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Sahin S, Garnæs MF, Bennett A, Dwork N, Tang S, Liu X, Vaidya M, Wang ZJ, Larson PE. A pharmacokinetic model for hyperpolarized 13C-pyruvate MRI when using metabolite-specific bSSFP sequences. Magn Reson Med 2024; 92:1698-1713. [PMID: 38775035 PMCID: PMC11262974 DOI: 10.1002/mrm.30142] [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: 02/10/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Metabolite-specific balanced SSFP (MS-bSSFP) sequences are increasingly used in hyperpolarized [1-13C]Pyruvate (HP 13C) MRI studies as they improve SNR by refocusing the magnetization each TR. Currently, pharmacokinetic models used to fit conversion rate constants, kPL and kPB, and rate constant maps do not account for differences in the signal evolution of MS-bSSFP acquisitions. METHODS In this work, a flexible MS-bSSFP model was built that can be used to fit conversion rate constants for these experiments. The model was validated in vivo using paired animal (healthy rat kidneys n = 8, transgenic adenocarcinoma of the mouse prostate n = 3) and human renal cell carcinoma (n = 3) datasets. Gradient echo (GRE) acquisitions were used with a previous GRE model to compare to the results of the proposed GRE-bSSFP model. RESULTS Within simulations, the proposed GRE-bSSFP model fits the simulated data well, whereas a GRE model shows bias because of model mismatch. For the in vivo datasets, the estimated conversion rate constants using the proposed GRE-bSSFP model are consistent with a previous GRE model. Jointly fitting the lactate T2 with kPL resulted in less precise kPL estimates. CONCLUSION The proposed GRE-bSSFP model provides a method to estimate conversion rate constants, kPL and kPB, for MS-bSSFP HP 13C experiments. This model may also be modified and used for other applications, for example, estimating rate constants with other hyperpolarized reagents or multi-echo bSSFP.
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Affiliation(s)
- Sule Sahin
- UC Berkeley – UCSF Graduate Program in Bioengineering
- Radiology and Biomedical Imaging, University of California, San Francisco
| | | | - Anna Bennett
- Radiology and Biomedical Imaging, University of California, San Francisco
| | - Nicholas Dwork
- Biomedical Informatics and Radiology, University of Colorado Anschutz Medical Campus
| | | | - Xiaoxi Liu
- Radiology and Biomedical Imaging, University of California, San Francisco
| | - Manushka Vaidya
- Radiology and Biomedical Imaging, University of California, San Francisco
| | - Zhen Jane Wang
- Radiology and Biomedical Imaging, University of California, San Francisco
| | - Peder E.Z. Larson
- UC Berkeley – UCSF Graduate Program in Bioengineering
- Radiology and Biomedical Imaging, University of California, San Francisco
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Wang S, Wu R, Jia S, Diakite A, Li C, Liu Q, Zheng H, Ying L. Knowledge-driven deep learning for fast MR imaging: Undersampled MR image reconstruction from supervised to un-supervised learning. Magn Reson Med 2024; 92:496-518. [PMID: 38624162 DOI: 10.1002/mrm.30105] [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: 05/03/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
Deep learning (DL) has emerged as a leading approach in accelerating MRI. It employs deep neural networks to extract knowledge from available datasets and then applies the trained networks to reconstruct accurate images from limited measurements. Unlike natural image restoration problems, MRI involves physics-based imaging processes, unique data properties, and diverse imaging tasks. This domain knowledge needs to be integrated with data-driven approaches. Our review will introduce the significant challenges faced by such knowledge-driven DL approaches in the context of fast MRI along with several notable solutions, which include learning neural networks and addressing different imaging application scenarios. The traits and trends of these techniques have also been given which have shifted from supervised learning to semi-supervised learning, and finally, to unsupervised learning methods. In addition, MR vendors' choices of DL reconstruction have been provided along with some discussions on open questions and future directions, which are critical for the reliable imaging systems.
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Affiliation(s)
- Shanshan Wang
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ruoyou Wu
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Sen Jia
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Alou Diakite
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Cheng Li
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qiegen Liu
- Department of Electronic Information Engineering, Nanchang University, Nanchang, China
| | - Hairong Zheng
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Leslie Ying
- Department of Biomedical Engineering and Department of Electrical Engineering, The State University of New York, Buffalo, New York, USA
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3
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Gordon JW, Chen HY, Nickles T, Lee PM, Bok R, Ohliger MA, Okamoto K, Ko AH, Larson PEZ, Wang ZJ. Hyperpolarized 13C Metabolic MRI of Patients with Pancreatic Ductal Adenocarcinoma. J Magn Reson Imaging 2024; 60:741-749. [PMID: 38041836 PMCID: PMC11144260 DOI: 10.1002/jmri.29162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDA) is the third leading cause of cancer-related death in the United States. However, early response assessment using the current approach of measuring changes in tumor size on computed tomography (CT) or MRI is challenging. PURPOSE To investigate the feasibility of hyperpolarized (HP) [1-13C]pyruvate MRI to quantify metabolism in the normal appearing pancreas and PDA, and to assess changes in PDA metabolism following systemic chemotherapy. STUDY TYPE Prospective. SUBJECTS Six patients (65.0 ± 7.6 years, 2 females) with locally advanced or metastatic PDA enrolled prior to starting a new line of systemic chemotherapy. FIELD STRENGTH/SEQUENCE 3-T, T1-weighted gradient echo, metabolite-selective 13C echoplanar imaging. ASSESSMENT Time-resolved HP [1-13C]pyruvate data were acquired before (N = 6) and 4-weeks after (N = 3) treatment initiation. Pyruvate metabolism, as quantified by pharmacokinetic modeling and metabolite area-under-the-curve ratios, was assessed in manually segmented PDA and normal appearing pancreas ROIs (N = 5). The change in tumor metabolism before and 4-weeks after treatment initiation was assessed in primary PDA (N = 2) and liver metastases (N = 1), and was compared to objective tumor response defined by response evaluation criteria in solid tumors (RECIST) on subsequent CTs. STATISTICAL TESTS Descriptive tests (mean ± standard deviation), model fit error for pharmacokinetic rate constants. RESULTS Primary PDA showed reduced alanine-to-lactate ratios when compared to normal pancreas, due to increased lactate-to-pyruvate or reduced alanine-to-pyruvate ratios. Of the three patients who received HP [1-13C]pyruvate MRI before and 4-weeks after treatment initiation, one patient had a primary tumor with early metabolic response (increase in alanine-to-lactate) and subsequent partial response according to RECIST, one patient had a primary tumor with relatively stable metabolism and subsequent stable disease by RECIST, and one patient had metastatic PDA with increase in lactate-to-pyruvate of the liver metastases and corresponding progressive disease according to RECIST. DATA CONCLUSION Altered pyruvate metabolism with increased lactate or reduced alanine was observed in the primary tumor. Early metabolic response assessed at 4-weeks after treatment initiation correlated with subsequent objective tumor response assessed using RECIST. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Tanner Nickles
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Philip M Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Michael A Ohliger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Kimberly Okamoto
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Andrew H Ko
- Department of Medicine, University of California, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, San Francisco, California, USA
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Bøgh N, Bertelsen LB, Rasmussen CW, Bech SK, Keller AK, Madsen MG, Harving F, Thorsen TH, Mieritz IK, Hansen ES, Wanders A, Laustsen C. Metabolic MRI With Hyperpolarized 13 C-Pyruvate for Early Detection of Fibrogenic Kidney Metabolism. Invest Radiol 2024:00004424-990000000-00225. [PMID: 38913443 DOI: 10.1097/rli.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVES Fibrosis is the final common pathway for chronic kidney disease and the best predictor for disease progression. Besides invasive biopsies, biomarkers for its detection are lacking. To address this, we used hyperpolarized 13 C-pyruvate MRI to detect the metabolic changes associated with fibrogenic activity of myofibroblasts. MATERIALS AND METHODS Hyperpolarized 13 C-pyruvate MRI was performed in 2 pig models of kidney fibrosis (unilateral ureteral obstruction and ischemia-reperfusion injury). The imaging data were correlated with histology, biochemical, and genetic measures of metabolism and fibrosis. The porcine experiments were supplemented with cell-line experiments to inform the origins of metabolic changes in fibrogenesis. Lastly, healthy and fibrotic human kidneys were analyzed for the metabolic alterations accessible with hyperpolarized 13 C-pyruvate MRI. RESULTS In the 2 large animal models of kidney fibrosis, metabolic imaging revealed alterations in amino acid metabolism and glycolysis. Conversion from hyperpolarized 13 C-pyruvate to 13 C-alanine decreased, whereas conversion to 13 C-lactate increased. These changes were shown to reflect profibrotic activity in cultured epithelial cells, macrophages, and fibroblasts, which are important precursors of myofibroblasts. Importantly, metabolic MRI using hyperpolarized 13 C-pyruvate was able to detect these changes earlier than fibrosis-sensitive structural imaging. Lastly, we found that the same metabolic profile is present in fibrotic tissue from human kidneys. This affirms the translational potential of metabolic MRI as an early indicator of fibrogenesis associated metabolism. CONCLUSIONS Our findings demonstrate the promise of hyperpolarized 13 C-pyruvate MRI for noninvasive detection of fibrosis development, which could enable earlier diagnosis and intervention for patients at risk of kidney fibrosis.
