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Kamp B, Radke KL, Knet M, Strunk R, Gallinnis PJ, Nagel AM, Filler TJ, Antoch G, Abrar DB, Frenken M, Wittsack HJ, Müller-Lutz A. Sodium MRI of the Lumbar Intervertebral Discs of the Human Spine: An Ex Vivo Study. J Magn Reson Imaging 2024. [PMID: 38963154 DOI: 10.1002/jmri.29521] [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: 03/05/2024] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Lower back pain affects 75%-85% of people at some point in their lives. The detection of biochemical changes with sodium (23Na) MRI has potential to enable an earlier and more accurate diagnosis. PURPOSE To measure 23Na relaxation times and apparent tissue sodium concentration (aTSC) in ex-vivo intervertebral discs (IVDs), and to investigate the relationship between aTSC and histological Thompson grade. STUDY TYPE Ex-vivo. SPECIMEN Thirty IVDs from the lumbar spines of 11 human body donors (4 female, 7 male, mean age 86 ± 8 years). FIELD STRENGTH/SEQUENCE 3 T; density-adapted 3D radial sequence (DA-3D-RAD). ASSESSMENT IVD 23Na longitudinal (T1), short and long transverse (T2s* and T2l*) relaxation times and the proportion of the short transverse relaxation (ps) were calculated for one IVD per spine sample (11 IVDs). Furthermore, aTSCs were calculated for all IVDs. The degradation of the IVDs was assessed via histological Thompson grading. STATISTICAL TESTS A Kendall Tau correlation (τ) test was performed between the aTSCs and the Thompson grades. The significance level was set to P < 0.05. RESULTS Mean 23Na relaxation parameters of a subset of 11 IVDs were T1 = 9.8 ± 1.3 msec, T2s* = 0.7 ± 0.1 msec, T2l* = 7.3 ± 1.1 msec, and ps = 32.7 ± 4.0%. A total of 30 IVDs were examined, of which 3 had Thompson grade 1, 4 had grade 2, 5 had grade 3, 5 had grade 4, and 13 had grade 5. The aTSC decreased with increasing degradation, being 274.6 ± 18.9 mM for Thompson grade 1 and 190.5 ± 29.5 mM for Thompson grade 5. The correlation between whole IVD aTSC and Thompson grade was significant and strongly negative (τ = -0.56). DATA CONCLUSION This study showed a significant correlation between aTSC and degenerative IVD changes. Consequently, aTSC has potential to be useful as an indicator of degenerative spinal changes. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Marek Knet
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Rosanna Strunk
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Patrik J Gallinnis
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Timm J Filler
- Institute of Anatomy I, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Daniel B Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Rasmussen CW, Bøgh N, Ringgaard S, Birn H, Vaeggemose M, Schulte RF, Laustsen C. Daytime Variation in Kidney Perfusion, Oxygenation, and Sodium Concentration Assessed by Multiparametric MRI in Healthy Volunteers. J Magn Reson Imaging 2024; 59:1603-1611. [PMID: 37656067 DOI: 10.1002/jmri.28983] [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: 06/16/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND MRI can provide information on kidney structure, perfusion, and oxygenation. Furthermore, it allows for the assessment of kidney sodium concentrations and handling, allowing multiparametric evaluation of kidney physiology. Multiparametric MRI is promising for establishing prognosis and monitoring treatment responses in kidney diseases, but its intraindividual variation during the day is unresolved. PURPOSE To investigate the variation in multiparametric MRI measurements from the morning to the evening. STUDY TYPE Prospective. POPULATION Ten healthy volunteers, aged 29 ± 5 without history of kidney disease. FIELD STRENGTH/SEQUENCE 3 T/T1 mapping, blood-oxygen level dependent imaging, arterial spin labeling perfusion imaging, diffusion weighted imaging, and sodium imaging. ASSESSMENT A multiparametric MRI protocol, yielding T1, R2*, ADC, renal blood flow and renal sodium levels, was acquired in the morning, noon, and evening. The participants were fasting prior to the first examination. Urine biochemical analyses were performed to complement MRI data. The cortex and medulla were analyzed separately in a semi-automatic fashion, and gradients of total sodium concentration (TSC) and R2* gradients were calculated from outer cortex to inner medulla. STATISTICAL TEST Analyses of variance and mixed-effects models to estimate differences from time of day. Coefficients of variation to assess variability within and between participants. A P-value <0.05 was considered statistically significant. RESULTS The coefficients of variation varied from 5% to 18% for proton-based parametric sequences, while it was 38% for TSC over a day. DATA CONCLUSION Multiparametric MRI is stable over the day. The coefficients of variation over a day were lower for proton multiparametric MRI, but higher for sodium MRI. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Camilla W Rasmussen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Ringgaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Birn
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Vaeggemose
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- GE HealthCare, Broendby, Denmark
| | | | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Gast LV, Platt T, Nagel AM, Gerhalter T. Recent technical developments and clinical research applications of sodium ( 23Na) MRI. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2023; 138-139:1-51. [PMID: 38065665 DOI: 10.1016/j.pnmrs.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 12/18/2023]
Abstract
Sodium is an essential ion that plays a central role in many physiological processes including the transmembrane electrochemical gradient and the maintenance of the body's homeostasis. Due to the crucial role of sodium in the human body, the sodium nucleus is a promising candidate for non-invasively assessing (patho-)physiological changes. Almost 10 years ago, Madelin et al. provided a comprehensive review of methods and applications of sodium (23Na) MRI (Madelin et al., 2014) [1]. More recent review articles have focused mainly on specific applications of 23Na MRI. For example, several articles covered 23Na MRI applications for diseases such as osteoarthritis (Zbyn et al., 2016, Zaric et al., 2020) [2,3], multiple sclerosis (Petracca et al., 2016, Huhn et al., 2019) [4,5] and brain tumors (Schepkin, 2016) [6], or for imaging certain organs such as the kidneys (Zollner et al., 2016) [7], the brain (Shah et al., 2016, Thulborn et al., 2018) [8,9], and the heart (Bottomley, 2016) [10]. Other articles have reviewed technical developments such as radiofrequency (RF) coils for 23Na MRI (Wiggins et al., 2016, Bangerter et al., 2016) [11,12], pulse sequences (Konstandin et al., 2014) [13], image reconstruction methods (Chen et al., 2021) [14], and interleaved/simultaneous imaging techniques (Lopez Kolkovsky et al., 2022) [15]. In addition, 23Na MRI topics have been covered in review articles with broader topics such as multinuclear MRI or ultra-high-field MRI (Niesporek et al., 2019, Hu et al., 2019, Ladd et al., 2018) [16-18]. During the past decade, various research groups have continued working on technical improvements to sodium MRI and have investigated its potential to serve as a diagnostic and prognostic tool. Clinical research applications of 23Na MRI have covered a broad spectrum of diseases, mainly focusing on the brain, cartilage, and skeletal muscle (see Fig. 1). In this article, we aim to provide a comprehensive summary of methodological and hardware developments, as well as a review of various clinical research applications of sodium (23Na) MRI in the last decade (i.e., published from the beginning of 2013 to the end of 2022).
