 ppm in the human brain at 7T and investigate the metabolite correlates of CEST at 2 ppm via correlations with magnetic resonance spectroscopy (MRS). Simulations were performed to establish the optimal acquisition parameters, such as total saturation time (tsat) and B1 root mean squared (B1rms) for CEST at 2 ppm in the human brain. Parameters were validated via in vitro phantom studies at 7T using concentrations, pH and temperature comparable to what is found in the human brain. Finally, 10 healthy volunteers were scanned at 7T for comparison with MRS. Our results show that the optimal parameters to acquire CEST at 2 ppm images are: B1rms = 2.14 μT & tsat = 1500 ms, respectively. Comparison with MRS showed no significant correlation between CEST at 2 ppm and total Creatine measured by MRS (R = 0.19; p-value = 0.273). However, a significant correlation was found between CEST at 2 ppm and Glu (R = 0.39; p-value = 0.033), indicating the broad Glutamate-weighted CEST as the main measurable contributor to CEST at 2 ppm. We identified and confirmed optimal CEST at 2 ppm sequence parameters and validated CEST at 2 ppm measurements in a controlled in vitro environment. Our findings suggest that glutamate is a substantial contributor to the CEST at 2 ppm contrast observed in the human brain, whereas the creatine contribution to CEST at 2 ppm in the brain did not show a measurable contribution.

Specific and rapid guanidinium CEST imaging using double saturation power and QUASS analysis in a rodent model of global ischemia

PURPOSE

Guanidinium CEST is sensitive to metabolic changes and pH variation in ischemia, and it can offer advantages over conventional pH-sensitive amide proton transfer (APT) imaging by providing hyperintense contrast in stroke lesions. However, quantifying guanidinium CEST is challenging due to multiple overlapping components and a close frequency offset from water. This study aims to evaluate the applicability of a new rapid and model-free CEST quantification method using double saturation power, termed DSP-CEST, for isolating the guanidinium CEST effect from confounding factors in ischemia. To further reduce acquisition time, the DSP-CEST was combined with a quasi-steady state (QUASS) CEST technique to process non-steady-state CEST signals.

METHODS

The specificity and accuracy of the DSP-CEST method in quantifying the guanidinium CEST effect were assessed by comparing simulated CEST signals with/without the contribution from confounding factors. The feasibility of this method for quantifying guanidinium CEST was evaluated in a rat model of global ischemia induced by cardiac arrest and compared to a conventional multiple-pool Lorentzian fit method.

RESULTS

The DSP-CEST method was successful in removing all confounding components and quantifying the guanidinium CEST signal increase in ischemia. This suggests that the DSP-CEST has the potential to provide hyperintense contrast in stroke lesions. Additionally, the DSP-CEST was shown to be a rapid method that does not require the acquisition of the entire or a portion of the CEST Z-spectrum that is required in conventional model-based fitting approaches.

CONCLUSION

This study highlights the potential of DSP-CEST as a valuable tool for rapid and specific detection of viable tissues.

A rapid method for phosphocreatine-weighted imaging in muscle using double saturation power-chemical exchange saturation transfer

Monitoring the variation in phosphocreatine (PCr) levels following exercise provides valuable insights into muscle function. Chemical exchange saturation transfer (CEST) has emerged as a sensitive method with which to measure PCr levels in muscle, surpassing conventional MR spectroscopy. However, existing approaches for quantifying PCr CEST signals rely on time-consuming fitting methods that require the acquisition of the entire or a section of the CEST Z-spectrum. Additionally, traditional fitting methods often necessitate clear CEST peaks, which may be challenging to obtain at low magnetic fields. This paper evaluated the application of a new model-free method using double saturation power (DSP), termed DSP-CEST, to estimate the PCr CEST signal in muscle. The DSP-CEST method requires the acquisition of only two or a few CEST signals at the PCr frequency offset with two different saturation powers, enabling rapid dynamic imaging. Additionally, the DSP-CEST approach inherently eliminates confounding signals, offering enhanced robustness compared with fitting methods. Furthermore, DSP-CEST does not demand clear CEST peaks, making it suitable for low-field applications. We evaluated the capability of DSP-CEST to enhance the specificity of PCr CEST imaging through simulations and experiments on muscle tissue phantoms at 4.7 T. Furthermore, we applied DSP-CEST to animal leg muscle both before and after euthanasia and observed successful reduction of confounding signals. The DSP-CEST signal still has contaminations from a residual magnetization transfer (MT) effect and an aromatic nuclear Overhauser enhancement effect, and thus only provides a PCr-weighted imaging. The residual MT effect can be reduced by a subtraction of DSP-CEST signals at 2.6 and 5 ppm. Results show that the residual MT-corrected DSP-CEST signal at 2.6 ppm has significant variation in postmortem tissues. By contrast, both the CEST signal at 2.6 ppm and a conventional Lorentzian difference analysis of CEST signal at 2.6 ppm demonstrate no significant variation in postmortem tissues.

Adjustment of rotation and saturation effects (AROSE) for CEST imaging

PURPOSE

Endogenous CEST signal usually has low specificity due to contaminations from the magnetization transfer contrast (MTC) and other labile protons with overlapping or close Larmor frequencies. We propose to improve CEST signal specificity with adjustment of rotation and saturation effects (AROSE).

METHODS

The AROSE approach measures the difference between CEST signals acquired with the same average irradiation power but largely different duty cycles, for example, a continuous wave or a high duty cycle pulse train versus a low duty cycle pulse train with a flip angle φ. Simulation, phantom, and in vivo rodent studies were performed to evaluate the characteristics of the AROSEφ signal.

RESULTS

Simulation and experimental results show that AROSE2π is a low-pass filter that can suppress fast exchanging processes (e.g., >3000 s-1 ), whereas AROSEπ is a band-pass filter suppressing both fast and slow exchange (e.g., <30 s-1 ) rates. For other φ angles, the sensitivity and the exchange-rate filtering effect of AROSEφ falls between AROSEπ and AROSE2π . AROSE can also minimize MTC and improve the Larmor frequency selectivity of the CEST signal. The linewidth of the AROSE1.5π spectrum is about 60% to 65% when compared to the CEST spectrum measured by continuous wave. Depending on the needs of an application, the sensitivity, exchange-rate filtering, and Larmor frequency selectivity can be adjusted by varying the flip angle, duty cycle, and average irradiation power.

CONCLUSION

Compared to conventional CEST signals, AROSE can minimize MTC and improve exchange rate filtering and Larmor frequency specificity.