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Affiliation(s)
- Nikolaj Bøgh
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (N.B., L.B.B., C.W.R., S.K.B., T.H.T., I.K.M., E.S.S.H., C.L.); Department of Urology, Aarhus University Hospital, Aarhus, Denmark (A.K.K., M.G.M.); and Department of Pathology, Aalborg University Hospital, Aalborg, Denmark (F.H., A.W.)
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5
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Larson PEZ, Bernard JML, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D. Current methods for hyperpolarized [1- 13C]pyruvate MRI human studies. Magn Reson Med 2024; 91:2204-2228. [PMID: 38441968 PMCID: PMC10997462 DOI: 10.1002/mrm.29875] [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: 05/13/2023] [Revised: 08/12/2023] [Accepted: 09/06/2023] [Indexed: 03/07/2024]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of HP agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate-by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation; (2) MRI system setup and calibrations; (3) data acquisition and image reconstruction; and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the "HP 13C MRI Consensus Group" as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods and Equipment study groups. It further aims to provide a comprehensive reference for future consensus, building as the field continues to advance human studies with this metabolic imaging modality.
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Affiliation(s)
- Peder EZ Larson
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
| | - Jenna ML Bernard
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - James A Bankson
- Department of Imaging Physics, MD Anderson Medical Center,
Houston, TX, USA
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | - Charles H Cunningham
- Physical Sciences, Sunnybrook Research Institute, Toronto,
Ontario, Canada
- Department of Medical Biophysics, University of Toronto,
Toronto, Ontario, Canada
| | - Jeremy Gordon
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North
Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University
Medical Center Schleswig-Holstein (UKSH), Kiel University, Am Botanischen Garten 14,
24118, Kiel, Germany
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
| | - Dirk Mayer
- Department of Diagnostic Radiology and Nuclear Medicine,
University of Maryland School of Medicine, Baltimore, MD, USA
- Greenebaum Cancer Center, University of Maryland School
of Medicine, Baltimore, MD, USA
| | - Mary A McLean
- Department of Radiology, University of Cambridge,
Cambridge, United Kingdom
- Cancer Research UK Cambridge Institute, University of
Cambridge, Li Ka Shing Center, Cambridge, United Kingdom
| | - Franz Schilling
- Department of Nuclear Medicine, School of Medicine,
Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich,
Germany
| | - James Slater
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
| | | | | | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, CA 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley, CA
94143, USA
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6
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Diaz E, Sriram R, Gordon JW, Sinha A, Liu X, Sahin S, Crane J, Olson MP, Chen HY, Bernard J, Vigneron DB, Wang ZJ, Xu D, Larson PEZ. Data Format Standardization and DICOM Integration for Hyperpolarized 13C MRI. ARXIV 2024:arXiv:2405.03147v1. [PMID: 38764595 PMCID: PMC11100919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Hyperpolarized (HP) 13C MRI has shown promise as a valuable modality for in vivo measurements of metabolism and is currently in human trials at 15 research sites worldwide. With this growth it is important to adopt standardized data storage practices as it will allow sites to meaningfully compare data. In this paper we (1) describe data that we believe should be stored and (2) demonstrate pipelines and methods that utilize the Digital Imaging and Communications in Medicine (DICOM) standard. This includes proposing a set of minimum set of information that is specific to HP 13C MRI studies. We then show where the majority of these can be fit into existing DICOM Attributes, primarily via the "Contrast/Bolus" module. We also demonstrate pipelines for utilizing DICOM for HP 13C MRI. DICOM is the most common standard for clinical medical image storage and provides the flexibility to accommodate the unique aspects of HP 13C MRI, including the HP agent information but also spectroscopic and metabolite dimensions. The pipelines shown include creating DICOM objects for studies on human and animal imaging systems with various pulse sequences. We also show a python-based method to efficiently modify DICOM objects to incorporate the unique HP 13C MRI information that is not captured by existing pipelines. Moreover, we propose best practices for HP 13C MRI data storage that will support future multi-site trials, research studies and technical developments of this imaging technique.
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Affiliation(s)
- Ernesto Diaz
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Avantika Sinha
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Sule Sahin
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Jason Crane
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Marram P Olson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Jenna Bernard
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
| | - Zhen Jane Wang
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
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7
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Diaz E, Sriram R, Gordon JW, Sinha A, Liu X, Sahin SI, Crane JC, Olson MP, Chen HY, Bernard JML, Vigneron DB, Wang ZJ, Xu D, Larson PEZ. Data Format Standardization and DICOM Integration for Hyperpolarized 13C MRI. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01100-2. [PMID: 38710970 DOI: 10.1007/s10278-024-01100-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 05/08/2024]
Abstract
Hyperpolarized (HP) 13C MRI has shown promise as a valuable modality for in vivo measurements of metabolism and is currently in human trials at 15 research sites worldwide. With this growth, it is important to adopt standardized data storage practices as it will allow sites to meaningfully compare data. In this paper, we (1) describe data that we believe should be stored and (2) demonstrate pipelines and methods that utilize the Digital Imaging and Communications in Medicine (DICOM) standard. This includes proposing a set of minimum set of information that is specific to HP 13C MRI studies. We then show where the majority of these can be fit into existing DICOM attributes, primarily via the "Contrast/Bolus" module. We also demonstrate pipelines for utilizing DICOM for HP 13C MRI. DICOM is the most common standard for clinical medical image storage and provides the flexibility to accommodate the unique aspects of HP 13C MRI, including the HP agent information but also spectroscopic and metabolite dimensions. The pipelines shown include creating DICOM objects for studies on human and animal imaging systems with various pulse sequences. We also show a python-based method to efficiently modify DICOM objects to incorporate the unique HP 13C MRI information that is not captured by existing pipelines. Moreover, we propose best practices for HP 13C MRI data storage that will support future multi-site trials, research studies, and technical developments of this imaging technique.
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Affiliation(s)
- Ernesto Diaz
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Renuka Sriram
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Avantika Sinha
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Sule I Sahin
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
- UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley and San Francisco, CA, USA
| | - Jason C Crane
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Marram P Olson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Jenna M L Bernard
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
- UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley and San Francisco, CA, USA
| | - Zhen Jane Wang
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
- UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley and San Francisco, CA, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA.
- UC Berkeley/UCSF Graduate Program in Bioengineering, Berkeley and San Francisco, CA, USA.
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8
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Autry AW, Vaziri S, Gordon JW, Chen HY, Kim Y, Dang D, LaFontaine M, Noeske R, Bok R, Villanueva-Meyer JE, Clarke JL, Oberheim Bush NA, Chang SM, Xu D, Lupo JM, Larson PEZ, Vigneron DB, Li Y. Advanced Hyperpolarized 13C Metabolic Imaging Protocol for Patients with Gliomas: A Comprehensive Multimodal MRI Approach. Cancers (Basel) 2024; 16:354. [PMID: 38254844 PMCID: PMC10814348 DOI: 10.3390/cancers16020354] [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: 09/27/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
This study aimed to implement a multimodal 1H/HP-13C imaging protocol to augment the serial monitoring of patients with glioma, while simultaneously pursuing methods for improving the robustness of HP-13C metabolic data. A total of 100 1H/HP [1-13C]-pyruvate MR examinations (104 HP-13C datasets) were acquired from 42 patients according to the comprehensive multimodal glioma imaging protocol. Serial data coverage, accuracy of frequency reference, and acquisition delay were evaluated using a mixed-effects model to account for multiple exams per patient. Serial atlas-based HP-13C MRI demonstrated consistency in volumetric coverage measured by inter-exam dice coefficients (0.977 ± 0.008, mean ± SD; four patients/11 exams). The atlas-derived prescription provided significantly improved data quality compared to manually prescribed acquisitions (n = 26/78; p = 0.04). The water-based method for referencing [1-13C]-pyruvate center frequency significantly reduced off-resonance excitation relative to the coil-embedded [13C]-urea phantom (4.1 ± 3.7 Hz vs. 9.9 ± 10.7 Hz; p = 0.0007). Significantly improved capture of tracer inflow was achieved with the 2-s versus 5-s HP-13C MRI acquisition delay (p = 0.007). This study demonstrated the implementation of a comprehensive multimodal 1H/HP-13C MR protocol emphasizing the monitoring of steady-state/dynamic metabolism in patients with glioma.