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Tanja Platt
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Akbari A, McIntyre CW. Recent Advances in Sodium Magnetic Resonance Imaging and Its Future Role in Kidney Disease. J Clin Med 2023; 12:4381. [PMID: 37445416 PMCID: PMC10342976 DOI: 10.3390/jcm12134381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Sodium imbalance is a hallmark of chronic kidney disease (CKD). Excess tissue sodium in CKD is associated with hypertension, inflammation, and cardiorenal disease. Sodium magnetic resonance imaging (23Na MRI) has been increasingly utilized in CKD clinical trials especially in the past few years. These studies have demonstrated the association of excess sodium tissue accumulation with declining renal function across whole CKD spectrum (early- to end-stage), biomarkers of systemic inflammation, and cardiovascular dysfunction. In this article, we review recent advances of 23Na MRI in CKD and discuss its future role with a focus on the skin, the heart, and the kidney itself.
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Affiliation(s)
- Alireza Akbari
- Robarts Research Institute, Western University, London, ON N6A 3K7, Canada;
- Lilibeth Caberto Kidney Clinic Research Unit, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Christopher W. McIntyre
- Robarts Research Institute, Western University, London, ON N6A 3K7, Canada;
- Lilibeth Caberto Kidney Clinic Research Unit, London Health Sciences Centre, London, ON N6A 5W9, Canada
- Departments of Medicine, Pediatrics and Medical Biophysics, Western University, London, ON N6A 3K7, Canada
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Rasmussen CW, Bøgh N, Bech SK, Thorsen TH, Hansen ESS, Bertelsen LB, Laustsen C. Fibrosis imaging with multiparametric proton and sodium MRI in pig injury models. NMR IN BIOMEDICINE 2023; 36:e4838. [PMID: 36151711 PMCID: PMC10078455 DOI: 10.1002/nbm.4838] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
Chronic kidney disease (CKD) is common and has huge implications for health and mortality. It is aggravated by intrarenal fibrosis, but the assessment of fibrosis is limited to kidney biopsies, which carry a risk of complications and sampling errors. This calls for a noninvasive modality for diagnosing and staging intrarenal fibrosis. The current, exploratory study evaluates a multiparametric MRI protocol including sodium imaging (23 Na-MRI) to determine the opportunities within this modality to assess kidney injury as a surrogate endpoint of fibrosis. The study includes 43 pigs exposed to ischemia-reperfusion injury (IRI) or unilateral ureteral obstruction (UUO), or serving as healthy controls. Fibrosis was determined using gene expression analysis of collagen. The medulla/cortex ratio of 23 Na-MRI decreased in the injured kidney in the IRI pigs, but not in the UUO pigs (p = 0.0180, p = 0.0754). To assess the combination of MRI parameters in estimating fibrosis, we created a linear regression model consisting of the cortical apparent diffusion coefficient, ΔR2*, ΔT1, the 23 Na medulla/cortex ratio, and plasma creatinine (R2 = 0.8009, p = 0.0117). The 23 Na medulla/cortex ratio only slightly improved the fibrosis prediction model, leaving 23 Na-MRI in an ambiguous place for evaluation of intrarenal fibrosis. Use of multiparametric MRI in combination with plasma creatinine shows potential for the estimation of fibrosis in human kidney disease, but more translational and clinical work is warranted before MRI can contribute to earlier diagnosis and evaluation of treatment for acute kidney injury and CKD.
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Affiliation(s)
- Camilla W. Rasmussen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Nikolaj Bøgh
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Sabrina K. Bech
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Thomas H. Thorsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Esben S. S. Hansen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Lotte B. Bertelsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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Vaeggemose M, Schulte RF, Laustsen C. Clinically feasible B 1 field correction for multi-organ sodium imaging at 3 T. NMR IN BIOMEDICINE 2023; 36:e4835. [PMID: 36115017 PMCID: PMC10078323 DOI: 10.1002/nbm.4835] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
Sodium MRI allows the non-invasive quantification of intra-organ sodium concentration. RF inhomogeneity introduces uncertainty in this estimated concentration. B1 field corrections can be used to overcome some of these limitations. However, the low signal-to-noise ratio in sodium MRI makes accurate B1 mapping in reasonable scan times challenging. The study aims to evaluate Bloch-Siegert off-resonance (BLOSI) B1 field correction for sodium MRI using a 3D Fermat looped, orthogonally encoded trajectories (FLORET) read-out trajectory. We propose a clinically feasible B1 field map correction method for sodium imaging at 3 T, evaluating five healthy subjects' brain, heart blood, kidneys, and thigh muscle. We scanned the subjects twice for repeatability measures and used sodium phantoms to determine organ total sodium concentration. Conventional proton scans were compared with sodium images for organ structural integrity. The BLOSI approach based on the 3D FLORET read-out trajectory was used in B1 field correction and 3D density-adapted radial acquisition for sodium imaging. Results indicate improvements in sodium imaging based on B1 field correction in a clinically feasible protocol. Improvements are determined in all organs by enhanced anatomical representation, organ homogeneity, and an increase in the total sodium concentration after applying a B1 field correction. The proposed BLOSI-based B1 field correction using a 3D FLORET read-out trajectory is clinically feasible for sodium imaging, which is shown in the brain, heart, kidney, and thigh muscle. This supports using fast B1 field mapping in the clinical setting.
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Affiliation(s)
- Michael Vaeggemose
- GE HealthcareBrondbyDenmark
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical MedicineAarhus UniversityAarhusDenmark
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7
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Adlung A, Licht C, Reichert S, Özdemir S, Mohamed SA, Samartzi M, Fatar M, Gass A, Prost EN, Schad LR. Quantification of tissue sodium concentration in the ischemic stroke: A comparison between external and internal references for 23Na MRI. J Neurosci Methods 2022; 382:109721. [PMID: 36202191 DOI: 10.1016/j.jneumeth.2022.109721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Anne Adlung
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - Christian Licht
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Simon Reichert
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Safa Özdemir
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sherif A Mohamed
- Department of Neuroradiology, Medical Faculty Mannheim, Heidelberg University, Germany; Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | - Melina Samartzi
- Department of Neurology, Medical Faculty Mannheim and Mannheim Center of Translational Neurosciences (MCTN), Heidelberg University, Germany
| | - Marc Fatar
- Department of Neurology, Medical Faculty Mannheim and Mannheim Center of Translational Neurosciences (MCTN), Heidelberg University, Germany
| | - Achim Gass
- Department of Neurology, Medical Faculty Mannheim and Mannheim Center of Translational Neurosciences (MCTN), Heidelberg University, Germany
| | - Eva Neumaier Prost
- Department of Neuroradiology, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Germany
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Evaluation of Sodium Relaxation Times and Concentrations in the Achilles Tendon Using MRI. Int J Mol Sci 2022; 23:ijms231810890. [PMID: 36142810 PMCID: PMC9501448 DOI: 10.3390/ijms231810890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
Sodium magnetic resonance imaging (MRI) can be used to evaluate the change in the proteoglycan content in Achilles tendons (ATs) of patients with different AT pathologies by measuring the 23Na signal-to-noise ratio (SNR). As 23Na SNR alone is difficult to compare between different studies, because of the high influence of hardware configurations and sequence settings on the SNR, we further set out to measure the apparent tissue sodium content (aTSC) in the AT as a better comparable parameter. Ten healthy controls and one patient with tendinopathy in the AT were examined using a clinical 3 Tesla (T) MRI scanner in conjunction with a dual tuned 1H/23Na surface coil to measure 23Na SNR and aTSC in their ATs. 23Na T1 and T2* of the AT were also measured for three controls to correct for different relaxation behavior. The results were as follows: 23Na SNR = 11.7 ± 2.2, aTSC = 82.2 ± 13.9 mM, 23Na T1 = 20.4 ± 2.4 ms, 23Na T2s* = 1.4 ± 0.4 ms, and 23Na T2l* = 13.9 ± 0.8 ms for the whole AT of healthy controls with significant regional differences. These are the first reported aTSCs and 23Na relaxation times for the AT using sodium MRI and may serve for future comparability in different studies regarding examinations of diseased ATs with sodium MRI.
