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John M, Rüttger F. Multinuclear Residual Quadrupolar Couplings for Structure and Assignment. Chemphyschem 2024; 25:e202400068. [PMID: 38465709 DOI: 10.1002/cphc.202400068] [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: 01/24/2024] [Revised: 03/08/2024] [Accepted: 03/10/2024] [Indexed: 03/12/2024]
Abstract
Most stable isotopes have a nuclear spin >1/2, but the quadrupole interaction poses challenge on their detection by nuclear magnetic resonance (NMR). On the other hand, the quadrupole interaction is a rich source of structural information that may be exploited for solution NMR in the form of residual quadrupolar couplings (RQCs) of weakly oriented samples. While 2H RQCs are now well established for structure verification and enantiomeric discrimination of organic molecules, we will in this article highlight some recent work on RQCs of other nuclei (especially 7Li and 11B).
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Affiliation(s)
- Michael John
- Fakultät für Chemie, Georg-August-Universität Göttingen, Tammannstrasse 4, D-37077, Göttingen
| | - Franziska Rüttger
- Fakultät für Chemie, Georg-August-Universität Göttingen, Tammannstrasse 4, D-37077, Göttingen
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Asano H, Elhelaly AE, Hyodo F, Iwasaki R, Noda Y, Kato H, Ichihashi K, Tomita H, Murata M, Mori T, Matsuo M. Deuterium Magnetic Resonance Imaging Using Deuterated Water-Induced 2H-Tissue Labeling Allows Monitoring Cancer Treatment at Clinical Field Strength. Clin Cancer Res 2023; 29:5173-5182. [PMID: 37732903 PMCID: PMC10722130 DOI: 10.1158/1078-0432.ccr-23-1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/24/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE An accurate and noninvasive assessment of tumor response following treatment other than traditional anatomical imaging techniques is essential. Deuterium magnetic resonance spectroscopic (MRS) imaging has been demonstrated as an alternative for cancer metabolic imaging by high-field MRI using deuterium-labeled molecules. The study aim was to use 2H tissue labeling and deuterium MRI at clinical field strength for tumor visualization and assessment of three anticancer therapies in pancreatic cancer model mice. EXPERIMENTAL DESIGN MIA PaCa-2 pancreatic carcinoma and C26 colorectal carcinoma models of BALB/c-nu mice was prepared, and repeated deuterium MRI was performed during the first 10 days of free drinking of 30% D2O to track 2H distribution in tissues. 2H accumulation in the tumor after irradiation, bevacizumab administration, or gemcitabine administration was also measured in MIA PaCa-2-bearing mice. Confirmatory proton MRI, ex vivo metabolic hyperpolarization 13C-MRS, and histopathology were performed. RESULTS The mouse's whole-body distribution of 2H was visible 1 day after drinking, and the signal intensity increased daily. Although the tumor size did not change 1 and 3 days after irradiation, the amount of 2H decreased significantly. The 2H image intensity of the tumor also significantly decreased after the administration of bevacizumab or gemcitabine. Metabolic hyperpolarization 13C-MRS, proton MRI, and 2H-NMR spectroscopy confirmed the efficacy of the anticancer treatments. CONCLUSIONS Deuterium MRI at 1.5T proved feasible to track 2H distribution throughout mouse tissues during D2O administration and revealed a higher 2H accumulation in the tumor xenografts. This research demonstrated a promising successful method for preliminary assessment of radiotherapy and chemotherapy of cancer.