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Affiliation(s)
- Adam W. Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Sana Vaziri
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Duy Dang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Marisa LaFontaine
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | | | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Javier E. Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jennifer L. Clarke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Susan M. Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Janine M. Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
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Wodtke P, Grashei M, Schilling F. Quo Vadis Hyperpolarized 13C MRI? Z Med Phys 2023:S0939-3889(23)00120-4. [PMID: 38160135 DOI: 10.1016/j.zemedi.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 01/03/2024]
Abstract
Over the last two decades, hyperpolarized 13C MRI has gained significance in both preclinical and clinical studies, hereby relying on technologies like PHIP-SAH (ParaHydrogen-Induced Polarization-Side Arm Hydrogenation), SABRE (Signal Amplification by Reversible Exchange), and dDNP (dissolution Dynamic Nuclear Polarization), with dDNP being applied in humans. A clinical dDNP polarizer has enabled studies across 24 sites, despite challenges like high cost and slow polarization. Parahydrogen-based techniques like SABRE and PHIP offer faster, more cost-efficient alternatives but require molecule-specific optimization. The focus has been on imaging metabolism of hyperpolarized probes, which requires long T1, high polarization and rapid contrast generation. Efforts to establish novel probes, improve acquisition techniques and enhance data analysis methods including artificial intelligence are ongoing. Potential clinical value of hyperpolarized 13C MRI was demonstrated primarily for treatment response assessment in oncology, but also in cardiology, nephrology, hepatology and CNS characterization. In this review on biomedical hyperpolarized 13C MRI, we summarize important and recent advances in polarization techniques, probe development, acquisition and analysis methods as well as clinical trials. Starting from those we try to sketch a trajectory where the field of biomedical hyperpolarized 13C MRI might go.
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Affiliation(s)
- Pascal Wodtke
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge UK
| | - Martin Grashei
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany
| | - Franz Schilling
- Department of Nuclear Medicine, TUM School of Medicine and Health, Klinikum rechts der Isar of Technical University of Munich, 81675 Munich, Germany; Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany; German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany.
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10
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Larson PEZ, Tang S, Liu X, Sinha A, Dwork N, Sivalokanathan S, Liu J, Bok R, Ordovas KG, Slater J, Gordon JW, Abraham MR. Regional quantification of cardiac metabolism with hyperpolarized [1- 13C]-pyruvate CMR evaluated in an oral glucose challenge. J Cardiovasc Magn Reson 2023; 25:77. [PMID: 38093285 PMCID: PMC10720165 DOI: 10.1186/s12968-023-00972-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The heart has metabolic flexibility, which is influenced by fed/fasting states, and pathologies such as myocardial ischemia and hypertrophic cardiomyopathy (HCM). Hyperpolarized (HP) 13C-pyruvate MRI is a promising new tool for non-invasive quantification of myocardial glycolytic and Krebs cycle flux. However, human studies of HP 13C-MRI have yet to demonstrate regional quantification of metabolism, which is important in regional ischemia and HCM patients with asymmetric septal/apical hypertrophy. METHODS We developed and applied methods for whole-heart imaging of 13C-pyruvate, 13C-lactate and 13C-bicarbonate, following intravenous administration of [1-13C]-pyruvate. The image acquisition used an autonomous scanning method including bolus tracking, real-time magnetic field calibrations and metabolite-specific imaging. For quantification of metabolism, we evaluated 13C metabolite images, ratio metrics, and pharmacokinetic modeling to provide measurements of myocardial lactate dehydrogenase (LDH) and pyruvate dehydrogenase (PDH) mediated metabolic conversion in 5 healthy volunteers (fasting & 30 min following oral glucose load). RESULTS We demonstrate whole heart coverage for dynamic measurement of pyruvate-to-lactate conversion via LDH and pyruvate-to-bicarbonate conversion via PDH at a resolution of 6 × 6 × 21 mm3 (13C-pyruvate) and 12 × 12 × 21 mm3 (13C-lactate, 13C-bicarbonate). 13C-pyruvate and 13C-lactate were detected simultaneously in the RV blood pool, immediately after intravenous injection, reflecting LDH activity in blood. In healthy volunteers, myocardial 13C-pyruvate-SNR, 13C-lactate-SNR, 13C-bicarbonate-SNR, 13C-lactate/pyruvate ratio, 13C-pyruvate-to-lactate conversion rate, kPL, and 13C-pyruvate-to-bicarbonate conversion rate, kPB, all had statistically significant increases following oral glucose challenge. kPB, reflecting PDH activity and pyruvate entering the Krebs Cycle, had the highest correlation with blood glucose levels and was statistically significant. CONCLUSIONS We demonstrate first-in-human regional quantifications of cardiac metabolism by HP 13C-pyruvate MRI that aims to reflect LDH and PDH activity.
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Affiliation(s)
- Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA.
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, CA, USA.
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, CA, USA
- Vista.ai, Palo Alto, CA, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - Avantika Sinha
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - Nicholas Dwork
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
- Departments of Bioinformatics and Radiology, University of Colorado School of Medicine, Denver, CO, USA
| | - Sanjay Sivalokanathan
- Division of Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - Karen G Ordovas
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - James Slater
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of CA-San Francisco, 1700 4th Street, Byers Hall Room 102C, San Francisco, CA, 94143, USA
| | - M Roselle Abraham
- Cardiology Division, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
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11
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Hu JY, Vaziri S, Bøgh N, Kim Y, Autry AW, Bok RA, Li Y, Laustsen C, Xu D, Larson PEZ, Chang S, Vigneron DB, Gordon JW. Investigating cerebral perfusion with high resolution hyperpolarized [1- 13 C]pyruvate MRI. Magn Reson Med 2023; 90:2233-2241. [PMID: 37665726 PMCID: PMC10543485 DOI: 10.1002/mrm.29844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate high-resolution hyperpolarized (HP) 13 C pyruvate MRI for measuring cerebral perfusion in the human brain. METHODS HP [1-13 C]pyruvate MRI was acquired in five healthy volunteers with a multi-resolution EPI sequence with 7.5 × 7.5 mm2 resolution for pyruvate. Perfusion parameters were calculated from pyruvate MRI using block-circulant singular value decomposition and compared to relative cerebral blood flow calculated from arterial spin labeling (ASL). To examine regional perfusion patterns, correlations between pyruvate and ASL perfusion were performed for whole brain, gray matter, and white matter voxels. RESULTS High resolution 7.5 × 7.5 mm2 pyruvate images were used to obtain relative cerebral blood flow (rCBF) values that were significantly positively correlated with ASL rCBF values (r = 0.48, 0.20, 0.28 for whole brain, gray matter, and white matter voxels respectively). Whole brain voxels exhibited the highest correlation between pyruvate and ASL perfusion, and there were distinct regional patterns of relatively high ASL and low pyruvate normalized rCBF found across subjects. CONCLUSION Acquiring HP 13 C pyruvate metabolic images at higher resolution allows for finer spatial delineation of brain structures and can be used to obtain cerebral perfusion parameters. Pyruvate perfusion parameters were positively correlated to proton ASL perfusion values, indicating a relationship between the two perfusion measures. This HP 13 C study demonstrated that hyperpolarized pyruvate MRI can assess cerebral metabolism and perfusion within the same study.
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Affiliation(s)
- Jasmine Y. Hu
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Sana Vaziri
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Nikolaj Bøgh
- MR Research Center, Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Adam W. Autry
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Christoffer Laustsen
- MR Research Center, Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Susan Chang
- Department of Neurological Surgery, University of
California San Francisco, San Francisco, California, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering,
University of California, San Francisco and University of California, Berkeley,
California, USA
| | - Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University
of California San Francisco, San Francisco, California, USA
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12
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Larson PE, Bernard JM, Bankson JA, Bøgh N, Bok RA, Chen AP, Cunningham CH, Gordon J, Hövener JB, Laustsen C, Mayer D, McLean MA, Schilling F, Slater J, Vanderheyden JL, von Morze C, Vigneron DB, Xu D, Group THCMC. Current Methods for Hyperpolarized [1-13C]pyruvate MRI Human Studies. ARXIV 2023:arXiv:2309.04040v2. [PMID: 37731660 PMCID: PMC10508833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
MRI with hyperpolarized (HP) 13C agents, also known as HP 13C MRI, can measure processes such as localized metabolism that is altered in numerous cancers, liver, heart, kidney diseases, and more. It has been translated into human studies during the past 10 years, with recent rapid growth in studies largely based on increasing availability of hyperpolarized agent preparation methods suitable for use in humans. This paper aims to capture the current successful practices for HP MRI human studies with [1-13C]pyruvate - by far the most commonly used agent, which sits at a key metabolic junction in glycolysis. The paper is divided into four major topic areas: (1) HP 13C-pyruvate preparation, (2) MRI system setup and calibrations, (3) data acquisition and image reconstruction, and (4) data analysis and quantification. In each area, we identified the key components for a successful study, summarized both published studies and current practices, and discuss evidence gaps, strengths, and limitations. This paper is the output of the HP 13C MRI Consensus Group as well as the ISMRM Hyperpolarized Media MR and Hyperpolarized Methods & Equipment study groups. It further aims to provide a comprehensive reference for future consensus building as the field continues to advance human studies with this metabolic imaging modality.