Simultaneous creatine and phosphocreatine mapping of skeletal muscle by CEST MRI at 3T

PURPOSE

To confirm that CrCEST in muscle exhibits a slow-exchanging process, and to obtain high-resolution amide, creatine (Cr), and phosphocreatine (PCr) maps of skeletal muscle using a POlynomial and Lorentzian Line-shape Fitting (PLOF) CEST at 3T.

METHODS

We used dynamic changes in PCr/CrCEST of mouse hindlimb before and after euthanasia to assign the Cr and PCr CEST peaks in the Z-spectrum at 3T and to obtain the optimum saturation parameters. Segmented 3D EPI was employed to obtain multi-slice amide, PCr, and Cr CEST maps of human skeletal muscle. Subsequently, the PCrCEST maps were calibrated using the PCr concentrations determined by 31 P MRS.

RESULTS

A comparison of the Z-spectra in mouse hindlimb before and after euthanasia indicated that CrCEST is a slow-exchanging process in muscle (<150.7 s-1 ). This allowed us to simultaneously extract PCr/CrCEST signals at 3T using the PLOF method. We determined optimal B1 values ranging from 0.3 to 0.6 μT for CrCEST in muscle and 0.3-1.2 μT for PCrCEST. For the study on human calf muscle, we determined an optimum saturation time of 2 s for both PCr/CrCEST (B1  = 0.6 μT). The PCr/CrCEST using 3D EPI were found to be comparable to those obtained using turbo spin echo (TSE). (3D EPI/TSE PCr: (2.6 ± 0.3) %/(2.3 ± 0.1) %; Cr: (1.3 ± 0.1) %/(1.4 ± 0.07) %).

CONCLUSIONS

Our study showed that in vivo CrCEST is a slow-exchanging process. Hence, amide, Cr, and PCr CEST in the skeletal muscle can be mapped simultaneously at 3T by PLOF CEST.

Creatine mapping of the brain at 3T by CEST MRI

PURPOSE

To assess the feasibility of CEST-based creatine (Cr) mapping in brain at 3T using the guanidino (Guan) proton resonance.

METHODS

Wild type and knockout mice with guanidinoacetate N-methyltransferase deficiency and low Cr and phosphocreatine (PCr) concentrations in the brain were used to assign the Cr and protein-based arginine contributions to the GuanCEST signal at 2.0 ppm. To quantify the Cr proton exchange rate, two-step Bloch-McConnell fitting was used to fit the extracted CrCEST line-shape and multi-B1 Z-spectral data. The pH response of GuanCEST was simulated to demonstrate its potential for pH mapping.

RESULTS

Brain Z-spectra of wild type and guanidinoacetate N-methyltransferase deficiency mice show a clear Guan proton peak at 2.0 ppm at 3T. The CrCEST signal contributes ∼23% to the GuanCEST signal at B1  = 0.8 μT, where a maximum CrCEST effect of 0.007 was detected. An exchange rate range of 200-300 s-1 was estimated for the Cr Guan protons. As revealed by the simulation, an elevated GuanCEST in the brain is observed when B1 is less than 0.4 μT at 3T, when intracellular pH reduces by 0.2. Conversely, the GuanCEST decreases when B1 is greater than 0.4 μT with the same pH drop.

CONCLUSIONS

CrCEST mapping is possible at 3T, which has potential for detecting intracellular pH and Cr concentration in brain.

Dual contrast CEST MRI for pH-weighted imaging in stroke

PURPOSE

pH enhanced (pHenh ) CEST imaging combines the pH sensitivity from amide and guanidino signals, but the saturation parameters have not been optimized. We propose pHdual as a variant of pHenh that suppresses background signal variations, while enhancing pH sensitivity and potential for imaging ischemic brain injury of stroke.

METHODS

Simulation and in vivo rodent stroke experiments of pHenh MRI were performed with varied RF saturation powers for both amide and guanidino protons to optimize the contrast between lesion/normal tissues, while simultaneously minimizing signal variations across different types of normal tissues. In acute stroke, contrast and volume ratio measured by pHdual imaging were compared with an amide-CEST approach, and perfusion and diffusion MRI.

RESULTS

Simulation experiments indicated that amide and guanidino CEST signals exhibit unique sensitivities across different pH ranges, with pHenh producing greater sensitivity over a broader pH regime. The pHenh data of rodent stroke brain demonstrated that the lesion/normal tissue contrast was maximized for an RF saturation power pair of 0.5 μT at 2.0 ppm and 1.0 μT at 3.6 ppm, whereas an optimal contrast-to-variation ratio (CVR) was obtained with a 0.7 μT saturation at 2.0 ppm and 0.8 μT at 3.6 ppm. In acute stroke, CVR optimized pHenh (i.e., pHdual ) achieved a higher sensitivity than the three-point amide-CEST approach, and distinct patterns of lesion tissue compared to diffusion and perfusion MRI.

CONCLUSION

pHdual MRI improves the sensitivity of pH-weighted imaging and will be a valuable tool for assessing tissue viability in stroke.

Fast and robust pulsed chemical exchange saturation transfer (CEST) MRI using a quasi-steady-state (QUASS) algorithm at 3 T

Chemical exchange saturation transfer (CEST) has emerged as a powerful technique to image dilute labile protons. However, its measurement depends on the RF saturation duration (Tsat) and relaxation delay (Trec). Although the recently developed quasi-steady-state (QUASS) solution can reconstruct equilibrium CEST effects under continuous-wave RF saturation, it does not apply to pulsed-CEST MRI on clinical scanners with restricted hardware or specific absorption rate limits. This study proposed a QUASS algorithm for pulsed-CEST MRI and evaluated its performance in muscle CEST measurement. An approximated expression of a steady-state pulsed-CEST signal was incorporated in the off-resonance spin-lock model, from which the QUASS pulsed-CEST effect was derived. Numerical simulation, creatine phantom, and healthy volunteer scans were conducted at 3 T. The CEST effect was quantified with asymmetry analysis in the simulation and phantom experiments. CEST effects of creatine, amide proton transfer, phosphocreatine, and combined magnetization transfer and nuclear Overhauser effects were isolated from a multi-pool Lorentzian model in muscles. Apparent and QUASS CEST measurements were compared under different Tsat/Trec and duty cycles. Paired Student's t-test was employed with P < 0.05 as statistically significant. The simulation, phantom, and human studies showed the strong impact of Tsat/Trec on apparent CEST measurements, which were significantly smaller than the corresponding QUASS CEST measures, especially under short Tsat/Trec times. In comparison, the QUASS algorithm mitigates such impact and enables accurate CEST measurements under short Tsat/Trec times. In conclusion, the QUASS algorithm can accelerate robust pulsed-CEST MRI, promising the efficient detection and evaluation of muscle diseases in clinical settings.