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Affiliation(s)
- Hirofumi Asano
- Department of Radiology, Gifu University, Gifu, Japan
- Department of Radiological Technology, Central Japan International Medical Center, Gifu, Japan
| | - Abdelazim Elsayed Elhelaly
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
- Department of Food Hygiene and Control, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, Gifu, Japan
- Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Gifu, Japan
| | - Ryota Iwasaki
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | | | - Hiroki Kato
- Department of Radiology, Gifu University, Gifu, Japan
| | - Koki Ichihashi
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masaharu Murata
- Center for Advanced Medical Open Innovation, Kyushu University, Fukuoka, Japan
| | - Takashi Mori
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
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Gast LV, Platt T, Nagel AM, Gerhalter T. Recent technical developments and clinical research applications of sodium ( 23Na) MRI. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2023; 138-139:1-51. [PMID: 38065665 DOI: 10.1016/j.pnmrs.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 12/18/2023]
Abstract
Sodium is an essential ion that plays a central role in many physiological processes including the transmembrane electrochemical gradient and the maintenance of the body's homeostasis. Due to the crucial role of sodium in the human body, the sodium nucleus is a promising candidate for non-invasively assessing (patho-)physiological changes. Almost 10 years ago, Madelin et al. provided a comprehensive review of methods and applications of sodium (23Na) MRI (Madelin et al., 2014) [1]. More recent review articles have focused mainly on specific applications of 23Na MRI. For example, several articles covered 23Na MRI applications for diseases such as osteoarthritis (Zbyn et al., 2016, Zaric et al., 2020) [2,3], multiple sclerosis (Petracca et al., 2016, Huhn et al., 2019) [4,5] and brain tumors (Schepkin, 2016) [6], or for imaging certain organs such as the kidneys (Zollner et al., 2016) [7], the brain (Shah et al., 2016, Thulborn et al., 2018) [8,9], and the heart (Bottomley, 2016) [10]. Other articles have reviewed technical developments such as radiofrequency (RF) coils for 23Na MRI (Wiggins et al., 2016, Bangerter et al., 2016) [11,12], pulse sequences (Konstandin et al., 2014) [13], image reconstruction methods (Chen et al., 2021) [14], and interleaved/simultaneous imaging techniques (Lopez Kolkovsky et al., 2022) [15]. In addition, 23Na MRI topics have been covered in review articles with broader topics such as multinuclear MRI or ultra-high-field MRI (Niesporek et al., 2019, Hu et al., 2019, Ladd et al., 2018) [16-18]. During the past decade, various research groups have continued working on technical improvements to sodium MRI and have investigated its potential to serve as a diagnostic and prognostic tool. Clinical research applications of 23Na MRI have covered a broad spectrum of diseases, mainly focusing on the brain, cartilage, and skeletal muscle (see Fig. 1). In this article, we aim to provide a comprehensive summary of methodological and hardware developments, as well as a review of various clinical research applications of sodium (23Na) MRI in the last decade (i.e., published from the beginning of 2013 to the end of 2022).
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Tanja Platt
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, 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.
| | - Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Zou C, Ruan Y, Li H, Wan Q, Du F, Yuan J, Qin Q, Thompson GJ, Yang X, Li Y, Liu X, Zheng H. A new deuterium-labeled compound [2,3,4,6,6'- 2 H 5 ]-D-glucose for deuterium magnetic resonance metabolic imaging. NMR IN BIOMEDICINE 2023; 36:e4890. [PMID: 36477944 DOI: 10.1002/nbm.4890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/15/2023]
Abstract
Deuterium (2 H) magnetic resonance imaging is an emerging approach for noninvasively studying glucose metabolism in vivo, which is important for understanding pathogenesis and monitoring the progression of many diseases such as tumors, diabetes, and neurodegenerative diseases. However, the synthesis of 2 H-labeled glucose is costly because of the expensive raw substrates and the requirement for extreme reaction conditions, making the 2 H-labeled glucose rather expensive and unaffordable for clinic use. In this study, we present a new deuterated compound, [2,3,4,6,6'-2 H5 ]-D-glucose, with an approximate 10-fold reduction in production costs. The synthesis route uses cheaper raw substrate methyl-α-D-glucopyranoside, relies on mild reaction conditions (80°C), and has higher deuterium labeling efficiency. Magnetic resonance spectroscopy (MRS) and mass spectroscopy experiments confirmed the successful deuterium labeling in the compound. Animal studies demonstrated that the substrate could describe the glycolytic metabolism in a glioma rat model by quantifying the downstream metabolites through 2 H-MRS on an ultrahigh field system. Comparison of the glucose metabolism characteristics was carried out between [2,3,4,6,6'-2 H5 ]-D-glucose and commercial [6,6'-2 H2 ]-D-glucose in the animal studies. This cost-effective compound will help facilitate the clinical translation of deuterium magnetic resonance imaging, and enable this powerful metabolic imaging modality to be widely used in both preclinical and clinical research and applications.