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13
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Larson PEZ, Tang S, Liu X, Sinha A, Dwork N, Sivalokanathan S, Liu J, Bok R, Ordovas KG, Slater J, Gordon JW, Abraham MR. Regional quantification of cardiac metabolism with hyperpolarized [1- 13C]-pyruvate MRI evaluated in an oral glucose challenge. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.16.23297052. [PMID: 37904936 PMCID: PMC10615005 DOI: 10.1101/2023.10.16.23297052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Background The heart has metabolic flexibility, which is influenced by fed/fasting states, and pathologies such as myocardial ischemia and hypertrophic cardiomyopathy (HCM). Hyperpolarized (HP) 13C-pyruvate MRI is a promising new tool for non-invasive quantification of myocardial glycolytic and Krebs cycle flux. However, human studies of HP 13C-MRI have yet to demonstrate regional quantification of metabolism, which is important in regional ischemia and HCM patients with asymmetric septal/apical hypertrophy. Methods We developed and applied methods for whole-heart imaging of 13C-pyruvate, 13C-lactate and 13C-bicarbonate, following intravenous administration of [1-13C]-pyruvate. The image acquisition used an autonomous scanning method including bolus tracking, real-time magnetic field calibrations and metabolite-specific imaging. For quantification of metabolism, we evaluated 13C metabolite images, ratio metrics, and pharmacokinetic modeling to provide measurements of myocardial lactate dehydrogenase (LDH) and pyruvate dehydrogenase (PDH) mediated metabolic conversion in 5 healthy volunteers (fasting & 30 min following oral glucose load). Results We demonstrate whole heart coverage for dynamic measurement of pyruvate-to-lactate conversion via LDH and pyruvate-to-bicarbonate conversion via PDH at a resolution of 6×6×21 mm3 (13C-pyruvate) and 12×12×21 mm3 (13C-lactate, 13C-bicarbonate) . 13C-pyruvate and 13C-lactate were detected simultaneously in the RV blood pool, immediately after intravenous injection, reflecting LDH activity in blood. In healthy volunteers, myocardial 13C-pyruvate-SNR, 13C-lactate-SNR, 13C-bicarbonate-SNR, 13C-lactate/pyruvate ratio, 13C-pyruvate-to-lactate conversion rate, kPL, and 13C-pyruvate-to-bicarbonate conversion rate, kPB, all had statistically significant increases following oral glucose challenge. kPB, reflecting PDH activity and pyruvate entering the Krebs Cycle, had the highest correlation with blood glucose levels and was statistically significant. Conclusions We demonstrate first-in-human regional quantifications of cardiac metabolism by HP 13C-pyruvate MRI that aims to reflect LDH and PDH activity.
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Affiliation(s)
- Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Vista.ai, Palo Alto, CA, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Avantika Sinha
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Nicholas Dwork
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
- Departments of Bioinformatics and Radiology, University of Colorado School of Medicine, Denver, CO, USA
| | - Sanjay Sivalokanathan
- Department of Medicine - Division of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Karen G Ordovas
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - James Slater
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, California, USA
| | - M Roselle Abraham
- Department of Medicine - Cardiology Division, University of California - San Francisco, San Francisco, California, USA
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14
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Chung BT, Kim Y, Gordon JW, Chen HY, Autry AW, Lee PM, Hu JY, Tan CT, Suszczynski C, Chang SM, Villanueva-Meyer JE, Bok RA, Larson PEZ, Xu D, Li Y, Vigneron DB. Hyperpolarized [2- 13C]pyruvate MR molecular imaging with whole brain coverage. Neuroimage 2023; 280:120350. [PMID: 37634883 PMCID: PMC10530049 DOI: 10.1016/j.neuroimage.2023.120350] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/20/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023] Open
Abstract
Hyperpolarized (HP) 13C Magnetic Resonance Imaging (MRI) was applied for the first time to image and quantify the uptake and metabolism of [2-13C]pyruvate in the human brain to provide new metabolic information on cerebral energy metabolism. HP [2-13C]pyruvate was injected intravenously and imaged in 5 healthy human volunteer exams with whole brain coverage in a 1-minute acquisition using a specialized spectral-spatial multi-slice echoplanar imaging (EPI) pulse sequence to acquire 13C-labeled volumetric and dynamic images of [2-13C]pyruvate and downstream metabolites [5-13C]glutamate and [2-13C]lactate. Metabolic ratios and apparent conversion rates of pyruvate-to-lactate (kPL) and pyruvate-to-glutamate (kPG) were quantified to investigate simultaneously glycolytic and oxidative metabolism in a single injection.
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Affiliation(s)
- Brian T Chung
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA.
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Philip M Lee
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA
| | - Jasmine Y Hu
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA
| | - Chou T Tan
- ISOTEC Stable Isotope Division, MilliporeSigma, Merck KGaA, Miamisburg, OH 45342, USA
| | - Chris Suszczynski
- ISOTEC Stable Isotope Division, MilliporeSigma, Merck KGaA, Miamisburg, OH 45342, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, CA 94158, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, 1700 Fourth Street, Byers Hall Suite 102, San Francisco, CA 94158, USA; UCSF - UC Berkeley Graduate Program in Bioengineering, University of California, USA; Department of Neurological Surgery, University of California, San Francisco, CA 94158, USA
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15
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Autry AW, Vaziri S, LaFontaine M, Gordon JW, Chen HY, Kim Y, Villanueva-Meyer JE, Molinaro A, Clarke JL, Oberheim Bush NA, Xu D, Lupo JM, Larson PEZ, Vigneron DB, Chang SM, Li Y. Multi-parametric hyperpolarized 13C/ 1H imaging reveals Warburg-related metabolic dysfunction and associated regional heterogeneity in high-grade human gliomas. Neuroimage Clin 2023; 39:103501. [PMID: 37611371 PMCID: PMC10470324 DOI: 10.1016/j.nicl.2023.103501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/29/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Dynamic hyperpolarized (HP)-13C MRI has enabled real-time, non-invasive assessment of Warburg-related metabolic dysregulation in glioma using a [1-13C]pyruvate tracer that undergoes conversion to [1-13C]lactate and [13C]bicarbonate. Using a multi-parametric 1H/HP-13C imaging approach, we investigated dynamic and steady-state metabolism, together with physiological parameters, in high-grade gliomas to characterize active tumor. METHODS Multi-parametric 1H/HP-13C MRI data were acquired from fifteen patients with progressive/treatment-naïve glioblastoma [prog/TN GBM, IDH-wildtype (n = 11)], progressive astrocytoma, IDH-mutant, grade 4 (G4AIDH+, n = 2) and GBM manifesting treatment effects (n = 2). Voxel-wise regional analysis of the cohort with prog/TN GBM assessed imaging heterogeneity across contrast-enhancing/non-enhancing lesions (CEL/NEL) and normal-appearing white matter (NAWM) using a mixed effects model. To enable cross-nucleus parameter association, normalized perfusion, diffusion, and dynamic/steady-state (HP-13C/spectroscopic) metabolic data were collectively examined at the 13C resolution. Prog/TN GBM were similarly compared against progressive G4AIDH+ and treatment effects. RESULTS Regional analysis of Prog/TN GBM metabolism revealed statistically significant heterogeneity in 1H choline-to-N-acetylaspartate index (CNI)max, [1-13C]lactate, modified [1-13C]lactate-to-[1-13C]pyruvate ratio (CELval > NELval > NAWMval); [1-13C]lactate-to-[13C]bicarbonate ratio (CELval > NELval/NAWMval); and 1H-lactate (CELval/NELval > NAWMundetected). Significant associations were found between normalized perfusion (cerebral blood volume, nCBV; peak height, nPH) and levels of [1-13C]pyruvate and [1-13C]lactate, as well as between CNImax and levels of [1-13C]pyruvate, [1-13C]lactate and modified ratio. GBM, by comparison to G4AIDH+, displayed lower perfusion %-recovery and modeled rate constants for [1-13C]pyruvate-to-[1-13C]lactate conversion (kPL), and higher 1H-lactate and [1-13C]pyruvate levels, while having higher nCBV, %-recovery, kPL, [1-13C]pyruvate-to-[1-13C]lactate and modified ratios relative to treatment effects. CONCLUSIONS GBM consistently displayed aberrant, Warburg-related metabolism and regional heterogeneity detectable by novel HP-13C/1H imaging techniques.