A Pilot Study of Ratiometric Creatine CEST MRI Assessment of Rabbit Skeletal Muscle Energy Metabolism at 3 T

BACKGROUND

pH MRI may provide useful information to evaluate metabolic disruption following ischemia. Radiofrequency amplitude-based creatine chemical exchange saturation transfer (CrCEST) ratiometric MRI is pH-sensitive, which could but has not been explored to examine muscle ischemia.

PURPOSE

To investigate skeletal muscle energy metabolism alterations with CrCEST ratiometric MRI.

STUDY TYPE

Prospective.

ANIMAL MODEL

Seven adult New Zealand rabbits with ipsilateral hindlimb muscle ischemia.

FIELD STRENGTH/SEQUENCE

3 T/two MRI scans, including MRA and CEST imaging, were performed under two B1 amplitudes of 0.5 and 1.25 μT after 2 hours of hindlimb muscle ischemia and 1 hour of reperfusion recovery, respectively.

ASSESSMENT

CEST effects of two energy metabolites of creatine and phosphocreatine (PCrCEST) were resolved with the multipool Lorentzian fitting approach. The pixel-wise CrCEST ratio was quantified by calculating the ratio of the resolved CrCEST peaks under a B1 amplitude of 1.25 μT to those under 0.5 μT in the entire muscle.

STATISTICAL TESTS

One-way ANOVA and Pearson's correlation. P < 0.05 was considered statistically significant.

RESULTS

MRA images confirmed the blood flow loss and restoration in the ischemic hindlimb at the ischemia and recovery phases, respectively. Ischemic muscles exhibited a significant decrease of PCr at the ischemia (under both B1 amplitudes) and recovery phases (under B1 amplitude of 0.5 μT) and significantly increased CrCEST from normal tissues at both phases (under both B1 levels). Specifically, CrCEST decreased, and PCrCEST increased with the CrCEST ratio. Significantly strong correlations were observed among the CrCEST ratio, and CrCEST and PCrCEST under both B1 levels (r > 0.80).

DATA CONCLUSION

The CrCEST ratio altered substantially with muscle pathological states and was closely related to CEST effects of energy metabolites of Cr and PCr, suggesting that the pH-sensitive CrCEST ratiometric MRI is feasible to evaluate muscle injuries at the metabolic level.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY STAGE: 1.

Comparison of model-free Lorentzian and spinlock model-based fittings in quantitative CEST imaging of acute stroke

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.

Biogenic Imaging Contrast Agents

Imaging contrast agents are widely investigated in preclinical and clinical studies, among which biogenic imaging contrast agents (BICAs) are developing rapidly and playing an increasingly important role in biomedical research ranging from subcellular level to individual level. The unique properties of BICAs, including expression by cells as reporters and specific genetic modification, facilitate various in vitro and in vivo studies, such as quantification of gene expression, observation of protein interactions, visualization of cellular proliferation, monitoring of metabolism, and detection of dysfunctions. Furthermore, in human body, BICAs are remarkably helpful for disease diagnosis when the dysregulation of these agents occurs and can be detected through imaging techniques. There are various BICAs matched with a set of imaging techniques, including fluorescent proteins for fluorescence imaging, gas vesicles for ultrasound imaging, and ferritin for magnetic resonance imaging. In addition, bimodal and multimodal imaging can be realized through combining the functions of different BICAs, which helps overcome the limitations of monomodal imaging. In this review, the focus is on the properties, mechanisms, applications, and future directions of BICAs.

The exchange rate of creatine CEST in mouse brain

PURPOSE

To estimate the exchange rate of creatine (Cr) CEST and to evaluate the pH sensitivity of guanidinium (Guan) CEST in the mouse brain.

METHODS

Polynomial and Lorentzian line-shape fitting (PLOF) were implemented to extract the amine, amide, and Guan CEST signals from the brain Z-spectrum at 11.7T. Wild-type (WT) and knockout mice with the guanidinoacetate N-methyltransferase deficiency (GAMT-/- ) that have low Cr and phosphocreatine (PCr) concentrations in the brain were used to extract the CrCEST signal. To quantify the CrCEST exchange rate, a two-step Bloch-McConnell (BM) fitting was used to fit the CrCEST line-shape, B1 -dependent CrCEST, and the pH response with different B1 values. The pH in the brain cells was altered by hypercapnia to measure the pH sensitivity of GuanCEST.

RESULTS

Comparison between the Z-spectra of WT and GAMT-/- mice suggest that the CrCEST is between 20% and 25% of the GuanCEST in the Z-spectrum at 1.95 ppm between B1  = 0.8 and 2 μT. The CrCEST exchange rate was found to be around 240-480 s-1 in the mouse brain, which is significantly lower than that in solutions (∼1000 s-1 ). The hypercapnia study on the mouse brain revealed that CrCEST at B1  = 2 μT and amineCEST at B1  = 0.8 μT are highly sensitive to pH change in the WT mouse brain.

CONCLUSIONS

The in vivo CrCEST exchange rate is slow, and the acquisition parameters for the CrCEST should be adjusted accordingly. CrCEST is the major contribution to the opposite pH-dependence of GuanCEST signal under different conditions of B1 in the brain.

Detection of tissue pH with quantitative chemical exchange saturation transfer magnetic resonance imaging

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.