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Laustsen C, Bøgh N. Sodium MRI of the Renal Corticomedullary Gradient. Radiology 2022; 303:390-391. [PMID: 35133202 DOI: 10.1148/radiol.213007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Christoffer Laustsen
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Nikolaj Bøgh
- From the MR Research Center, Department of Clinical Medicine, Aarhus University, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
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Akbari A, Lemoine S, Salerno F, Marcus TL, Duffy T, Scholl TJ, Filler G, House AA, McIntyre CW. Functional Sodium MRI Helps to Measure Corticomedullary Sodium Content in Normal and Diseased Human Kidneys. Radiology 2022; 303:384-389. [PMID: 35133199 DOI: 10.1148/radiol.211238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background To the knowledge of the authors, urinary osmolarity is the only tool currently available to assess kidney corticomedullary gradient (CMG). Comparisons between CMG and urinary osmolarity and the use of modalities such as sodium MRI to evaluate renal disease in humans are lacking. Purpose To investigate the ability of sodium MRI to measure CMG dynamics compared with urinary osmolarity after water load in healthy volunteers and CMG in participants with kidney disease. Materials and Methods A prospective study was conducted from July 2020 to January 2021 in fasting healthy volunteers undergoing water load and participants with chronic kidney disease (CKD) from cardiorenal syndrome included in a clinical trial. In both groups, CMG was estimated by measuring the medulla-to-cortex signal ratio from sodium MRI at 3.0 T. A custom-built two-loop (diameter, 18 cm) butterfly radiofrequency surface coil, tuned for sodium frequency (33.786 MHz), was used to acquire renal sodium images. Two independent observers measured all sodium MRI cortical and medullary values for each region of interest to compute the intraclass correlation coefficient. Pearson correlation was performed between urinary osmolarity and CMG. Results Five participants with CKD (mean age, 77 years ± 12 [standard deviation]; all men) and 10 healthy volunteers (mean age, 42 years ± 15; six men, four women) were evaluated. A reduction was observed between baseline and peak urinary dilution time for both mean medulla-to-cortex ratios (1.55 ± 0.11 to 1.31 ± 0.09, respectively; P < .001) and mean urinary osmolarity (756 mOsm/L ± 157 to 73 mOsm/L ± 14, respectively; P < .001) in healthy volunteers. Medulla-to-cortex and corresponding urinary osmolarity were correlated in both groups (r2 = 0.22; P < .001). Kidney sodium tissue content was successfully acquired in all five participants with CKD. The intraclass correlation coefficient measurement was 0.99 (P < .001). Conclusion Functional sodium MRI accurately depicted corticomedullary gradient (CMG) dynamic changes in healthy volunteers and demonstrated feasibility of CMG measurement in participants with reduced kidney function. Clinical trial registration no. NCT04170855. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Laustsen and Bøgh in this issue.
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Affiliation(s)
- Alireza Akbari
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Sandrine Lemoine
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Fabio Salerno
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Taylor L Marcus
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Tristan Duffy
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Timothy J Scholl
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Guido Filler
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Andrew A House
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
| | - Christopher W McIntyre
- From the Lilibeth Caberto Kidney Clinical Research Unit (KCRU), London Health Sciences Centre (A.A., S.L., F.S., T.L.M., G.F., C.W.M.), Department of Medical Biophysics (T.L.M., T.D., T.J.S., C.W.M.), Departments of Paediatrics, Medicine and Pathology, and Laboratory Medicine, Paediatric Nephrology (G.F.), and Division of Nephrology, Schulich School of Medicine & Dentistry (A.A.H., C.W.M.), University of Western Ontario, 800 Commissioners Rd E, Room ELL-101, London, ON, Canada N6A 5W9; Robarts Research Institute, Western University, London, Canada (A.A., F.S., T.J.S.); and Lawson Health Research Institute, London, Canada (S.L., F.S., G.F., A.A.H., C.W.M.)
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11
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Kamp B, Frenken M, Henke JM, Abrar DB, Nagel AM, Gast LV, Oeltzschner G, Wilms LM, Nebelung S, Antoch G, Wittsack HJ, Müller-Lutz A. Quantification of Sodium Relaxation Times and Concentrations as Surrogates of Proteoglycan Content of Patellar CARTILAGE at 3T MRI. Diagnostics (Basel) 2021; 11:diagnostics11122301. [PMID: 34943538 PMCID: PMC8700247 DOI: 10.3390/diagnostics11122301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
Sodium MRI has the potential to depict cartilage health accurately, but synovial fluid can influence the estimation of sodium parameters of cartilage. Therefore, this study aimed to reduce the impact of synovial fluid to render the quantitative compositional analyses of cartilage tissue technically more robust. Two dedicated protocols were applied for determining sodium T1 and T2* relaxation times. For each protocol, data were acquired from 10 healthy volunteers and one patient with patellar cartilage damage. Data recorded with multiple repetition times for T1 measurement and multi-echo data acquired with an additional inversion recovery pulse for T2* measurement were analysed using biexponential models to differentiate longitudinal relaxation components of cartilage (T1,car) and synovial fluid (T1,syn), and short (T2s*) from long (T2l*) transversal relaxation components. Sodium relaxation times and concentration estimates in patellar cartilage were successfully determined: T1,car = 14.5 ± 0.7 ms; T1,syn = 37.9 ± 2.9 ms; c(T1-protocol) = 200 ± 48 mmol/L; T2s* = 0.4 ± 0.1 ms; T2l* = 12.6 ± 0.7 ms; c(T2*-protocol) = 215 ± 44 mmol/L for healthy volunteers. In conclusion, a robust determination of sodium relaxation times is possible at a clinical field strength of 3T to quantify sodium concentrations, which might be a valuable tool to determine cartilage health.
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Affiliation(s)
- Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Correspondence:
| | - Jan M. Henke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Clinic of Nuclear Medicine, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
| | - Daniel B. Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Armin M. Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, D-69120 Heidelberg, Germany
| | - Lena V. Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
| | - Georg Oeltzschner
- Russell H. Morgan Department for Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196, USA;
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205-2196, USA
| | - Lena M. Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
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12
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Platt T, Ladd ME, Paech D. 7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging. Invest Radiol 2021; 56:705-725. [PMID: 34510098 PMCID: PMC8505159 DOI: 10.1097/rli.0000000000000820] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 12/15/2022]
Abstract
ABSTRACT Ultrahigh magnetic fields offer significantly higher signal-to-noise ratio, and several magnetic resonance applications additionally benefit from a higher contrast-to-noise ratio, with static magnetic field strengths of B0 ≥ 7 T currently being referred to as ultrahigh fields (UHFs). The advantages of UHF can be used to resolve structures more precisely or to visualize physiological/pathophysiological effects that would be difficult or even impossible to detect at lower field strengths. However, with these advantages also come challenges, such as inhomogeneities applying standard radiofrequency excitation techniques, higher energy deposition in the human body, and enhanced B0 field inhomogeneities. The advantages but also the challenges of UHF as well as promising advanced methodological developments and clinical applications that particularly benefit from UHF are discussed in this review article.