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Affiliation(s)
- Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Sana Vaziri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Marisa LaFontaine
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA; Department of Neurological Surgery, University of California, San Francisco, USA
| | - Annette Molinaro
- Department of Neurological Surgery, University of California, San Francisco, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Jennifer L Clarke
- Department of Neurological Surgery, University of California, San Francisco, USA; Department of Neurology, University of California, San Francisco, USA
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California, San Francisco, USA; Department of Neurology, University of California, San Francisco, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA; Department of Bioengineering and Therapeutic Science, University of California, San Francisco, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
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16
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Liu X, Tang S, Cui D, Bok RA, Chen HY, Gordon JW, Wang ZJ, Larson PEZ. A metabolite specific 3D stack-of-spirals bSSFP sequence for improved bicarbonate imaging in hyperpolarized [1- 13C]Pyruvate MRI. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 353:107518. [PMID: 37402333 PMCID: PMC10498937 DOI: 10.1016/j.jmr.2023.107518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023]
Abstract
13C-bicarbonate is a crucial measure of pyruvate oxidation and TCA cycle flux, but is challenging to measure due to its relatively low concentration and thus will greatly benefit from improved signal-to-noise ratio (SNR). To address this, we developed and investigated the feasibility of a 3D stack-of-spirals metabolite-specific balanced steady-state free precession (MS-bSSFP) sequence for improving the SNR and spatial resolution of dynamic 13C-bicarbonate imaging in hyperpolarized [1-13C]pyruvate studies. The bicarbonate MS-bSSFP sequence was evaluated by simulations, phantoms studies, preclinical studies on five rats, brain studies on two healthy volunteers and renal study on one renal cell carcinoma patient. The simulations and phantom results showed that the bicarbonate-specific pulse had minimal perturbation of other metabolites (<1%). In the animal studies, the MS-bSSFP sequence provided an approximately 2.6-3 × improvement in 13C-bicarbonate SNR compared to a metabolite-specific gradient echo (MS-GRE) sequence without altering the bicarbonate or pyruvate kinetics, and the shorter spiral readout in the MS-bSSFP approach reduced blurring. Using the SNR ratio between MS-bSSFP and MS-GRE, the T2 values of bicarbonate and lactate in the rat kidneys were estimated as 0.5 s and 1.1 s, respectively. The in-vivo feasibility of bicarbonate MS-bSSFP sequence was demonstrated in two human brain studies and one renal study. These studies demonstrate the potential of the sequence for in-vivo applications, laying the foundation for future studies to observe this relatively low concentration metabolite with high-quality images and improve measurements of pyruvate oxidation.
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Affiliation(s)
- Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Di Cui
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, San Francisco, CA, USA.
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17
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Lee PM, Chen HY, Gordon JW, Wang ZJ, Bok R, Hashoian R, Kim Y, Liu X, Nickles T, Cheung K, De Las Alas F, Daniel H, Larson PEZ, von Morze C, Vigneron DB, Ohliger MA. Whole-Abdomen Metabolic Imaging of Healthy Volunteers Using Hyperpolarized [1- 13 C]pyruvate MRI. J Magn Reson Imaging 2022; 56:1792-1806. [PMID: 35420227 PMCID: PMC9562149 DOI: 10.1002/jmri.28196] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Hyperpolarized 13 C MRI quantitatively measures enzyme-catalyzed metabolism in cancer and metabolic diseases. Whole-abdomen imaging will permit dynamic metabolic imaging of several abdominal organs simultaneously in healthy and diseased subjects. PURPOSE Image hyperpolarized [1-13 C]pyruvate and products in the abdomens of healthy volunteers, overcoming challenges of motion, magnetic field variations, and spatial coverage. Compare hyperpolarized [1-13 C]pyruvate metabolism across abdominal organs of healthy volunteers. STUDY TYPE Prospective technical development. SUBJECTS A total of 13 healthy volunteers (8 male), 21-64 years (median 36). FIELD STRENGTH/SEQUENCE A 3 T. Proton: T1 -weighted spoiled gradient echo, T2 -weighted single-shot fast spin echo, multiecho fat/water imaging. Carbon-13: echo-planar spectroscopic imaging, metabolite-specific echo-planar imaging. ASSESSMENT Transmit magnetic field was measured. Variations in main magnetic field (ΔB0 ) determined using multiecho proton acquisitions were compared to carbon-13 acquisitions. Changes in ΔB0 were measured after localized shimming. Improvements in metabolite signal-to-noise ratio were calculated. Whole-organ regions of interests were drawn over the liver, spleen, pancreas, and kidneys by a single investigator. Metabolite signals, time-to-peak, decay times, and mean first-order rate constants for pyruvate-to-lactate (kPL ) and alanine (kPA ) conversion were measured in each organ. STATISTICAL TESTS Linear regression, one-sample Kolmogorov-Smirnov tests, paired t-tests, one-way ANOVA, Tukey's multiple comparisons tests. P ≤ 0.05 considered statistically significant. RESULTS Proton ΔB0 maps correlated with carbon-13 ΔB0 maps (slope = 0.93, y-intercept = -2.88, R2 = 0.73). Localized shimming resulted in mean frequency offset within ±25 Hz for all organs. Metabolite SNR significantly increased after denoising. Mean kPL and kPA were highest in liver, followed by pancreas, spleen, and kidneys (all comparisons with liver were significant). DATA CONCLUSION Whole-abdomen coverage with hyperpolarized carbon-13 MRI was feasible despite technical challenges. Multiecho gradient echo 1 H acquisitions accurately predicted chemical shifts observed using carbon-13 spectroscopy. Carbon-13 acquisitions benefited from local shimming. Metabolite energetics in the abdomen compiled for healthy volunteers can be used to design larger clinical trials in patients with metabolic diseases. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Philip M Lee
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Zhen J Wang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | | | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Xiaoxi Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Tanner Nickles
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Kiersten Cheung
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Francesca De Las Alas
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Heather Daniel
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Peder EZ Larson
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Cornelius von Morze
- Mallinckrodt Institute of Radiology, Washington University in St. Louis; St. Louis, Missouri, USA
| | - Daniel B Vigneron
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
| | - Michael A Ohliger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco; San Francisco, California, USA
- Department of Radiology, Zuckerberg San Francisco General Hospital and Trauma Center; San Francisco, California, USA
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18
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Hu JY, Kim Y, Autry AW, Frost MM, Bok RA, Villanueva-Meyer JE, Xu D, Li Y, Larson PEZ, Vigneron DB, Gordon JW. Kinetic analysis of multi-resolution hyperpolarized 13 C human brain MRI to study cerebral metabolism. Magn Reson Med 2022; 88:2190-2197. [PMID: 35754148 PMCID: PMC9420752 DOI: 10.1002/mrm.29354] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE To investigate multi-resolution hyperpolarized (HP) 13 C pyruvate MRI for measuring kinetic conversion rates in the human brain. METHODS HP [1-13 C]pyruvate MRI was acquired in 6 subjects with a multi-resolution EPI sequence at 7.5 × 7.5 mm2 resolution for pyruvate and 15 × 15 mm2 resolution for lactate and bicarbonate. With the same lactate data, 2 quantitative maps of pyruvate-to-lactate conversion (kPL ) maps were generated: 1 using 7.5 × 7.5 mm2 resolution pyruvate data and the other using synthetic 15 × 15 mm2 resolution pyruvate data to simulate a standard constant resolution acquisition. To examine local kPL values, 4 voxels were manually selected in each study representing brain tissue near arteries, brain tissue near veins, white matter, and gray matter. RESULTS High resolution 7.5 × 7.5 mm2 pyruvate images increased the spatial delineation of brain structures and decreased partial volume effects compared to coarser resolution 15 × 15 mm2 pyruvate images. Voxels near arteries, veins and in white matter exhibited higher calculated kPL for multi-resolution images. CONCLUSION Acquiring HP 13 C pyruvate metabolic data with a multi-resolution approach minimized partial volume effects from vascular pyruvate signals while maintaining the SNR of downstream metabolites. Higher resolution pyruvate images for kinetic fitting resulted in increased kinetic rate values, particularly around the superior sagittal sinus and cerebral arteries, by reducing extracellular pyruvate signal contributions from adjacent blood vessels. This HP 13 C study showed that acquiring pyruvate with finer resolution improved the quantification of kinetic rates throughout the human brain.
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Affiliation(s)
- Jasmine Y Hu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Mary M Frost
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Robert A Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
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19
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Vaziri S, Autry AW, Lafontaine M, Kim Y, Gordon JW, Chen HY, Hu JY, Lupo JM, Chang SM, Clarke JL, Villanueva-Meyer JE, Bush NAO, Xu D, Larson PEZ, Vigneron DB, Li Y. Assessment of higher-order singular value decomposition denoising methods on dynamic hyperpolarized [1- 13C]pyruvate MRI data from patients with glioma. Neuroimage Clin 2022; 36:103155. [PMID: 36007439 PMCID: PMC9421383 DOI: 10.1016/j.nicl.2022.103155] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Real-time metabolic conversion of intravenously-injected hyperpolarized [1-13C]pyruvate to [1-13C]lactate and [13C]bicarbonate in the brain can be measured using dynamic hyperpolarized carbon-13 (HP-13C) MRI. However, voxel-wise evaluation of metabolism in patients with glioma is challenged by the limited signal-to-noise ratio (SNR) of downstream 13C metabolites, especially within lesions. The purpose of this study was to evaluate the ability of higher-order singular value decomposition (HOSVD) denoising methods to enhance dynamic HP [1-13C]pyruvate MRI data acquired from patients with glioma. METHODS Dynamic HP-13C MRI were acquired from 14 patients with glioma. The effects of two HOSVD denoising techniques, tensor rank truncation-image enhancement (TRI) and global-local HOSVD (GL-HOSVD), on the SNR and kinetic modeling were analyzed in [1-13C]lactate data with simulated noise that matched the levels of [13C]bicarbonate signals. Both methods were then evaluated in patient data based on their ability to improve [1-13C]pyruvate, [1-13C]lactate and [13C]bicarbonate SNR. The effects of denoising on voxel-wise kinetic modeling of kPL and kPB was also evaluated. The number of voxels with reliable kinetic modeling of pyruvate-to-lactate (kPL) and pyruvate-to-bicarbonate (kPB) conversion rates within regions of interest (ROIs) before and after denoising was then compared. RESULTS Both denoising methods improved metabolite SNR and regional signal coverage. In patient data, the average increase in peak dynamic metabolite SNR was 2-fold using TRI and 4-5 folds using GL-HOSVD denoising compared to acquired data. Denoising reduced kPL modeling errors from a native average of 23% to 16% (TRI) and 15% (GL-HOSVD); and kPB error from 42% to 34% (TRI) and 37% (GL-HOSVD) (values were averaged voxelwise over all datasets). In contrast-enhancing lesions, the average number of voxels demonstrating within-tolerance kPL modeling error relative to the total voxels increased from 48% in the original data to 84% (TRI) and 90% (GL-HOSVD), while the number of voxels showing within-tolerance kPB modeling error increased from 0% to 15% (TRI) and 8% (GL-HOSVD). CONCLUSION Post-processing denoising methods significantly improved the SNR of dynamic HP-13C imaging data, resulting in a greater number of voxels satisfying minimum SNR criteria and maximum kinetic modeling errors in tumor lesions. This enhancement can aid in the voxel-wise analysis of HP-13C data and thereby improve monitoring of metabolic changes in patients with glioma following treatment.