7 tricks for 7 T CEST: Improving the reproducibility of multipool evaluation provides insights into the effects of age and the early stages of Parkinson's disease

The objective of the current study was to optimize the postprocessing pipeline of 7 T chemical exchange saturation transfer (CEST) imaging for reproducibility and to prove this optimization for the detection of age differences and differences between patients with Parkinson's disease versus normal subjects. The following 7 T CEST MRI experiments were analyzed: repeated measurements of a healthy subject, subjects of two age cohorts (14 older, seven younger subjects), and measurements of 12 patients with Parkinson's disease. A slab-selective, B 1 + -homogeneous parallel transmit protocol was used. The postprocessing, consisting of motion correction, smoothing, B 0 -correction, normalization, denoising, B 1 + -correction and Lorentzian fitting, was optimized regarding the intrasubject and intersubject coefficient of variation (CoV) of the amplitudes of the amide pool and the aliphatic relayed nuclear Overhauser effect (rNOE) pool within the brain. Seven "tricks" for postprocessing accomplished an improvement of the mean voxel CoV of the amide pool and the aliphatic rNOE pool amplitudes of less than 5% and 3%, respectively. These postprocessing steps are: motion correction with interpolation of the motion of low-signal offsets (1) using the amide pool frequency offset image as reference (2), normalization of the Z-spectrum using the outermost saturated measurements (3), B 0 correction of the Z-spectrum with moderate spline smoothing (4), denoising using principal component analysis preserving the 11 highest intensity components (5), B 1 + correction using a linear fit (6) and Lorentzian fitting using the five-pool fit model (7). With the optimized postprocessing pipeline, a significant age effect in the amide pool can be detected. Additionally, for the first time, an aliphatic rNOE contrast between subjects with Parkinson's disease and age-matched healthy controls in the substantia nigra is detected. We propose an optimized postprocessing pipeline for CEST multipool evaluation. It is shown that by the use of these seven "tricks", the reproducibility and, thus, the statistical power of a CEST measurement, can be greatly improved and subtle changes can be detected.

Chemical exchange saturation transfer imaging of creatine, phosphocreatine, and protein arginine residue in tissues

Chemical exchange saturation transfer (CEST) MRI has become a promising technique to assay target proteins and metabolites through their exchangeable protons, noninvasively. The ubiquity of creatine (Cr) and phosphocreatine (PCr) due to their pivotal roles in energy homeostasis through the creatine phosphate pathway has made them prime targets for CEST in the diagnosis and monitoring of disease pathologies, particularly in tissues heavily dependent on the maintenance of rich energy reserves. Guanidinium CEST from protein arginine residues (i.e. arginine CEST) can also provide information about the protein profile in tissue. However, numerous obfuscating factors stand as obstacles to the specificity of arginine, Cr, and PCr imaging through CEST, such as semisolid magnetization transfer, fast chemical exchanges such as primary amines, and the effects of nuclear Overhauser enhancement from aromatic and amide protons. In this review, the specific exchange properties of protein arginine residues, Cr, and PCr, along with their validation, are discussed, including the considerations necessary to target and tune their signal effects through CEST imaging. Additionally, strategies that have been employed to enhance the specificity of these exchanges in CEST imaging are described, along with how they have opened up possible applications of protein arginine residues, Cr and PCr CEST imaging in the study and diagnosis of pathology. A clear understanding of the capabilities and caveats of using CEST to image these vital metabolites and mitigation strategies is crucial to expanding the possibilities of this promising technology.

Dual-Peak Lorentzian CEST MRI for antiretroviral drug brain distribution

Objectives

Spatial-temporal biodistribution of antiretroviral drugs (ARVs) can now be achieved using MRI by utilizing chemical exchange saturation transfer (CEST) contrasts. However, the presence of biomolecules in tissue limits the specificity of current CEST methods. To overcome this limitation, a Lorentzian line-shape fitting algorithm was developed that simultaneously fits CEST peaks of ARV protons on its Z-spectrum.

Case presentation

This algorithm was tested on the common first line ARV, lamivudine (3TC), that has two peaks resulting from amino (-NH2) and hydroxyl (-OH) protons in 3TC. The developed dual-peak Lorentzian function fitted these two peaks simultaneously, and used the ratio of -NH2 and -OH CEST contrasts as a constraint parameter to measure 3TC presence in brains of drug-treated mice. 3TC biodistribution calculated using the new algorithm was compared against actual drug levels measured using UPLC-MS/MS. In comparison to the method that employs the -NH2 CEST peak only, the dual-peak Lorentzian fitting algorithm showed stronger correlation with brain tissue 3TC levels, signifying estimation of actual drug levels.

Conclusions

We concluded that 3TC levels can be extracted from confounding CEST effects of tissue biomolecules resulting in improved specificity for drug mapping. This algorithm can be expanded to measure a variety of ARVs using CEST MRI.

Demonstration of accurate multi-pool chemical exchange saturation transfer MRI quantification - Quasi-steady-state reconstruction empowered quantitative CEST analysis

Chemical exchange saturation transfer (CEST) MRI is sensitive to dilute labile protons and microenvironment properties, yet CEST quantification has been challenging. This difficulty is because the CEST measurement depends not only on the underlying CEST system but also on the scan protocols, including RF saturation amplitude, duration, and repetition time. In addition, T1 normalization is not straightforward under non-equilibrium conditions. Recently, a quasi-steady-state (QUASS) algorithm was established to reconstruct the desired equilibrium state from experimental measurements. Our study aimed to determine the accuracy of spinlock-model-based multi-pool CEST quantification using numerical simulations and phantom experiments. In short, CEST Z-spectra were simulated for a representative 3-pool model, and CEST amplitudes were solved with spinlock model-based multi-pool fitting and assessed as a function of RF saturation time (Ts), repetition time (TR), and T1. Although the apparent CEST signals showed significant T1 dependence, such relationships were not observed following QUASS reconstruction. To test the accuracy of T1 correction, a multi-vial phantom of nicotinamide and creatine was doped with manganese chloride, resulting in T1 ranging from 1 s to beyond 2 s. The multi-labile signals determined from the routine measurements showed significant dependence on Ts, TR, and T1. In contrast, CEST signals from the QUASS reconstruction showed consistent quantification independent of such variables. To summarize, our study demonstrated that accurate CEST quantification is feasible in multi-pool CEST systems with the spinlock-model-based fitting of QUASS CEST MRI.

Average saturation efficiency filter ASEF-CEST MRI of stroke rodents

PURPOSE

The average saturation efficiency filter (ASEF) is a novel method of improving the specificity of CEST; however, there is a mismatch between the magnetization transfer (MT) effect under high-duty cycle and low-duty cycle pulse trains. We explore measures of mitigation and the sensitivity and potential of ASEF imaging in phantoms and stroke rats.

METHODS

Simulation and nicotinamide phantoms in denatured protein were used to investigate the effect of different average saturation powers and MT pool parameters on matching coefficients used for correction as well as the ASEF ratio signal and baseline. Then, in vivo studies were performed in stroke rodents to further investigate the sensitivity and fidelity of ASEF ratio spectra.

RESULTS

Simulation and studies of nicotinamide phantoms show that the matching coefficient needed to correct the baseline MT mismatch is strongly dependent on the average saturation power. In vivo studies in stroke rodents show that the matching coefficient required to correct the baseline MT mismatch is different for normal versus ischemic tissue. Thus, a baseline correction was performed to further suppress the residue MT mismatch. After correction of the mismatch, ASEF ratio achieved comparable contrast at 3.6 ppm between normal and ischemic tissue when compared to the apparent amide proton transfer (APT*) approach. Moreover, contrasts for 2.0 and 2.6 ppm were also ascertainable from the same spectra.