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Affiliation(s)
- Tanja Platt
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
| | - Mark E. Ladd
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
- Faculty of Physics and Astronomy
- Faculty of Medicine, University of Heidelberg, Heidelberg
- Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg
- Clinic for Neuroradiology, University of Bonn, Bonn, Germany
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13
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Martin K, Tan SJ, Toussaint ND. Magnetic resonance imaging determination of tissue sodium in patients with chronic kidney disease. Nephrology (Carlton) 2021; 27:117-125. [PMID: 34510658 DOI: 10.1111/nep.13975] [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: 06/02/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Excess sodium is a major modifiable contributor to hypertension and cardiovascular risk. Knowledge of sodium storage and metabolism has derived mainly from indirect measurements of dietary sodium intake and urinary sodium excretion, however both attempt to measure body sodium and fluid in a two-compartment model of intracellular and extracellular spaces. Our understanding of total body sodium has recently included a storage pool in tissues. In the last two decades, sodium-23 magnetic resonance imaging (23 Na MRI) has allowed dynamic quantification of tissue sodium in vivo. Tissue sodium is independently associated with cardiovascular dysfunction and inflammation. This review explores (i) The revolution of our understanding of sodium physiology, (ii) The development and potential clinical adoption of 23 Na MRI to provide improved measurement of total body sodium in CKD and (iii) How we can better understand mechanistic and clinical implications of tissue sodium in hypertension, cardiovascular disease and immune dysregulation, especially in the CKD population.
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Affiliation(s)
- Kylie Martin
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia
| | - Sven-Jean Tan
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia
| | - Nigel D Toussaint
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia
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14
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Kemėšienė J, Rühle A, Gomolka R, Wurnig MC, Rossi C, Boss A. Advanced diffusion imaging of abdominal organs in different hydration states of the human body: stability of biomarkers. Heliyon 2021; 7:e06072. [PMID: 33553749 PMCID: PMC7848648 DOI: 10.1016/j.heliyon.2021.e06072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND MR diffusion weighted imaging (DWI) may provide important information regarding the pathophysiology of parenchymal abdominal organs. The purpose of our study was to investigate the stability of imaging biomarkers of diffusion weighted imaging (DWI), intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in abdominal parenchymal organs regarding two body hydration states. METHODS Ten healthy volunteers twice underwent DWI of abdominal organs using a double-refocused spin-echo echo-planar imaging sequences with 11 different b-values (ranging from 0 to 1,500 s/mm2): after 4 h of fluid deprivation; 45 min following 1000 ml of water intake. Four different diffusion models were evaluated and compared: standard DWI, DKI with mono-exponential fitting, multistep algorithm with variable b-value threshold for IVIM, combined IVIM-Kurtosis; in four abdominal organs: kidneys, liver, spleen and psoas muscle. RESULTS Diffusion parameters from all four models remained similar for the renal parenchyma before and after the water challenge. Significant differences were found for the liver, spleen, and psoas muscle. The largest effects were seen for: the liver parenchyma after the water challenge by means of IVIM model's true diffusion (p < 0.02); the spleen, for IVIM's perfusion fraction (p < 0.03), the psoas muscle for the ADC value (p < 0.02). CONCLUSIONS Herein, we showed that diffusion parameters of the kidney remain remarkably stable regarding the hydration status. This may be attributed to the kidney-specific compensatory mechanisms. For the liver, spleen and psoas muscle the diffusion parameters were sensitive to changes of the hydration. This phenomenon needs to be considered when evaluating diffusion data of these organs.
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Affiliation(s)
- Jūratė Kemėšienė
- Department of Radiology, Hospital of Lithuanian University of Health Sciences, Kaunas Clinics, Lithuania
| | - Alexander Rühle
- Department of Molecular Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Ryszard Gomolka
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Moritz C. Wurnig
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Cristina Rossi
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - Andreas Boss
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
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15
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Grist JT, Riemer F, Hansen ESS, Tougaard RS, McLean MA, Kaggie J, Bøgh N, Graves MJ, Gallagher FA, Laustsen C. Visualization of sodium dynamics in the kidney by magnetic resonance imaging in a multi-site study. Kidney Int 2020; 98:1174-1178. [PMID: 32585166 PMCID: PMC7652549 DOI: 10.1016/j.kint.2020.04.056] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
Sodium magnetic resonance imaging (MRI) is a powerful, non-invasive technique to assess sodium distribution within the kidney. Here we undertook pre-clinical and clinical studies to quantify the corticomedullary sodium gradient in healthy individuals and in a porcine model of diuresis. The results demonstrated that sodium MRI could detect spatial differences in sodium biodistribution across the kidney. The sodium gradient of the kidney changed significantly after diuresis in the pig model and was independent of blood electrolyte measurements. Thus, rapid sodium MRI can be used to dynamically quantify sodium biodistribution in the porcine and human kidney.
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Affiliation(s)
- James T Grist
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Esben S S Hansen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Rasmus S Tougaard
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge, UK; Cancer Research UK, Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Joshua Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Nikolaj Bøgh
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Martin J Graves
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Christoffer Laustsen
- MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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16
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Müller-Lutz A, Kamp B, Nagel AM, Ljimani A, Abrar D, Schleich C, Wollschläger L, Nebelung S, Wittsack HJ. Sodium MRI of human articular cartilage of the wrist: a feasibility study on a clinical 3T MRI scanner. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:241-248. [PMID: 32500389 DOI: 10.1007/s10334-020-00856-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure sodium relaxation times and concentrations in human wrists on a clinical magnetic resonance imaging (MRI) scanner with a density-adapted radial sequence. MATERIALS AND METHODS Sodium MRI of human wrists was conducted on a 3T MR system using a dual-tuned 1H/23Na surface coil. We performed two studies with 10 volunteers each investigating either sodium T1 (study 1) or sodium T2* (study 2) relaxation times in the radiocarpal joint (RCJ) and midcarpal joint (MCJ). Sodium concentrations of both regions were determined. RESULTS No differences for transversal of longitudinal relaxation times were found between RCJ and MCJ (T2,s*(RCJ) = (0.9 ± 0.4) ms; T2,s*(MCJ) = (0.9 ± 0.3) ms; T2,l*(RCJ) = (14.9 ± 0.9) ms; T2,l*(MCJ) = (13.9 ± 1.1) ms; T1(RCJ) = (19.0 ± 2.4) ms; T1(MCJ) = (18.5 ± 2.1) ms). Sodium concentrations were (157.7 ± 28.4) mmol/l for study 1 and (159.8 ± 29.1) mmol/l for study 2 in the RCJ, and (172.7 ± 35.6) mmol/l for study 1 and (163.4 ± 26.3) mmol/l for study 2 in the MCJ. CONCLUSION We successfully determined sodium relaxation times and concentrations of the human wrist on a 3T MRI scanner.