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Affiliation(s)
- Sana Vaziri
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Marisa Lafontaine
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Jasmine Y Hu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Susan M Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Jennifer L Clarke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States.
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20
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Joergensen SH, Hansen ESS, Bøgh N, Bertelsen LB, Staehr PB, Schulte RF, Malloy C, Wiggers H, Laustsen C. Detection of increased pyruvate dehydrogenase flux in the human heart during adenosine stress test using hyperpolarized [1- 13C]pyruvate cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2022; 24:34. [PMID: 35658896 PMCID: PMC9169396 DOI: 10.1186/s12968-022-00860-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hyperpolarized (HP) [1-13C]pyruvate cardiovascular magnetic resonance (CMR) imaging can visualize the uptake and intracellular conversion of [1-13C]pyruvate to either [1-13C]lactate or 13C-bicarbonate depending on the prevailing metabolic state. The aim of the present study was to combine an adenosine stress test with HP [1-13C]pyruvate CMR to detect cardiac metabolism in the healthy human heart at rest and during moderate stress. METHODS A prospective descriptive study was performed between October 2019 and August 2020. Healthy human subjects underwent cine CMR and HP [1-13C]pyruvate CMR at rest and during adenosine stress. HP [1-13C]pyruvate CMR images were acquired at the mid-left-ventricle (LV) level. Semi-quantitative assessment of first-pass myocardial [1-13C]pyruvate perfusion and metabolism were assessed. Paired t-tests were used to compare mean values at rest and during stress. RESULTS Six healthy subjects (two female), age 29 ± 7 years were studied and no adverse reactions occurred. Myocardial [1-13C]pyruvate perfusion was significantly increased during stress with a reduction in time-to-peak from 6.2 ± 2.8 to 2.7 ± 1.3 s, p = 0.02. This higher perfusion was accompanied by an overall increased myocardial uptake and metabolism. The conversion rate constant (kPL) for lactate increased from 11 ± 9 *10-3 to 20 ± 10 * 10-3 s-1, p = 0.04. The pyruvate oxidation rate (kPB) increased from 4 ± 4 *10-3 to 12 ± 7 *10-3 s-1, p = 0.008. This increase in carbohydrate metabolism was positively correlated with heart rate (R2 = 0.44, p = 0.02). CONCLUSIONS Adenosine stress testing combined with HP [1-13C]pyruvate CMR is feasible and well-tolerated in healthy subjects. We observed an increased pyruvate oxidation during cardiac stress. The present study is an important step in the translation of HP [1-13C]pyruvate CMR into clinical cardiac imaging. Trial registration EUDRACT, 2018-003533-15. Registered 4th of December 2018, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-003533-15.
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Affiliation(s)
- Steen Hylgaard Joergensen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Department of Clinical Medicine, Department of Cardiology, Aarhus University Hospital, Hjoerring, Denmark.
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark.
| | - Esben Soevsoe S Hansen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Nikolaj Bøgh
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Lotte Bonde Bertelsen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Peter Bisgaard Staehr
- Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800, Hjoerring, Denmark
| | | | - Craig Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, USA
| | - Henrik Wiggers
- Department of Clinical Medicine, Department of Cardiology, Aarhus University Hospital, Hjoerring, Denmark
| | - Christoffer Laustsen
- Department of Clinical Medicine, Aarhus University Hospital, The MR-Research Centre, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark
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21
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Ye Z, Song B, Lee PM, Ohliger MA, Laustsen C. Hyperpolarized carbon 13 MRI in liver diseases: Recent advances and future opportunities. Liver Int 2022; 42:973-983. [PMID: 35230742 PMCID: PMC9313895 DOI: 10.1111/liv.15222] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/20/2022] [Accepted: 02/04/2022] [Indexed: 02/05/2023]
Abstract
Hyperpolarized carbon-13 magnetic resonance imaging (HP 13 C MRI) is a recently translated metabolic imaging technique. With dissolution dynamic nuclear polarization (d-DNP), more than 10 000-fold signal enhancement can be readily reached, making it possible to visualize real-time metabolism and specific substrate-to-metabolite conversions in the liver after injecting carbon-13 labelled probes. Increasing evidence suggests that HP 13 C MRI is a potential tool in detecting liver abnormalities, predicting disease progression and monitoring response treatment. In this review, we will introduce the recent progresses of HP 13 C MRI in diffuse liver diseases and liver malignancies and discuss its future opportunities from a clinical perspective, hoping to provide a comprehensive overview of this novel technique in liver diseases and highlight its scientific and clinical potential in the field of hepatology.
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Affiliation(s)
- Zheng Ye
- Department of RadiologyWest China Hospital, Sichuan UniversityChengduSichuanChina
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Bin Song
- Department of RadiologyWest China Hospital, Sichuan UniversityChengduSichuanChina
| | - Philip M. Lee
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Michael A. Ohliger
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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22
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Initial Experience on Hyperpolarized [1-13C]Pyruvate MRI Multicenter Reproducibility—Are Multicenter Trials Feasible? Tomography 2022; 8:585-595. [PMID: 35314625 PMCID: PMC8938827 DOI: 10.3390/tomography8020048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/31/2022] Open
Abstract
Background: Magnetic resonance imaging (MRI) with hyperpolarized [1-13C]pyruvate allows real-time and pathway specific clinical detection of otherwise unimageable in vivo metabolism. However, the comparability between sites and protocols is unknown. Here, we provide initial experiences on the agreement of hyperpolarized MRI between sites and protocols by repeated imaging of same healthy volunteers in Europe and the US. Methods: Three healthy volunteers traveled for repeated multicenter brain MRI exams with hyperpolarized [1-13C]pyruvate within one year. First, multisite agreement was assessed with the same echo-planar imaging protocol at both sites. Then, this was compared to a variable resolution echo-planar imaging protocol. In total, 12 examinations were performed. Common metrics of 13C-pyruvate to 13C-lactate conversion were calculated, including the kPL, a model-based kinetic rate constant, and its model-free equivalents. Repeatability was evaluated with intraclass correlation coefficients (ICC) for absolute agreement computed using two-way random effects models. Results: The mean kPL across all examinations in the multisite comparison was 0.024 ± 0.0016 s−1. The ICC of the kPL was 0.83 (p = 0.14) between sites and 0.7 (p = 0.09) between examinations of the same volunteer at any of the two sites. For the model-free metrics, the lactate Z-score had similar site-to-site ICC, while it was considerably lower for the lactate-to-pyruvate ratio. Conclusions: Estimation of metabolic conversion from hyperpolarized [1-13C]pyruvate to lactate using model-based metrics such as kPL suggests close agreement between sites and examinations in volunteers. Our initial results support harmonization of protocols, support multicenter studies, and inform their design.
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23
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Li Y, Vigneron DB, Xu D. Current human brain applications and challenges of dynamic hyperpolarized carbon-13 labeled pyruvate MR metabolic imaging. Eur J Nucl Med Mol Imaging 2021; 48:4225-4235. [PMID: 34432118 PMCID: PMC8566394 DOI: 10.1007/s00259-021-05508-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
The ability of hyperpolarized carbon-13 MR metabolic imaging to acquire dynamic metabolic information in real time is crucial to gain mechanistic insights into metabolic pathways, which are complementary to anatomic and other functional imaging methods. This review presents the advantages of this emerging functional imaging technology, describes considerations in clinical translations, and summarizes current human brain applications. Despite rapid development in methodologies, significant technological and physiological related challenges continue to impede broader clinical translation.
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Affiliation(s)
- Yan Li
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA.