CONCLUSION

ASEF can improve the CEST signal specificity of slow exchange labile protons such as amide and guanidyl, with small loss to sensitivity. It has strong potential in the CEST imaging of various diseases.

Average saturation efficiency filter (ASEF) for CEST imaging

PURPOSE

Endogenous CEST signal usually has low specificity due to contamination from the magnetization transfer effect and from fast exchanging labile protons with close Larmor frequencies. We propose to improve CEST signal specificity with an average saturation efficiency filter (ASEF).

METHODS

ASEF measures the difference between CEST signals acquired with similar average irradiation power but largely different duty cycles (DC), for example, a continuous wave or a high DC pulse train versus a low DC one. Simulation and Cr phantom studies were performed to evaluate the characteristics of ASEF for CEST.

RESULTS

Theoretical and simulation studies show that ASEF can suppress fast exchanging processes, with only a small loss of chemical exchange contrast for slow-to-intermediate exchange rates if the difference in DC is large. In the RF offset range of 2 to 5 ppm with an averaged saturation power of 0.8 and 1.6 microteslas, there is a mismatch of ∼0.1% to 2% in the magnetization transfer signal between saturation by continuous wave and a pulse train with DC = 15% and pulse duration of 24 ms, respectively. This mismatch can be minimized by careful selection of saturation power, pulse duration, and DC differences or by applying a small fudge factor between the 2 irradiation powers. Phantom studies of Cr confirmed that ASEF can minimize the magnetization transfer effect and reduce sensitivity to fast exchange processes.

CONCLUSION

ASEF can improve the specificity of slow-to-intermediate exchanging CEST signal with a relatively small loss of sensitivity.

Dynamic alteration in myocardium creatine during acute infarction using MR CEST imaging

Creatine (Cr) is an essential metabolite in the creatine kinase reaction, which plays a critical role in maintaining normal cardiac function. Chemical exchange saturation transfer (CEST) MRI offers a novel way to map myocardium Cr. This study aims to investigate the dynamic alteration in myocardium Cr during acute infarction using CEST MRI, which may facilitate understanding of the heart remodeling mechanism at the molecular level. Seven adult Bama pigs underwent cardiac cine, Cr CEST, and late gadolinium-enhanced (LGE) T₁ -weighted (T₁ w) imaging three and 14 days after myocardial infarction induction on a 3 T scanner. Cardiac structural and functional indices, including myocardium mass (MM), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF), were measured from cines. Infarct angle was determined from LGE T₁ w images, based on which myocardium was classified into infarct, adjacent, and remote regions. Cr-weighted CEST signal was quantified from a three-pool Lorentzian fitting model and measured within each region and the entire myocardium. Student's t-test was conducted to evaluate any significant differences in measurements between the two time points. Correlation was assessed with Pearson correlation. P values less than 0.05 were considered statistically significant. Over the studied period, MM, EDV, and ESV did not alter significantly (P > 0.05), whereas significant increases of SV and EF and decrease of infarct angle were observed (P < 0.05). Meanwhile, the Cr-weighted CEST signal elevated significantly on Day 14 compared with Day 3 in the infarct (10.00 ± 1.28% versus 6.91 ± 1.54%, P < 0.01), adjacent (11.17 ± 2.00% versus 8.01 ± 1.58%, P = 0.01), and entire myocardium (11.03 ± 1.36% versus 8.19 ± 1.28%, P < 0.01). Moderate negative correlations were shown between the infarct angle and Cr-weighted CEST signals in the infarct (r = -0.80, P < 0.001), adjacent (r = -0.58, P = 0.03), and entire myocardium (r = -0.76, P < 0.01). In conclusion, the dynamic increase of myocardium Cr during acute infarction may interact with cardiac structural and functional recovery. The study provides supplementary insights into the heart remodeling process from the metabolic viewpoint.

An end-to-end AI-based framework for automated discovery of rapid CEST/MT MRI acquisition protocols and molecular parameter quantification (AutoCEST)

PURPOSE

To develop an automated machine-learning-based method for the discovery of rapid and quantitative chemical exchange saturation transfer (CEST) MR fingerprinting acquisition and reconstruction protocols.

METHODS

An MR physics-governed AI system was trained to generate optimized acquisition schedules and the corresponding quantitative reconstruction neural network. The system (termed AutoCEST) is composed of a CEST saturation block, a spin dynamics module, and a deep reconstruction network, all differentiable and jointly connected. The method was validated using a variety of chemical exchange phantoms and in vivo mouse brains at 9.4T.

RESULTS

The acquisition times for AutoCEST optimized schedules ranged from 35 to 71 s, with a quantitative image reconstruction time of only 29 ms. The resulting exchangeable proton concentration maps for the phantoms were in good agreement with the known solute concentrations for AutoCEST sequences (mean absolute error = 2.42 mM; Pearson's r=0.992 , p<0.0001 ), but not for an unoptimized sequence (mean absolute error = 65.19 mM; Pearson's r=-0.161 , p=0.522 ). Similarly, improved exchange rate agreement was observed between AutoCEST and quantification of exchange using saturation power (QUESP) methods (mean absolute error: 35.8 Hz, Pearson's r=0.971 , p<0.0001 ) compared to an unoptimized schedule and QUESP (mean absolute error = 58.2 Hz; Pearson's r=0.959 , p<0.0001 ). The AutoCEST in vivo mouse brain semi-solid proton volume fractions were lower in the cortex (12.77% ± 0.75%) compared to the white matter (19.80% ± 0.50%), as expected.

CONCLUSION

AutoCEST can automatically generate optimized CEST/MT acquisition protocols that can be rapidly reconstructed into quantitative exchange parameter maps.

An end-to-end AI-based framework for automated discovery of rapid CEST/MT MRI acquisition protocols and molecular parameter quantification (AutoCEST)

PURPOSE

To develop an automated machine-learning-based method for the discovery of rapid and quantitative chemical exchange saturation transfer (CEST) MR fingerprinting acquisition and reconstruction protocols.

METHODS

An MR physics-governed AI system was trained to generate optimized acquisition schedules and the corresponding quantitative reconstruction neural network. The system (termed AutoCEST) is composed of a CEST saturation block, a spin dynamics module, and a deep reconstruction network, all differentiable and jointly connected. The method was validated using a variety of chemical exchange phantoms and in vivo mouse brains at 9.4T.