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Affiliation(s)
- Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Daniel Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Lena Wollschläger
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Cardiorenal sodium MRI in small rodents using a quadrature birdcage volume resonator at 9.4 T. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:121-130. [PMID: 31797228 DOI: 10.1007/s10334-019-00810-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/22/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Design, implementation, evaluation and application of a quadrature birdcage radiofrequency (RF) resonator tailored for renal and cardiac sodium (23Na) magnetic resonance imaging (MRI) in rats at 9.4 T. MATERIALS AND METHODS A low pass birdcage resonator (16 rungs, din = 62 mm) was developed. The transmission field (B1+) was examined with EMF simulations. The scattering parameter (S-parameter) and the quality factor (Q-factor) were measured. For experimental validation B1+-field maps were acquired with the double-angle method. In vivo sodium imaging of the heart (spatial resolution: (1 × 1 × 5) mm3) and kidney (spatial resolution: (1 × 1 × 10) mm3) was performed with a FLASH technique. RESULTS The RF resonator exhibits RF characteristics, transmission field homogeneity and penetration that afford 23Na MR in vivo imaging of the kidney and heart at 9.4 T. For the renal cortex and medulla a SNRs of 8 and 13 were obtained and a SNRs of 14 and 15 were observed for the left and right ventricle. DISCUSSION These initial results obtained in vivo in rats using the quadrature birdcage volume RF resonator for 23Na MRI permit dedicated studies on experimental models of cardiac and renal diseases, which would contribute to translational research of the cardiorenal syndrome.
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18
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Feasibility study of a double resonant (1H/23Na) abdominal RF setup at 3 T. Z Med Phys 2019; 29:359-367. [DOI: 10.1016/j.zemedi.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/14/2018] [Accepted: 12/08/2018] [Indexed: 01/27/2023]
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Gomolka RS, Ciritsis A, Meier A, Rossi C. Quantification of sodium T1 in abdominal tissues at 3 T. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2019; 33:439-446. [DOI: 10.1007/s10334-019-00786-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/10/2019] [Accepted: 10/04/2019] [Indexed: 02/02/2023]
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Milani B, Delacoste J, Burnier M, Pruijm M. Exploring a new method for quantitative sodium MRI in the human upper leg with a surface coil and symmetrically arranged reference phantoms. Quant Imaging Med Surg 2019; 9:985-999. [PMID: 31367553 DOI: 10.21037/qims.2019.06.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The aim of this study is to validate and evaluate the reproducibility of a new setup for the quantification of the tissue sodium concentration (TSC) in the human upper leg muscles with sodium MRI at 3 Tesla. This setup is making use of an emit and receive single loop surface coil together with a set of square, symmetrically arranged reference phantoms. As a second aim, the performances of two MRI protocols for the TSC quantification in the upper leg muscles are compared: one using an ultra-short echo time (UTE) 3-dimensional radial sequence (UTE-protocol), and the other one using standard gradient echo sequence (GRE-protocol). Methods A validation test of the quantification of sodium concentration is performed in phantoms. The bias of the method is estimated and compared between both protocols. The reproducibility of TSC quantification is assessed in phantoms by the coefficient of variation (CV) and compared between both protocols. The reproducibility is also assessed in 11 health volunteers. Signal to noise ratio (SNR) maps are acquired in phantoms with both protocols in order to compare the resulting SNR. Results The apparatus and post processing were successfully implemented. The bias of the method was smaller than 10% in phantoms (excepted for Na concentration of 10 mmol/L when using the GRE protocol). The reproducibility of the method using symmetrically arranged phantoms was high in phantoms and humans (CV <5%). The GRE-protocol leads to a better SNR than the UTE-protocol in 2D images. Conclusions The use of symmetrically arranged reference phantoms lead to reproducible results in phantoms and humans. Sodium imaging in the human upper leg with a single loop surface coil should be performed with a standard 2-dimensional GRE protocol if an optimal SNR is needed. However, the quantification of the fast and slow decay time constants of the sodium signal, which plays a role in the TSC quantification, still has to be done with a UTE sequence. Moreover, the quantification of sodium concentration is more accurate with the UTE protocol for small sodium concentrations (<20 mmol).
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Affiliation(s)
- Bastien Milani
- Division of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Departement de Radiologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Jean Delacoste
- Departement de Radiologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Michel Burnier
- Division of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Menno Pruijm
- Division of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Meyer MM, Schmidt A, Benrath J, Konstandin S, Pilz LR, Harrington MG, Budjan J, Meyer M, Schad LR, Schoenberg SO, Haneder S. Cerebral sodium ( 23Na) magnetic resonance imaging in patients with migraine - a case-control study. Eur Radiol 2019; 29:7055-7062. [PMID: 31264011 DOI: 10.1007/s00330-019-06299-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/21/2019] [Accepted: 06/03/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Evaluation of MRI-derived cerebral 23Na concentrations in patients with migraine in comparison with healthy controls. MATERIALS AND METHODS In this case-control study, 24 female migraine patients (mean age, 34 ± 11 years) were enrolled after evaluation of standardized questionnaires. Half (n = 12) of the cohort suffered from migraine, the other half was impaired by both migraine and tension-type headaches (TTH). The combined patient cohort was matched to 12 healthy female controls (mean age, 34 ± 11 years). All participants underwent a cerebral 23Na-magnetic resonance imaging examination at 3.0 T, which included a T1w MP-RAGE sequence and a 3D density-adapted, radial gradient echo sequence for 23Na imaging. Circular regions of interests were placed in predetermined anatomic regions: cerebrospinal fluid (CSF), gray and white matter, brain stem, and cerebellum. External 23Na reference phantoms were used to calculate the total 23Na tissue concentrations. Pearson's correlation, Kendall Tau, and Wilcoxon rank sum test were used for statistical analysis. RESULTS 23Na concentrations of all patients in the CSF were significantly higher than in healthy controls (p < 0.001). The CSF of both the migraine and mixed migraine/TTH group showed significantly increased sodium concentrations compared to the control group (p = 0.007 and p < 0.001). Within the patient cohort, a positive correlation between pain level and TSC in the CSF (r = 0.62) could be observed. CONCLUSION MRI-derived cerebral 23Na concentrations in the CSF of migraine patients were found to be statistically significantly higher than in healthy controls. KEY POINTS • Cerebral sodium MRI supports the theory of ionic imbalances and may aid in the challenging pathophysiologic understanding of migraine. • Case-control study shows significantly higher sodium concentrations in cerebrospinal fluid of migraineurs. • Cerebral sodium MRI may become a non-invasive imaging tool for drugs to modulate sodium, and hence migraine, on a molecular level, and influence patient management.