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA
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24
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Kim Y, Chen HY, Autry AW, Villanueva-Meyer J, Chang SM, Li Y, Larson PEZ, Brender JR, Krishna MC, Xu D, Vigneron DB, Gordon JW. Denoising of hyperpolarized 13 C MR images of the human brain using patch-based higher-order singular value decomposition. Magn Reson Med 2021; 86:2497-2511. [PMID: 34173268 DOI: 10.1002/mrm.28887] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/23/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To improve hyperpolarized 13 C (HP-13 C) MRI by image denoising with a new approach, patch-based higher-order singular value decomposition (HOSVD). METHODS The benefit of using a patch-based HOSVD method to denoise dynamic HP-13 C MR imaging data was investigated. Image quality and the accuracy of quantitative analyses following denoising were evaluated first using simulated data of [1-13 C]pyruvate and its metabolic product, [1-13 C]lactate, and compared the results to a global HOSVD method. The patch-based HOSVD method was then applied to healthy volunteer HP [1-13 C]pyruvate EPI studies. Voxel-wise kinetic modeling was performed on both non-denoised and denoised data to compare the number of voxels quantifiable based on SNR criteria and fitting error. RESULTS Simulation results demonstrated an 8-fold increase in the calculated SNR of [1-13 C]pyruvate and [1-13 C]lactate with the patch-based HOSVD denoising. The voxel-wise quantification of kPL (pyruvate-to-lactate conversion rate) showed a 9-fold decrease in standard errors for the fitted kPL after denoising. The patch-based denoising performed superior to the global denoising in recovering kPL information. In volunteer data sets, [1-13 C]lactate and [13 C]bicarbonate signals became distinguishable from noise across captured time points with over a 5-fold apparent SNR gain. This resulted in >3-fold increase in the number of voxels quantifiable for mapping kPB (pyruvate-to-bicarbonate conversion rate) and whole brain coverage for mapping kPL . CONCLUSIONS Sensitivity enhancement provided by this denoising significantly improved quantification of metabolite dynamics and could benefit future studies by improving image quality, enabling higher spatial resolution, and facilitating the extraction of metabolic information for clinical research.
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Affiliation(s)
- Yaewon Kim
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Javier Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Jeffrey R Brender
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Murali C Krishna
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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25
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Crane JC, Gordon JW, Chen HY, Autry AW, Li Y, Olson MP, Kurhanewicz J, Vigneron DB, Larson PEZ, Xu D. Hyperpolarized 13 C MRI data acquisition and analysis in prostate and brain at University of California, San Francisco. NMR IN BIOMEDICINE 2021; 34:e4280. [PMID: 32189442 PMCID: PMC7501204 DOI: 10.1002/nbm.4280] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Based on the expanding set of applications for hyperpolarized carbon-13 (HP-13 C) MRI, this work aims to communicate standardized methodology implemented at the University of California, San Francisco, as a primer for conducting reproducible metabolic imaging studies of the prostate and brain. Current state-of-the-art HP-13 C acquisition, data processing/reconstruction and kinetic modeling approaches utilized in patient studies are presented together with the rationale underpinning their usage. Organized around spectroscopic and imaging-based methods, this guide provides an extensible framework for handling a variety of HP-13 C applications, which derives from two examples with dynamic acquisitions: 3D echo-planar spectroscopic imaging of the human prostate and frequency-specific 2D multislice echo-planar imaging of the human brain. Details of sequence-specific parameters and processing techniques contained in these examples should enable investigators to effectively tailor studies around individual-use cases. Given the importance of clinical integration in improving the utility of HP exams, practical aspects of standardizing data formats for reconstruction, analysis and visualization are also addressed alongside open-source software packages that enhance institutional interoperability and validation of methodology. To facilitate the adoption and further development of this methodology, example datasets and analysis pipelines have been made available in the supporting information.
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Affiliation(s)
- Jason C Crane
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Marram P Olson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - John Kurhanewicz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
- Department of Pharmaceutical Chemistry, University of California, San Francisco, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
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26
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Tang S, Meng MV, Slater JB, Gordon JW, Vigneron DB, Stohr BA, Larson PEZ, Wang ZJ. Metabolic imaging with hyperpolarized 13 C pyruvate magnetic resonance imaging in patients with renal tumors-Initial experience. Cancer 2021; 127:2693-2704. [PMID: 33844280 DOI: 10.1002/cncr.33554] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Optimal treatment selection for localized renal tumors is challenging because of their variable biologic behavior and limitations in the preoperative assessment of tumor aggressiveness. The authors investigated the emerging hyperpolarized (HP) 13 C magnetic resonance imaging (MRI) technique to noninvasively assess tumor lactate production, which is strongly associated with tumor aggressiveness. METHODS Eleven patients with renal tumors underwent HP 13 C pyruvate MRI before surgical resection. Tumor 13 C pyruvate and 13 C lactate images were acquired dynamically. Five patients underwent 2 scans on the same day to assess the intrapatient reproducibility of HP 13 C pyruvate MRI. Tumor metabolic data were compared with histopathology findings. RESULTS Eight patients had tumors with a sufficient metabolite signal-to-noise ratio for analysis; an insufficient tumor signal-to-noise ratio was noted in 2 patients, likely caused by poor tumor perfusion and, in 1 patient, because of technical errors. Of the 8 patients, 3 had high-grade clear cell renal cell carcinoma (ccRCC), 3 had low-grade ccRCC, and 2 had chromophobe RCC. There was a trend toward a higher lactate-to-pyruvate ratio in high-grade ccRCCs compared with low-grade ccRCCs. Both chromophobe RCCs had relatively high lactate-to-pyruvate ratios. Good reproducibility was noted across the 5 patients who underwent 2 HP 13 C pyruvate MRI scans on the same day. CONCLUSIONS The current results demonstrate the feasibility of HP 13 C pyruvate MRI for investigating the metabolic phenotype of localized renal tumors. The initial data indicate good reproducibility of metabolite measurements. In addition, the metabolic data indicate a trend toward differentiating low-grade and high-grade ccRCCs, the most common subtype of renal cancer. LAY SUMMARY Renal tumors are frequently discovered incidentally because of the increased use of medical imaging, but it is challenging to identify which aggressive tumors should be treated. A new metabolic imaging technique was applied to noninvasively predict renal tumor aggressiveness. The imaging results were compared with tumor samples taken during surgery and showed a trend toward differentiating between low-grade and high-grade clear cell renal cell carcinomas, which are the most common type of renal cancers.
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Affiliation(s)
- Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California.,UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California
| | - Maxwell V Meng
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - James B Slater
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California.,UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California
| | - Bradley A Stohr
- Department of Pathology, University of California-San Francisco, San Francisco, California
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California.,UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, California
| | - Zhen Jane Wang
- Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California
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27
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Gordon JW, Autry AW, Tang S, Graham JY, Bok RA, Zhu X, Villanueva-Meyer JE, Li Y, Ohilger MA, Abraham MR, Xu D, Vigneron DB, Larson PEZ. A variable resolution approach for improved acquisition of hyperpolarized 13 C metabolic MRI. Magn Reson Med 2020; 84:2943-2952. [PMID: 32697867 PMCID: PMC7719570 DOI: 10.1002/mrm.28421] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/27/2020] [Accepted: 06/19/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE To ameliorate tradeoffs between a fixed spatial resolution and signal-to-noise ratio (SNR) for hyperpolarized 13 C MRI. METHODS In MRI, SNR is proportional to voxel volume but retrospective downsampling or voxel averaging only improves SNR by the square root of voxel size. This can be exploited with a metabolite-selective imaging approach that independently encodes each compound, yielding high-resolution images for the injected substrate and coarser resolution images for downstream metabolites, while maintaining adequate SNR for each. To assess the efficacy of this approach, hyperpolarized [1-13 C]pyruvate data were acquired in healthy Sprague-Dawley rats (n = 4) and in two healthy human subjects. RESULTS Compared with a constant resolution acquisition, variable-resolution data sets showed improved detectability of metabolites in pre-clinical renal studies with a 3.5-fold, 8.7-fold, and 6.0-fold increase in SNR for lactate, alanine, and bicarbonate data, respectively. Variable-resolution data sets from healthy human subjects showed cardiac structure and neuro-vasculature in the higher resolution pyruvate images (6.0 × 6.0 mm2 for cardiac and 7.5 × 7.5 mm2 for brain) that would otherwise be missed due to partial-volume effects and illustrates the level of detail that can be achieved with hyperpolarized substrates in a clinical setting. CONCLUSION We developed a variable-resolution strategy for hyperpolarized 13 C MRI using metabolite-selective imaging and demonstrated that it mitigates tradeoffs between a fixed spatial resolution and SNR for hyperpolarized substrates, providing both high resolution pyruvate and coarse resolution metabolite data sets in a single exam. This technique shows promise to improve future studies by maximizing metabolite SNR while minimizing partial-volume effects from the injected substrate.