RESULTS

The acquisition times for AutoCEST optimized schedules ranged from 35 to 71 s, with a quantitative image reconstruction time of only 29 ms. The resulting exchangeable proton concentration maps for the phantoms were in good agreement with the known solute concentrations for AutoCEST sequences (mean absolute error = 2.42 mM; Pearson's r = 0.992 , p < 0.0001 ), but not for an unoptimized sequence (mean absolute error = 65.19 mM; Pearson's r = - 0.161 , p = 0.522 ). Similarly, improved exchange rate agreement was observed between AutoCEST and quantification of exchange using saturation power (QUESP) methods (mean absolute error: 35.8 Hz, Pearson's r = 0.971 , p < 0.0001 ) compared to an unoptimized schedule and QUESP (mean absolute error = 58.2 Hz; Pearson's r = 0.959 , p < 0.0001 ). The AutoCEST in vivo mouse brain semi-solid proton volume fractions were lower in the cortex (12.77% ± 0.75%) compared to the white matter (19.80% ± 0.50%), as expected.

CONCLUSION

AutoCEST can automatically generate optimized CEST/MT acquisition protocols that can be rapidly reconstructed into quantitative exchange parameter maps.

Role of chemical exchange on the relayed nuclear Overhauser enhancement signal in saturation transfer MRI

PURPOSE

The pH sensitivity of chemical exchange-relayed nuclear Overhauser enhancement (rNOE) signal in a saturation transfer experiment is not fully understood and needs further investigation.

METHODS

A three-pool-exchange model was simulated assuming that the magnetization transfer between an NOE pool and water is relayed by a chemical exchange (CE) pool. The saturation transfer signals from bovine serum albumin (BSA) and egg white albumin (EWA) phantoms were measured with different pH or different D₂ O/H₂ O mixture solutions.

RESULTS

Simulation results showed that the rNOE signal is independent of the Larmor frequency of the CE pool, indicating any CE pool can effectively relay NOE magnetization. The rNOE signal is sensitive to a change of the CE pool size and/or exchange rate only if the CE becomes a rate-limiting step in the relay process. The rNOE signal from BSA phantoms showed larger pH-dependence at -3.0 ppm than those at -1.9 and -4.0 ppm. However, rNOE signals from aliphatic protons have much weaker pH-dependence than the CEST signal, suggesting that CE is unlikely the rate-limiting step and the rNOE signals in BSA are mainly relayed by fast exchanging protons. The existence of aromatic NOE was confirmed by proton spectroscopy.

CONCLUSION

The pH-sensitivity of the rNOE signal is determined by whether the CE process is a rate-limiting step in the relay. The rNOE signal has much weaker pH-sensitivity than the CEST signal in BSA proteins, which can explain the weak pH sensitivity of rNOE in vivo.

Comparative evaluation of polynomial and Lorentzian lineshape-fitted amine CEST imaging in acute ischemic stroke

Purpose

Chemical exchange saturation transfer signals from amines are sensitive to pH, and detection of these signals can serve as an alternative pH imaging method to amide proton transfer (APT). However, conflicting results regarding amine CEST imaging at 2 ppm in ischemic stroke have been reported. Here, we correlated amine CEST with APT in animal stroke models to evaluate its specificity to pH, and investigated the reason for the different results through simulations and sample studies.

Methods

A three‐point quantification method was used to quantify APT. A polynomial fit method and a multiple‐pool Lorentzian fit method were used to quantify amine CEST. Samples of creatine and glutamate were prepared to study the different CEST effects from arginine amine and fast exchanging pools. Samples of tissue homogenates with different pH were prepared to study the variation in CEST signals due only to changes in pH.

Results

The polynomial fit of amine CEST at 2 ppm had a significant correlation with APT, whereas the Lorentzian fit did not. Further studies showed that arginine amine contributed to the polynomial fit, whereas both the arginine amine and the fast exchanging pools contributed to the Lorentzian fit with their CEST effects varying in opposite directions after stroke. The CEST signal from the fast exchanging pool decreased, probably due to the reduced pool concentration but not pH.

Conclusion

The variation in opposite directions led to an insignificant correlation of the Lorentzian fit of amine CEST with APT and the different results in different experimental conditions.

Quasi-steady-state chemical exchange saturation transfer (QUASS CEST) MRI analysis enables T1 normalized CEST quantification - Insight into T1 contribution to CEST measurement

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.

Hyperpolarized MRI, functional MRI, MR spectroscopy and CEST to provide metabolic information in vivo

Access to metabolic information in vivo using magnetic resonance (MR) technologies has generally been the niche of MR spectroscopy (MRS) and spectroscopic imaging (MRSI). Metabolic fluxes can be studied using the infusion of substrates labeled with magnetic isotopes, with the use of hyperpolarization especially powerful. Unfortunately, these promising methods are not yet accepted clinically, where fast, simple, and reliable measurement and diagnosis are key. Recent advances in functional MRI and chemical exchange saturation transfer (CEST) MRI allow the use of water imaging to study oxygen metabolism and tissue metabolite levels. These, together with the use of novel data analysis approaches such as machine learning for all of these metabolic MR approaches, are increasing the likelihood of their clinical translation.

Low duty cycle pulse trains for exchange rate insensitive chemical exchange saturation transfer MRI

PURPOSE

To introduce and validate a pulse scheme that uses low duty cycle trains of π-pulses to achieve saturation that is relatively insensitive to exchange rate yet linearly dependent on labile proton concentration.

METHODS

Simulations were performed to explore the exchange rate sensitivity of π-pulse trains and continuous wave chemical exchange saturation transfer (CEST) signals. Creatine phantoms with varying pH and varying concentrations were imaged to demonstrate pH insensitivity and concentration dependence of low duty cycle π-pulse saturation.

RESULTS

Simulations show decreasing the duty cycle of π-pulse saturation decreases peak sensitivity to exchange rate, and this range of insensitivity can be tuned to different exchange rates through average B₁ power. The range of insensitivity is unaffected by changes in relaxation and magnetization transfer, while the sensitivity of CEST signal maintains linear dependence on labile proton concentration. Under B_{1, avg} = 0.48 μT, 30 mM creatine with pHs ranging between 6.36 and 8.21 exhibited CEST contrast ranging between ~6 and 11% under continuous wave and ~4% across all pHs using 10% duty cycle π-pulses. Imaging these phantoms using duty cycles of 5, 10, 25, and 50% showed decreasing pH sensitivity with decreased duty cycle. Creatine phantoms with varied concentrations and pHs reveal that π-pulse train saturation exhibited stricter correlation to concentration at lower DCs.