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Affiliation(s)
- Melissa M Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Alexander Schmidt
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Justus Benrath
- Clinic for Anaesthesiology and Operative Intensive Care, University of Heidelberg, Mannheim, Germany
| | | | - Lothar R Pilz
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Mathias Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Stefan Haneder
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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22
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Boehmert L, Kuehne A, Waiczies H, Wenz D, Eigentler TW, Funk S, Knobelsdorff‐Brenkenhoff F, Schulz‐Menger J, Nagel AM, Seeliger E, Niendorf T. Cardiorenal sodium MRI at 7.0 Tesla using a 4/4 channel
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Na radiofrequency antenna array. Magn Reson Med 2019; 82:2343-2356. [DOI: 10.1002/mrm.27880] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Laura Boehmert
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | | | | | - Daniel Wenz
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Thomas Wilhelm Eigentler
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
| | - Stephanie Funk
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine Helios Clinics Berlin‐Buch Berlin Germany
| | - Florian Knobelsdorff‐Brenkenhoff
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine Helios Clinics Berlin‐Buch Berlin Germany
- Clinic Agatharied, Dept. of Cardiology Academic Teaching Hospital of the Ludwig‐Maximilians‐University Munich Hausham Germany
| | - Jeanette Schulz‐Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine Helios Clinics Berlin‐Buch Berlin Germany
- DZHK (German Centre for Cardiovascular Research) partner site Berlin Germany
| | - Armin M. Nagel
- Institute of Radiology University Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Erlangen Germany
- Division of Medical Physics in Radiology German Cancer Research Centre (DKFZ) Heidelberg Germany
- Institute of Medical Physics University of Erlangen, Friedrich‐Alexander‐Universität Erlangen‐Nürnberg (FAU) Erlangen Germany
| | - Erdmann Seeliger
- Institute of Vegetative Physiology Charité University Medicine Berlin Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.) Max Delbrück Center for Molecular Medicine in the Helmholtz Association Berlin Germany
- MRI.TOOLS GmbH Berlin Germany
- DZHK (German Centre for Cardiovascular Research) partner site Berlin Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine Berlin Germany
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Abstract
In this article, an overview of the current developments and research applications for non-proton magnetic resonance imaging (MRI) at ultrahigh magnetic fields (UHFs) is given. Due to technical and methodical advances, efficient MRI of physiologically relevant nuclei, such as Na, Cl, Cl, K, O, or P has become feasible and is of interest to obtain spatially and temporally resolved information that can be used for biomedical and diagnostic applications. Sodium (Na) MRI is the most widespread multinuclear imaging method with applications ranging over all regions of the human body. Na MRI yields the second largest in vivo NMR signal after the clinically used proton signal (H). However, other nuclei such as O and P (energy metabolism) or Cl and K (cell viability) are used in an increasing number of MRI studies at UHF. One major advancement has been the increased availability of whole-body MR scanners with UHFs (B0 ≥7T) expanding the range of detectable nuclei. Nevertheless, efforts in terms of pulse sequence and post-processing developments as well as hardware designs must be made to obtain valuable information in clinically feasible measurement times. This review summarizes the available methods in the field of non-proton UHF MRI, especially for Na MRI, as well as introduces potential applications in clinical research.
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Affiliation(s)
- Sebastian C Niesporek
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Armin M Nagel
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Tanja Platt
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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24
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Hu R, Kleimaier D, Malzacher M, Hoesl MA, Paschke NK, Schad LR. X‐nuclei imaging: Current state, technical challenges, and future directions. J Magn Reson Imaging 2019; 51:355-376. [DOI: 10.1002/jmri.26780] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ruomin Hu
- Computer Assisted Clinical MedicineHeidelberg University Mannheim Germany
| | - Dennis Kleimaier
- Computer Assisted Clinical MedicineHeidelberg University Mannheim Germany
| | - Matthias Malzacher
- Computer Assisted Clinical MedicineHeidelberg University Mannheim Germany
| | | | - Nadia K. Paschke
- Computer Assisted Clinical MedicineHeidelberg University Mannheim Germany
| | - Lothar R. Schad
- Computer Assisted Clinical MedicineHeidelberg University Mannheim Germany
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Deen SS, Riemer F, McLean MA, Gill AB, Kaggie JD, Grist JT, Crawford R, Latimer J, Baldwin P, Earl HM, Parkinson CA, Smith SA, Hodgkin C, Moore E, Jimenez-Linan M, Brodie CR, Addley HC, Freeman SJ, Moyle PL, Sala E, Graves MJ, Brenton JD, Gallagher FA. Sodium MRI with 3D-cones as a measure of tumour cellularity in high grade serous ovarian cancer. Eur J Radiol Open 2019; 6:156-162. [PMID: 31032385 PMCID: PMC6477161 DOI: 10.1016/j.ejro.2019.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/10/2019] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to assess the feasibility of rapid sodium MRI (23Na-MRI) for the imaging of peritoneal cancer deposits in high grade serous ovarian cancer (HGSOC) and to evaluate the relationship of 23Na-MRI with tumour cellularity. 23Na-MRI was performed at 3 T on twelve HGSOC patients using a 3D-cones acquisition technique. Tumour biopsies specimens were collected after imaging and cellularity was measured from histology. Total 23Na-MRI scan time for each patient was approximately 11 min. At an isotropic resolution of 5.6 mm, signal-to-noise ratios (SNRs) of 82.2 ± 15.3 and 15.1 ± 7.1 (mean ± standard deviation) were achieved for imaging of tumour tissue sodium concentration (TSC) and intracellular weighted sodium concentration (IWS) respectively. Tumour TSC and IWS concentrations were: 56.8 ± 19.1 mM and 30.8 ± 9.2 mM respectively and skeletal muscle TSC and IWS concentrations were 33.2 ± 16.3 mM and 20.5 ± 9.9 mM respectively. There were significant sodium concentration differences between cancer and skeletal muscle, Wilcoxon signed-rank test, P < 0.001 for TSC and P = 0.01 for IWS imaging. Tumour cellularity displayed a strong negative correlation with TSC, Spearman's rho = -0.92, P < 0.001, but did not correlate with IWS. This study demonstrates that 23Na-MRI using 3D-cones can rapidly assess sodium concentration in peritoneal deposits of HGSOC and that TSC may serve as a biomarker of tumour cellularity.
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Affiliation(s)
- Surrin S. Deen
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Frank Riemer
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Mary A. McLean
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Andrew B. Gill
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Joshua D. Kaggie
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - James T. Grist
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Robin Crawford
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - John Latimer
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Peter Baldwin
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Helena M. Earl
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Christine A. Parkinson
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Sarah A. Smith
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Charlotte Hodgkin
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Elizabeth Moore
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Mercedes Jimenez-Linan
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Cara R. Brodie
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Helen C. Addley
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Susan J. Freeman
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Penelope L. Moyle
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Martin J. Graves
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - James D. Brenton
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | - Ferdia A. Gallagher
- Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, United Kingdom
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26
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Meyer MM, Haneder S, Konstandin S, Budjan J, Morelli JN, Schad LR, Kerl HU, Schoenberg SO, Kabbasch C. Repeatability and reproducibility of cerebral 23Na imaging in healthy subjects. BMC Med Imaging 2019; 19:26. [PMID: 30943911 PMCID: PMC6446283 DOI: 10.1186/s12880-019-0324-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 03/11/2019] [Indexed: 02/04/2023] Open
Abstract
Background Initial reports of 23Na magnetic resonance imaging (MRI) date back to the 1970s. However, methodological challenges of the technique hampered its widespread adoption for many years. Recent technical developments have overcome some of these limitations and have led to more optimal conditions for 23Na-MR imaging. In order to serve as a reliable tool for the assessment of clinical stroke or brain tumor patients, we investigated the repeatability and reproducibility of cerebral sodium (23Na) imaging in healthy subjects. Methods In this prospective, IRB approved study 12 consecutive healthy volunteers (8 female, age 31 ± 8.3) underwent three cerebral 23Na-MRI examinations at 3.0 T (TimTrio, Siemens Healthineers) distributed between two separate visits with an 8 day interval. For each scan a T1w MP-RAGE sequence for anatomical referencing and a 3D-density-adapted, radial GRE-sequence for 23Na-imaging were acquired using a dual-tuned (23Na/1H) head-coil. On 1 day, these scans were repeated consecutively; on the other day, the scans were performed once. 23Na-sequences were reconstructed according to the MP-RAGE sequence, allowing direct cross-referencing of ROIs. Circular ROIs were placed in predetermined anatomic regions: gray and white matter (GM, WM), head of the caudate nucleus (HCN), pons, and cerebellum. External 23Na-reference phantoms were used to calculate the tissue sodium content. Results Excellent correlation was found between repeated measurements on the same day (r2 = 0.94), as well as on a different day (r2 = 0.86). No significant differences were found based on laterality other than in the HCN (63.1 vs. 58.7 mmol/kg WW on the right (p = 0.01)). Pronounced inter-individual differences were identified in all anatomic regions. Moderate to good correlation (0.310 to 0.701) was found between the readers. Conclusion Our study has shown that intra-individual 23Na-concentrations in healthy subjects do not significantly differ after repeated scans on the same day and a pre-set time interval. This confirms the repeatability and reproducibility of cerebral 23Na-imaging. However, with manual ROI placement in predetermined anatomic landmarks, fluctuations in 23Na-concentrations can be observed.