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Affiliation(s)
- Jeremy W. Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Adam W. Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Shuyu Tang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
| | - Jasmine Y. Graham
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
| | - Robert A. Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Xucheng Zhu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
| | - Javier E. Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Michael A. Ohilger
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Maria Roselle Abraham
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
| | - Daniel B. Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California, Berkeley, California, USA
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28
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Sánchez-Heredia JD, Olin RB, McLean MA, Laustsen C, Hansen AE, Hanson LG, Ardenkjær-Larsen JH. Multi-site benchmarking of clinical 13C RF coils at 3T. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2020; 318:106798. [PMID: 32755748 PMCID: PMC7501735 DOI: 10.1016/j.jmr.2020.106798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/17/2020] [Accepted: 07/23/2020] [Indexed: 05/06/2023]
Abstract
A quality assurance protocol for RF coils is proposed, which can be used for volume (Tx/Rx) and surface (Rx) coils. Following this protocol, a benchmarking of seven coils (from three different MR sites) dedicated to 13C MRI at 3T is reported. Coil performance is particularly important for 3T MRI at the 13C frequency, since the coil-to-sample noise ratio is typically high. The coils are evaluated experimentally using the proposed protocol based on MR spectroscopic imaging performed with two different phantoms: one head-shaped, and one with cylindrical shape and nearly twice the volume of the first one. To achieve an unbiased SNR comparison of volume and array coils, coil combination was done using sensitivity profiles extracted from the data. SNR, noise correlation matrices and example g-factor maps are reported. For globally calibrated, equal excitation angles, the measured SNR shows large differences for the volume coils of up to 115% at the phantom center for a head phantom. The arrays show lower differences in superficial SNR. The sample surface depth at which the volume coils outperform the arrays is estimated to 7 cm, and SNR furthest away from the coil surface is 28% lower for the best array compared to the best volume coil. A broad set of coils for 13C at 3T have been benchmarked. The results reported, and the method used to benchmark them, should guide the 13C community to choose the most suitable coil for a given experiment.
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Affiliation(s)
| | - Rie B Olin
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Adam E Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars G Hanson
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Jan Henrik Ardenkjær-Larsen
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark; GE Healthcare, Brøndby, Denmark.
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29
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Autry AW, Gordon JW, Chen HY, LaFontaine M, Bok R, Van Criekinge M, Slater JB, Carvajal L, Villanueva-Meyer JE, Chang SM, Clarke JL, Lupo JM, Xu D, Larson PEZ, Vigneron DB, Li Y. Characterization of serial hyperpolarized 13C metabolic imaging in patients with glioma. NEUROIMAGE-CLINICAL 2020; 27:102323. [PMID: 32623139 PMCID: PMC7334458 DOI: 10.1016/j.nicl.2020.102323] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 01/07/2023]
Abstract
Serial HP 13C MRI was evaluated for data consistency and abnormal metabolism. Metabolism of [1-13C]pyruvate to lactate and bicarbonate was kinetically modeled. Conversion rates within NAWM were consistent in healthy volunteer and patient scans Progressed tumor lesions showed higher relative conversion rates to [1-13C]lactate. Globally elevated rate constants were observed with anti-angiogenic treatment.
Background Hyperpolarized carbon-13 (HP-13C) MRI is a non-invasive imaging technique for probing brain metabolism, which may improve clinical cancer surveillance. This work aimed to characterize the consistency of serial HP-13C imaging in patients undergoing treatment for brain tumors and determine whether there is evidence of aberrant metabolism in the tumor lesion compared to normal-appearing tissue. Methods Serial dynamic HP [1-13C]pyruvate MRI was performed on 3 healthy volunteers (6 total examinations) and 5 patients (21 total examinations) with diffuse infiltrating glioma during their course of treatment, using a frequency-selective echo-planar imaging (EPI) sequence. HP-13C imaging at routine clinical timepoints overlapped treatment, including radiotherapy (RT), temozolomide (TMZ) chemotherapy, and anti-angiogenic/investigational agents. Apparent rate constants for [1-13C]pyruvate conversion to [1-13C]lactate (kPL) and [13C]bicarbonate (kPB) were simultaneously quantified based on an inputless kinetic model within normal-appearing white matter (NAWM) and anatomic lesions defined from 1H MRI. The inter/intra-subject consistency of kPL-NAWM and kPB-NAWM was measured in terms of the coefficient of variation (CV). Results When excluding scans following anti-angiogenic therapy, patient values of kPL-NAWM and kPB-NAWM were 0.020 s−1 ± 23.8% and 0.0058 s−1 ± 27.7% (mean ± CV) across 17 HP-13C MRIs, with intra-patient serial kPL-NAWM/kPB-NAWM CVs ranging 6.8–16.6%/10.6–40.7%. In 4/5 patients, these values (0.018 s−1 ± 13.4% and 0.0058 s−1 ± 24.4%; n = 13) were more similar to those from healthy volunteers (0.018 s−1 ± 5.0% and 0.0043 s−1 ± 12.6%; n = 6) (mean ± CV). The anti-angiogenic agent bevacizumab was associated with global elevations in apparent rate constants, with maximum kPL-NAWM in 2 patients reaching 0.047 ± 0.001 and 0.047 ± 0.003 s−1 (±model error). In 3 patients with progressive disease, anatomic lesions showed elevated kPL relative to kPL-NAWM of 0.024 ± 0.001 s−1 (±model error) in the absence of gadolinium enhancement, and 0.032 ± 0.008, 0.040 ± 0.003 and 0.041 ± 0.009 s−1 with gadolinium enhancement. The lesion kPB in patients was reduced to unquantifiable values compared to kPB-NAWM. Conclusion Serial measures of HP [1-13C]pyruvate metabolism displayed consistency in the NAWM of healthy volunteers and patients. Both kPL and kPB were globally elevated following bevacizumab treatment, while progressive disease demonstrated elevated kPL in gadolinium-enhancing and non-enhancing lesions. Larger prospective studies with homogeneous patient populations are planned to evaluate metabolic changes following treatment.
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Affiliation(s)
- Adam W Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Jeremy W Gordon
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Hsin-Yu Chen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Marisa LaFontaine
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Mark Van Criekinge
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - James B Slater
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Lucas Carvajal
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Susan M Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, USA
| | - Jennifer L Clarke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, USA
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA.
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30
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Tang S, Bok R, Qin H, Reed G, VanCriekinge M, Delos Santos R, Overall W, Santos J, Gordon J, Wang ZJ, Vigneron DB, Larson PEZ. A metabolite-specific 3D stack-of-spiral bSSFP sequence for improved lactate imaging in hyperpolarized [1- 13 C]pyruvate studies on a 3T clinical scanner. Magn Reson Med 2020; 84:1113-1125. [PMID: 32086845 DOI: 10.1002/mrm.28204] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/23/2019] [Accepted: 01/17/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE The balanced steady-state free precession sequence has been previously explored to improve the efficient use of nonrecoverable hyperpolarized 13C magnetization, but suffers from poor spectral selectivity and long acquisition time. The purpose of this study was to develop a novel metabolite-specific 3D bSSFP ("MS-3DSSFP") sequence with stack-of-spiral readouts for improved lactate imaging in hyperpolarized [1-13 C]pyruvate studies on a clinical 3T scanner. METHODS Simulations were performed to evaluate the spectral response of the MS-3DSSFP sequence. Thermal 13C phantom experiments were performed to validate the MS-3DSSFP sequence. In vivo hyperpolarized [1-13 C], pyruvate studies were performed to compare the MS-3DSSFP sequence with metabolite-specific gradient echo ("MS-GRE") sequences for lactate imaging. RESULTS Simulations, phantom, and in vivo studies demonstrate that the MS-3DSSFP sequence achieved spectrally selective excitation on lactate while minimally perturbing other metabolites. Compared with MS-GRE sequences, the MS-3DSSFP sequence showed approximately a 2.5-fold SNR improvement for lactate imaging in rat kidneys, prostate tumors in a mouse model, and human kidneys. CONCLUSIONS Improved lactate imaging using the MS-3DSSFP sequence in hyperpolarized [1-13 C]pyruvate studies was demonstrated in animals and humans. The MS-3DSSFP sequence could be applied for other clinical applications such as in the brain or adapted for imaging other metabolites such as pyruvate and bicarbonate.
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Affiliation(s)
- Shuyu Tang
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Robert Bok
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Hecong Qin
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Mark VanCriekinge
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Romelyn Delos Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - William Overall
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Santos
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jeremy Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Zhen Jane Wang
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel B Vigneron
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Peder E Z Larson
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco and University of California, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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31
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Hansen RB, Sánchez‐Heredia JD, Bøgh N, Hansen ESS, Laustsen C, Hanson LG, Ardenkjær‐Larsen JH. Coil profile estimation strategies for parallel imaging with hyperpolarized
13
C MRI. Magn Reson Med 2019; 82:2104-2117. [DOI: 10.1002/mrm.27892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 01/16/2023]
Affiliation(s)
- Rie B. Hansen
- Department of Health Technology Technical University of Denmark Kongens Lyngby Denmark
| | | | - Nikolaj Bøgh
- MR Research Centre Aarhus University Aarhus Denmark
| | | | | | - Lars G. Hanson
- Department of Health Technology Technical University of Denmark Kongens Lyngby Denmark
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research Copenhagen University Hospital Hvidovre Copenhagen Denmark
| | - Jan H. Ardenkjær‐Larsen
- Department of Health Technology Technical University of Denmark Kongens Lyngby Denmark
- GE Healthcare Brøndby Denmark
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