CONCLUSION

Low DC π-pulse train is an easy-to-implement way of providing labile proton concentration-dependent CEST MRI signal that is insensitive to exchange rate. This approach can be useful in studies where a change of chemical exchange rate may interfere with accurate assessments of physiology or pathology.

Quasi-steady-state CEST (QUASS CEST) solution improves the accuracy of CEST quantification: QUASS CEST MRI-based omega plot analysis

PURPOSE

CEST MRI omega plot quantifies the labile proton fraction ratio (f_r ) and exchange rate (k_sw ), yet it assumes long RF saturation time (Ts) and relaxation delay (Td). Our study aimed to test if a quasi-steady-state (QUASS) CEST analysis that accounts for the effect of finite Ts and Td could improve the accuracy of CEST MRI quantification.

METHODS

We modeled the MRI signal evolution using a typical CEST EPI sequence. The signal relaxes toward its thermal equilibrium following the bulk water relaxation rate during Td, and then toward its CEST steady state following the spin-lock relaxation rate during Ts from which the QUASS CEST effect is derived. Both f_r and k_sw were solved from simulated conventional apparent CEST and QUASS CEST MRI. We also performed MRI experiments from a Cr-gel phantom under serially varied Ts and Td times from 1.5 to 7.5 s.

RESULTS

Simulation showed that, although k_sw could be slightly overestimated (3%-15%) for the range of Ts and Td, f_r could be substantially underestimated by as much as 67%. In contrast, the QUASS solution provided accurate k_sw and f_r determination within 2%. The CEST MRI experiments confirmed that the QUASS solution enabled robust quantification of k_sw and f_r , superior over the omega plot analysis based on the conventional apparent CEST MRI measurements.

CONCLUSIONS

The QUASS CEST MRI algorithm corrects the effect of finite Ts and Td times on CEST measurements, thereby allowing robust and accurate CEST quantification.

pH Mapping of Skeletal Muscle by Chemical Exchange Saturation Transfer (CEST) Imaging

Magnetic resonance imaging (MRI) is extensively used in clinical and basic biomedical research. However, MRI detection of pH changes still poses a technical challenge. Chemical exchange saturation transfer (CEST) imaging is a possible solution to this problem. Using saturation transfer, alterations in the exchange rates between the solute and water protons because of small pH changes can be detected with greater sensitivity. In this study, we examined a fatigued skeletal muscle model in electrically stimulated mice. The measured CEST signal ratio was between 1.96 ppm and 2.6 ppm in the z-spectrum, and this was associated with pH values based on the ratio between the creatine (Cr) and the phosphocreatine (PCr). The CEST results demonstrated a significant contrast change at the electrical stimulation site. Moreover, the pH value was observed to decrease from 7.23 to 7.15 within 20 h after electrical stimulation. This pH decrease was verified by 31P magnetic resonance spectroscopy and behavioral tests, which showed a consistent variation over time.

High-sensitivity CEST mapping using a spatiotemporal correlation-enhanced method

PURPOSE

To obtain high-sensitivity CEST maps by exploiting the spatiotemporal correlation between CEST images.

METHODS

A postprocessing method accomplished by multilinear singular value decomposition (MLSVD) was used to enhance the CEST SNR by exploiting the correlation between the Z-spectrum for each voxel and the low-rank property of the overall CEST data. The performance of this method was evaluated using CrCEST in ischemic mouse brain at 11.7 tesla. Then, MLSVD CEST was applied to obtain Cr, amide, and amine CEST maps of the ischemic mouse brain to demonstrate its general applications.

RESULTS

Complex-valued Gaussian noise was added to CEST k-space data to mimic a low SNR situation. MLSVD CEST analysis was able to suppress the noise, recover the degraded CEST peak, and provide better CrCEST quality compared to the smoothing and singular value decomposition (SVD)-based denoising methods. High-resolution Cr, amide, and amine CEST maps of an ischemic stroke using MLSVD CEST suggest that CrCEST is also a sensitive pH mapping method, and a wide range of pH changes can be detected by combing CrCEST with amine CEST at high magnetic fields.

CONCLUSION

MLSVD CEST provides a simple and efficient way to improve the SNR of CEST images.

Amplified detection of phosphocreatine and creatine after supplementation using CEST MRI at high and ultrahigh magnetic fields

Creatine is an important metabolite involved in muscle contraction. Administration of exogenous creatine (Cr) or phosphocreatine (PCr) has been used for improving exercise performance and protecting the heart during surgery including during valve replacements, coronary artery bypass grafting and repair of congenital heart defects. In this work we investigate whether it is possible to use chemical exchange saturation transfer (CEST) MRI to monitor uptake and clearance of exogenous creatine and phosphocreatine following supplementation. We were furthermore interested in determining the limiting conditions for distinguishing between creatine (1.9 ppm) and phosphocreatine (2.6 ppm) signals at ultra-high fields (21 T) and determine their concentrations could be reliably obtained using Bloch equation fits of the experimental CEST spectra. We have tested these items by performing CEST MRI of hind limb muscle and kidneys at 11.7 T and 21.1 T both before and after intravenous administration of PCr. We observed up to 4% increase in contrast in the kidneys at 2.6 ppm which peaked ~30 min after administration and a relative ratio of 1.3 in PCr:Cr signal. Overall, these results demonstrate the feasibility of independent monitoring of PCr and Cr concentration changes using CEST MRI.

In vivo imaging of phosphocreatine with artificial neural networks

Phosphocreatine (PCr) plays a vital role in neuron and myocyte energy homeostasis. Currently, there are no routine diagnostic tests to noninvasively map PCr distribution with clinically relevant spatial resolution and scan time. Here, we demonstrate that artificial neural network-based chemical exchange saturation transfer (ANNCEST) can be used to rapidly quantify PCr concentration with robust immunity to commonly seen MRI interferences. High-quality PCr mapping of human skeletal muscle, as well as the information of exchange rate, magnetic field and radio-frequency transmission inhomogeneities, can be obtained within 1.5 min on a 3 T standard MRI scanner using ANNCEST. For further validation, we apply ANNCEST to measure the PCr concentrations in exercised skeletal muscle. The ANNCEST outcomes strongly correlate with those from 31P magnetic resonance spectroscopy (R = 0.813, p < 0.001, t test). These results suggest that ANNCEST has potential as a cost-effective and widely available method for measuring PCr and diagnosing related diseases.