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Affiliation(s)
- Melissa M Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - John N Morelli
- St. John's Medical Center, 1923 South Utica Ave, Tulsa, OK, 74104, USA
| | - Lothar R Schad
- Department of Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | - Hans U Kerl
- Department of Neuroradiology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christoph Kabbasch
- Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, University of Cologne, Cologne, Germany
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Ladd ME, Bachert P, Meyerspeer M, Moser E, Nagel AM, Norris DG, Schmitter S, Speck O, Straub S, Zaiss M. Pros and cons of ultra-high-field MRI/MRS for human application. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 109:1-50. [PMID: 30527132 DOI: 10.1016/j.pnmrs.2018.06.001] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 05/08/2023]
Abstract
Magnetic resonance imaging and spectroscopic techniques are widely used in humans both for clinical diagnostic applications and in basic research areas such as cognitive neuroimaging. In recent years, new human MR systems have become available operating at static magnetic fields of 7 T or higher (≥300 MHz proton frequency). Imaging human-sized objects at such high frequencies presents several challenges including non-uniform radiofrequency fields, enhanced susceptibility artifacts, and higher radiofrequency energy deposition in the tissue. On the other side of the scale are gains in signal-to-noise or contrast-to-noise ratio that allow finer structures to be visualized and smaller physiological effects to be detected. This review presents an overview of some of the latest methodological developments in human ultra-high field MRI/MRS as well as associated clinical and scientific applications. Emphasis is given to techniques that particularly benefit from the changing physical characteristics at high magnetic fields, including susceptibility-weighted imaging and phase-contrast techniques, imaging with X-nuclei, MR spectroscopy, CEST imaging, as well as functional MRI. In addition, more general methodological developments such as parallel transmission and motion correction will be discussed that are required to leverage the full potential of higher magnetic fields, and an overview of relevant physiological considerations of human high magnetic field exposure is provided.
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Affiliation(s)
- Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany; Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen, Germany.
| | - Peter Bachert
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany.
| | - Martin Meyerspeer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
| | - Ewald Moser
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
| | - Armin M Nagel
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - David G Norris
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands; Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen, Germany.
| | - Sebastian Schmitter
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; German Center for Neurodegenerative Diseases, Magdeburg, Germany; Center for Behavioural Brain Sciences, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany.
| | - Sina Straub
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Moritz Zaiss
- High-Field Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany.
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Platt T, Umathum R, Fiedler TM, Nagel AM, Bitz AK, Maier F, Bachert P, Ladd ME, Wielpütz MO, Kauczor HU, Behl NG. In vivo self-gated 23
Na MRI at 7 T using an oval-shaped body resonator. Magn Reson Med 2018; 80:1005-1019. [DOI: 10.1002/mrm.27103] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Tanja Platt
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Reiner Umathum
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Thomas M. Fiedler
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Armin M. Nagel
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Institute of Radiology; University Hospital Erlangen, Maximiliansplatz 3; 91054 Erlangen Germany
| | - Andreas K. Bitz
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Electrical Engineering and Information Technology; University of Applied Sciences Aachen, Eupener Str. 70; 52066 Aachen Germany
| | - Florian Maier
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Peter Bachert
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Physics and Astronomy; University of Heidelberg, Im Neuenheimer Feld 226; 69120 Heidelberg Germany
| | - Mark E. Ladd
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Physics and Astronomy; University of Heidelberg, Im Neuenheimer Feld 226; 69120 Heidelberg Germany
- Faculty of Medicine; University of Heidelberg, Im Neuenheimer Feld 672; 69120 Heidelberg Germany
| | - Mark O. Wielpütz
- Translational Lung Research Center (TLRC); University of Heidelberg, German Center for Lung Research (DZL), Im Neuenheimer Feld 430; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology; University Hospital of Heidelberg, Im Neuenheimer Feld 110; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine; Thoraxklinik at University of Heidelberg, Röntgenstr. 1; 69126 Heidelberg Germany
| | - Hans-Ulrich Kauczor
- Translational Lung Research Center (TLRC); University of Heidelberg, German Center for Lung Research (DZL), Im Neuenheimer Feld 430; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology; University Hospital of Heidelberg, Im Neuenheimer Feld 110; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine; Thoraxklinik at University of Heidelberg, Röntgenstr. 1; 69126 Heidelberg Germany
| | - Nicolas G.R. Behl
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
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29
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Lommen JM, Flassbeck S, Behl NG, Niesporek S, Bachert P, Ladd ME, Nagel AM. Probing the microscopic environment of 23
Na ions in brain tissue by MRI: On the accuracy of different sampling schemes for the determination of rapid, biexponential T2* decay at low signal-to-noise ratio. Magn Reson Med 2018; 80:571-584. [DOI: 10.1002/mrm.27059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/21/2017] [Accepted: 12/05/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Jonathan M. Lommen
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Sebastian Flassbeck
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Nicolas G.R. Behl
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Sebastian Niesporek
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Peter Bachert
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
- University of Heidelberg, Faculty of Physics and Astronomy; Heidelberg Germany
| | - Mark E. Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
- University of Heidelberg, Faculty of Physics and Astronomy; Heidelberg Germany
- University of Heidelberg, Faculty of Medicine; Heidelberg Germany
| | - Armin M. Nagel
- Medical Physics in Radiology, German Cancer Research Center (DKFZ); Heidelberg Germany
- Institute of Radiology; University Hospital Erlangen; Erlangen Germany
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30
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Francis S, Buchanan CE, Prestwich B, Taal MW. Sodium MRI: a new frontier in imaging in nephrology. Curr Opin Nephrol Hypertens 2017; 26:435-441. [PMID: 28877041 DOI: 10.1097/mnh.0000000000000370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW This review focuses on the recent technological advances in quantitative sodium (Na) MRI to provide a noninvasive measure of tissue viability for use in clinical studies of patients with kidney disease. Na MRI is the only noninvasive imaging technique that allows for the absolute spatial quantification of tissue sodium concentration (TSC), providing assessment of the corticomedullary sodium gradient (CMSG) in the kidney, and allowing measures of TSC in the skin and muscle. RECENT FINDINGS Na MRI of the kidney has demonstrated the sensitivity to measure the CMSG, providing the normal range in healthy individuals and demonstrating a reduction in CMSG in kidney disease and transplanted kidneys. Studies using Na and H MRI have shown that in humans, skeletal muscle and skin can store sodium without water retention, and that sodium concentrations in muscle and skin increase with advancing age. Recent studies have shown that TSC can be mobilised during haemodialysis, and that skin sodium content links closely to left ventricular mass in patients with chronic kidney disease. SUMMARY Na MRI is currently a research technique, but with future advances, Na MRI has potential to become a noninvasive renal biomarker and a measure of tissue sodium storage for clinical studies.