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Affiliation(s)
- Chao Zou
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen, Guangdong, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yingheng Ruan
- Shenzhen Dingbang Bioscience Co., Ltd, Shenzhen, Guangdong, China
| | - Huanxi Li
- Shenzhen Dingbang Bioscience Co., Ltd, Shenzhen, Guangdong, China
| | - Qian Wan
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Feng Du
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jiawen Yuan
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Qikai Qin
- iHuman Institute, ShanghaiTech University, Shanghai, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China
| | | | - Xiaojun Yang
- Shenzhen Dingbang Bioscience Co., Ltd, Shenzhen, Guangdong, China
| | - Ye Li
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen, Guangdong, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen, Guangdong, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- University of Chinese Academy of Sciences, Beijing, China
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Nam KM, Gursan A, Bhogal AA, Wijnen JP, Klomp DWJ, Prompers JJ, Hendriks AD. Deuterium echo-planar spectroscopic imaging (EPSI) in the human liver in vivo at 7 T. Magn Reson Med 2023. [PMID: 37154391 DOI: 10.1002/mrm.29696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/04/2023] [Accepted: 04/19/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To demonstrate the feasibility of deuterium echo-planar spectroscopic imaging (EPSI) to accelerate 3D deuterium metabolic imaging in the human liver at 7 T. METHODS A deuterium EPSI sequence, featuring a Hamming-weighted k-space acquisition pattern for the phase-encoding directions, was implemented. Three-dimensional deuterium EPSI and conventional MRSI were performed on a water/acetone phantom and in vivo in the human liver at natural abundance. Moreover, in vivo deuterium EPSI measurements were acquired after oral administration of deuterated glucose. The effect of acquisition time on SNR was evaluated by retrospectively reducing the number of averages. RESULTS The SNR of natural abundance deuterated water signal in deuterium EPSI was 6.5% and 5.9% lower than that of MRSI in the phantom and in vivo experiments, respectively. In return, the acquisition time of in vivo EPSI data could be reduced retrospectively to 2 min, beyond the minimal acquisition time of conventional MRSI (of 20 min in this case), while still leaving sufficient SNR. Three-dimensional deuterium EPSI, after administration of deuterated glucose, enabled monitoring of hepatic glucose dynamics with full liver coverage, a spatial resolution of 20 mm isotropic, and a temporal resolution of 9 min 50 s, which could retrospectively be shortened to 2 min. CONCLUSION In this work, we demonstrate the feasibility of accelerated 3D deuterium metabolic imaging of the human liver using deuterium EPSI. The acceleration obtained with EPSI can be used to increase temporal and/or spatial resolution, which will be valuable to study tissue metabolism of deuterated compounds over time.
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Affiliation(s)
- Kyung Min Nam
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ayhan Gursan
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alex A Bhogal
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jannie P Wijnen
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dennis W J Klomp
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jeanine J Prompers
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Arjan D Hendriks
- Center for Image Sciences, Department of High Field MR Research, University Medical Center Utrecht, Utrecht, the Netherlands
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Cocking D, Damion RA, Franks H, Jaconelli M, Wilkinson D, Brook M, Auer DP, Bowtell R. Deuterium brain imaging at 7T during D 2 O dosing. Magn Reson Med 2023; 89:1514-1521. [PMID: 36426762 PMCID: PMC10099797 DOI: 10.1002/mrm.29539] [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: 09/27/2022] [Revised: 11/01/2022] [Accepted: 11/06/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To characterize the (2 H) deuterium MR signal measured from human brain at 7T in participants loading with D2 O to ˜1.5% enrichment over a six-week period. METHODS 2 H spectroscopy and imaging measurements were used to track the time-course of 2 H enrichment within the brain during the initial eight-hour loading period in two participants. Multi-echo gradient echo (MEGE) images were acquired at a range of TR values from four participants during the steady-state loading period and used for mapping 2 H T1 and T2 * relaxation times. Co-registration to higher resolution 1 H images allowed T1 and T2 * relaxation times of deuterium in HDO in cerebrospinal fluid (CSF), gray matter (GM), and white matter (WM) to be estimated. RESULTS 2 H concentrations measured during the eight-hour loading were consistent with values estimated from cumulative D2 O dose and body mass. Signal changes measured from three different regions of the brain during loading showed similar time-courses. After summing over echoes, gradient echo brain images acquired in 7.5 minutes with a voxel volume of 0.36 ml showed an SNR of ˜16 in subjects loaded to 1.5%. T1 -values for deuterium in HDO were significantly shorter than corresponding values for 1 H in H2 O, while T2 * values were similar. 2 H relaxation times in CSF were significantly longer than in GM or WM. CONCLUSION Deuterium MR Measurements at 7T were used to track the increase in concentration of 2 H in brain during heavy water loading. 2 H T1 and T2 * relaxation times from water in GM, WM, and CSF are reported.