High-resolution creatine mapping of mouse brain at 11.7 T using non-steady-state chemical exchange saturation transfer

The current study aims to optimize the acquisition scheme for the creatine chemical exchange saturation transfer weighted (CrCESTw) signal on mouse brain at 11.7 T, in which a strong magnetization transfer contrast (MTC) is present, and to further develop the polynomial and Lorentzian line-shape fitting (PLOF) method for quantifying CrCESTw signal with a non-steady-state (NSS) acquisition scheme. Studies on a Cr phantom with cross-linked bovine serum albumin (BSA) as well as on mouse brain demonstrated that the maximum CrCESTw signal was reached with a short saturation time determined by the rotating frame relaxation time of the MTC pool instead of the steady-state saturation. The saturation power for the maximal signal was around 1-1.5 μT for Cr with 20% cross-linked BSA and in vivo applications, but 2 μT was found to be most practical for signal stability. For the CrCEST acquisition with strong MTC interference, the optimal saturation power and length are completely different from those on Cr solution alone. This observation could be explained well using R_1ρ theory by incorporating the strong MTC pool. Finally, a high-resolution Cr map was obtained on mouse brain using the PLOF method with the NSS CEST acquisition and a cryogenic coil. The Cr map obtained by CEST showed homogenous intensity across the mouse brain except for regions with cerebrospinal fluid.

Approximated analytical characterization of the steady-state chemical exchange saturation transfer (CEST) signals

PURPOSE

CEST MRI can indirectly detect low-concentrated molecules via their proton exchange with the bulk water and is widely measured by a sensitivity index, the asymmetry of magnetization transfer ratio (MTRasym ). Because CEST applications are often limited by their low sensitivity or specificity, it is important to characterize MTRasym analytically to optimize its sensitivity or specifity.

METHODS

Approximated analytical solutions of the MTRasym spectrum were derived based on a 2-pool chemical exchange model for slow-to-intermediate exchanges. The optimal saturation pulse power for maximizing the MTRasym or tuning MTRasym to a specific exchange rate and the peak position and linewidth of a MTRasym spectrum were also derived. These approximated analytical solutions were compared with the solutions from the Bloch-McConnell equations using computer simulations.

RESULTS

The approximated analytical solutions of the MTRasym spectra, the optimizing parameters, and the peak and linewidth of MTRasym matched well with the solutions of Bloch-McConnell equations in the slow or slow-to-intermediate exchange regimes.

CONCLUSION

These approximate analytical solutions can provide insights to the understanding of CEST signal property and help the optimization of saturation parameters and the interpretation of CEST data.

Development of intravoxel inhomogeneity correction for chemical exchange saturation transfer spectral imaging: a high-resolution field map-based deconvolution algorithm for magnetic field inhomogeneity correction

PURPOSE

CEST MRI is sensitive to dilute proteins/peptides and microenvironmental properties yet susceptible to magnetic field inhomogeneity. We aimed to develop a high-resolution field map-based CEST intravoxel inhomogeneity correction (CIVIC) algorithm for CEST Z-spectral imaging.

METHODS

The proposed CIVIC approach treats the intravoxel inhomogeneity as a point spread function and applies the deconvolution algorithm to reconstruct the original Z-spectrum. We simulated the effect of B₀ field inhomogeneity on CEST measurement and tested the efficacy of the proposed CIVIC algorithm. We also performed CEST MRI on a dual-pH Creatine-gel phantom under varied field homogeneity conditions and compared the CEST MRI contrast-to-noise ratio from the raw Z-spectrum, water saturation shift referencing, and the proposed CIVIC methods.

RESULTS

The numerical simulation showed that the CIVIC algorithm remains effective even in the case of symmetric field dispersion with a 0 mean shift. The experimental results confirmed that the proposed CIVIC method substantially improves the CEST MRI contrast-to-noise ratio under different field homogeneity conditions.

CONCLUSION

Our study established a new intravoxel B₀ inhomogeneity correction algorithm, promising to facilitate CEST spectral imaging in challenging experimental conditions.

Mouse skeletal muscle creatine chemical exchange saturation transfer (CrCEST) imaging at 11.7T MRI

BACKGROUND

Creatine chemical exchange saturation transfer (CrCEST) imaging is expected to be a novel evaluation method of muscular energy metabolism.

PURPOSE

To develop CrCEST imaging of mouse skeletal muscle and to validate this technique by measuring changes in Cr concentration of ischemic hindlimbs.

STUDY TYPE

Prospective.

ANIMAL MODEL

C57BL/6 mice (n = 6), mild hindlimb ischemic mice (n = 6), and severe hindlimb ischemic mice (n = 6).

FIELD STRENGTH/SEQUENCE

Magnetic resonance angiography (MRA), CrCEST imaging, and phosphorus magnetic resonance spectroscopy (³¹ P MRS) obtained at 11.7T.

ASSESSMENT

MRA and ³¹ P MRS were performed to confirm the presence of ischemia following the compression by rubber tourniquet. CrCEST imaging was performed and magnetization transfer ratio asymmetry (MTR_asym ), which reflects Cr concentration, and was calculated in severe ischemia models, mild ischemia models, and control mice. Follow-up CrCEST imaging was performed after the release of ischemia in the mild ischemia models.

STATISTICAL TESTS

Mean ± SD, one-way analysis of variance (ANOVA) with Tukey's HSD test, unpaired or paired t-test.

RESULTS

MRA revealed the loss of blood flow of the femoral artery in the ischemic hindlimb. ³¹ P MRS revealed different degrees of PCr decrease in severe and mild ischemic hindlimb (n = 3 per group, normal hindlimb: 1.0 ± 0, mild ischemic hindlimb: 0.77 ± 0.13, severe ischemic hindlimb: 0 ± 0). CrCEST imaging inversely revealed a significant stepwise increase in the MTR_asym ratio of ischemic hindlimbs compared with controls (control, mild ischemia, and severe ischemia; 0.99 ± 0.04, 1.36 ± 0.08, and 1.59 ± 0.23, respectively, P < 0.0001). In addition, follow-up CrCEST imaging after the release of ischemia revealed normalization of the MTR_asym ratios (recovered hindlimb: 1.01 ± 0.05).

DATA CONCLUSION

We demonstrated an increase in the MTR_asym of ischemic hindlimbs, along with a decrease of PCr. We demonstrated the normalization of MTR_asym after the release of ischemia and developed CrCEST imaging of mouse skeletal muscle.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:563-570.