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Affiliation(s)
- Daniel Cocking
- School of Physics and AstronomyUniversity of NottinghamNottinghamUK
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
| | - Robin A. Damion
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- Mental Health and Clinical Neuroscience, School of MedicineUniversity of NottinghamNottinghamUK
- NIHR Nottingham Biomedical Research Centre/Nottingham Clinical Research FacilitiesQueen's Medical CentreNottinghamUK
| | - Hester Franks
- Centre for Cancer Sciences Biodiscovery Institute, School of MedicineUniversity of NottinghamNottinghamUK
- Department of OncologyNottingham University Hospitals NHS TrustNottinghamUK
| | - Matthew Jaconelli
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of NottinghamNottinghamUK
- School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Daniel Wilkinson
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of NottinghamNottinghamUK
- Division of Medical Sciences and Graduate Entry MedicineSchool of Medicine, University of NottinghamNottinghamUK
| | - Matthew Brook
- NIHR Nottingham Biomedical Research Centre/Nottingham Clinical Research FacilitiesQueen's Medical CentreNottinghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of NottinghamNottinghamUK
- School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Dorothee P. Auer
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- Mental Health and Clinical Neuroscience, School of MedicineUniversity of NottinghamNottinghamUK
- NIHR Nottingham Biomedical Research Centre/Nottingham Clinical Research FacilitiesQueen's Medical CentreNottinghamUK
| | - Richard Bowtell
- School of Physics and AstronomyUniversity of NottinghamNottinghamUK
- Sir Peter Mansfield Imaging CentreUniversity of NottinghamNottinghamUK
- NIHR Nottingham Biomedical Research Centre/Nottingham Clinical Research FacilitiesQueen's Medical CentreNottinghamUK
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Gast LV, Baier LM, Chaudry O, Meixner CR, Müller M, Engelke K, Uder M, Heiss R, Nagel AM. Assessing muscle-specific potassium concentrations in human lower leg using potassium magnetic resonance imaging. NMR IN BIOMEDICINE 2023; 36:e4819. [PMID: 35994248 DOI: 10.1002/nbm.4819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
Noninvasively assessing tissue potassium concentrations (TPCs) using potassium magnetic resonance imaging (39 K MRI) could give valuable information on physiological processes connected to various pathologies. However, because of inherently low 39 K MR image resolution and strong signal blurring, a reliable measurement of the TPC is challenging. The aim of this work was to investigate the feasibility of a muscle-specific TPC determination with a focus on the influence of a varying residual quadrupolar interaction in human lower leg muscles. The quantification accuracy of a muscle-specific TPC determination was first assessed using simulated 39 K MRI data. In vivo 39 K and corresponding sodium (23 Na) MRI data of healthy lower leg muscles (n = 14, seven females) were acquired on a 7-T MR system using a double-resonant 23 Na/39 K birdcage Tx/Rx RF coil. Additional 1 H MR images were acquired on a 3-T MR system and used for tissue segmentation. Quantification of TPC was performed after a region-based partial volume correction (PVC) using five external reference phantoms. Simulations not only underlined the importance of PVC for correctly assessing muscle-specific TPC values, but also revealed the strong impact of a varying residual quadrupolar interaction between different muscle regions on the measured TPC. Using 39 K T2 * decay curves, we found significantly higher residual quadrupolar interaction in tibialis anterior muscle (TA; ωq = 194 ± 28 Hz) compared with gastrocnemius muscle (medial/lateral head, GM/GL; ωq = 151 ± 25 Hz) and soleus muscle (SOL; ωq = 102 ± 32 Hz). If considered in the PVC, TPC in individual muscles was similar (TPC = 98 ± 11/96 ± 14/99 ± 8/100 ± 12 mM in GM/GL/SOL/TA). Comparison with tissue sodium concentrations suggested that residual quadrupolar interactions might also influence the 23 Na MRI signal of lower leg muscles. A TPC determination of individual lower leg muscles is feasible and can therefore be applied in future studies. Considering a varying residual quadrupolar interaction for PVC of 39 K MRI data is essential to reliably assess potassium concentrations in individual muscles.
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Laura-Marie Baier
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Chaudry
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian R Meixner
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Max Müller
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Klaus Engelke
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rafael Heiss
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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