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Affiliation(s)
- Susan Francis
- aSir Peter Mansfield Imaging Centre, School of Physics and Astronomy bCentre for Kidney Research and Innovation, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, United Kingdom
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Grenier N, Merville P, Combe C. Radiologic imaging of the renal parenchyma structure and function. Nat Rev Nephrol 2016; 12:348-59. [DOI: 10.1038/nrneph.2016.44] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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de Boer A, Hoogduin JM, Blankestijn PJ, Li X, Luijten PR, Metzger GJ, Raaijmakers AJE, Umutlu L, Visser F, Leiner T. 7 T renal MRI: challenges and promises. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:417-33. [PMID: 27008461 PMCID: PMC4891364 DOI: 10.1007/s10334-016-0538-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/02/2016] [Accepted: 02/15/2016] [Indexed: 01/07/2023]
Abstract
The progression to 7 Tesla (7 T) magnetic resonance imaging (MRI) yields promises of substantial increase in signal-to-noise (SNR) ratio. This increase can be traded off to increase image spatial resolution or to decrease acquisition time. However, renal 7 T MRI remains challenging due to inhomogeneity of the radiofrequency field and due to specific absorption rate (SAR) constraints. A number of studies has been published in the field of renal 7 T imaging. While the focus initially was on anatomic imaging and renal MR angiography, later studies have explored renal functional imaging. Although anatomic imaging remains somewhat limited by inhomogeneous excitation and SAR constraints, functional imaging results are promising. The increased SNR at 7 T has been particularly advantageous for blood oxygen level-dependent and arterial spin labelling MRI, as well as sodium MR imaging, thanks to changes in field-strength-dependent magnetic properties. Here, we provide an overview of the currently available literature on renal 7 T MRI. In addition, we provide a brief overview of challenges and opportunities in renal 7 T MR imaging.
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Affiliation(s)
- Anneloes de Boer
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands
| | - Johannes M Hoogduin
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Peter J Blankestijn
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Xiufeng Li
- Department of Radiology, Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Peter R Luijten
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands
| | - Gregory J Metzger
- Department of Radiology, Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Alexander J E Raaijmakers
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Fredy Visser
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands.,Philips Healthcare, Best, The Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Centre Utrecht, Post box 85500, 3508 GA, Utrecht, The Netherlands
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Zöllner FG, Konstandin S, Lommen J, Budjan J, Schoenberg SO, Schad LR, Haneder S. Quantitative sodium MRI of kidney. NMR IN BIOMEDICINE 2016; 29:197-205. [PMID: 25728879 DOI: 10.1002/nbm.3274] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/13/2015] [Accepted: 01/25/2015] [Indexed: 05/25/2023]
Abstract
One of the main tasks of the human kidneys is to maintain the homeostasis of the body's fluid and electrolyte balance by filtration of the plasma and excretion of the end products. Herein, the regulation of extracellular sodium in the kidney is of particular importance. Sodium MRI ((23)Na MRI) allows for the absolute quantification of the tissue sodium concentration (TSC) and thereby provides a direct link between TSC and tissue viability. Renal (23)Na MRI can provide new insights into physiological tissue function and viability thought to differ from the information obtained by standard (1)H MRI. Sodium imaging has the potential to become an independent surrogate biomarker not only for renal imaging, but also for oncology indications. However, this technique is now on the threshold of clinical implementation. Numerous, initial pre-clinical and clinical studies have already outlined the potential of this technique; however, future studies need to be extended to larger patient groups to show the diagnostic outcome. In conclusion, (23)Na MRI is seen as a powerful technique with the option to establish a non-invasive renal biomarker for tissue viability, but is still a long way from real clinical implementation.
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Affiliation(s)
- Frank G Zöllner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simon Konstandin
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- MR-Imaging and Spectroscopy, Faculty 01 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Jonathan Lommen
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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Shah NJ, Worthoff WA, Langen KJ. Imaging of sodium in the brain: a brief review. NMR IN BIOMEDICINE 2016; 29:162-174. [PMID: 26451752 DOI: 10.1002/nbm.3389] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/30/2015] [Accepted: 08/07/2015] [Indexed: 06/05/2023]
Abstract
Sodium-based MRI plays a vital role in the study of metabolism and can unveil valuable information about emerging and existing pathology--in particular in the human brain. Sodium is the second most abundant MR active nucleus in living tissue and, due to its quadrupolar nature, has magnetic properties not common to conventional proton MRI, which can reveal further insights, such as information on the compartmental distribution of intra- and extracellular sodium. Nevertheless, the use of sodium nuclei for imaging comes at the expense of a lower sensitivity and significantly reduced relaxation times, making in vivo sodium studies feasible only at high magnetic field strength and by the use of dedicated pulse sequences. Hybrid imaging combining sodium MRI and positron emission tomography (PET) simultaneously is a novel and promising approach to access information on dynamic metabolism with much increased, PET-derived specificity. Application of this new methodology is demonstrated herein using examples from tumour imaging.
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Affiliation(s)
- N Jon Shah
- Institute of Neuroscience and Medicine-4, Forschungszentrum Juelich GmbH, 52425, Jülich, Germany
- Department of Neurology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine, Aachen and Jülich, Germany
| | - Wieland A Worthoff
- Institute of Neuroscience and Medicine-4, Forschungszentrum Juelich GmbH, 52425, Jülich, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine-4, Forschungszentrum Juelich GmbH, 52425, Jülich, Germany
- Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine, Aachen and Jülich, Germany
- Department of Nuclear Medicine, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
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Lommen J, Konstandin S, Krämer P, Schad LR. Enhancing the quantification of tissue sodium content by MRI: time-efficient sodium B1 mapping at clinical field strengths. NMR IN BIOMEDICINE 2016; 29:129-136. [PMID: 25904161 DOI: 10.1002/nbm.3292] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/19/2015] [Accepted: 03/03/2015] [Indexed: 06/04/2023]
Abstract
Tissue sodium content (TSC) is a sensitive measure of pathological changes and can be detected non-invasively by MRI. For the absolute quantification of TSC, B1 inhomogeneities must be corrected, which is not well established beyond research applications. An in-depth analysis of B1 mapping methods which are suitable for application in TSC quantification is presented. On the basis of these results, a method for simultaneous B1 mapping and imaging is proposed in order to enhance accuracy and to reduce measurement time at clinical field strengths. The B1 mapping techniques used were phase-sensitive (PS), Bloch-Siegert shift (BSS), double-angle (DAM) and actual flip-angle imaging (AFI) methods. Experimental and theoretical comparisons demonstrated that the PS technique yields the most accurate field profiles and exhibits the highest signal-to-noise ratio (SNR). Simultaneous B1 mapping and imaging was performed for the PS method, employing both degrees of freedom of the MR signal: the B1 field is encoded into signal phase and the amplitude provides the concentration information. In comparison with the more established DAM, a 13% higher SNR was obtained and field effects could be corrected more accurately without the need for additional measurement time. The protocol developed was applied to measure TSC in the healthy human head at an isotropic resolution of 4 mm. TSC was determined to be 35 ± 1 mM in white matter and 134 ± 3 mM in vitreous humor. By employing the proposed simultaneous characterization of the B1 field and acquisition of the spin density-weighted sodium signal, the accuracy of the non-invasive measurement of TSC is enhanced and the measurement time is reduced. This should allow (23)Na MRI to be better incorporated into clinical studies and routine.
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Affiliation(s)
- Jonathan Lommen
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon Konstandin
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
- MR-Imaging and Spectroscopy, Faculty 01 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Philipp Krämer
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
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Bangerter NK, Kaggie JD, Taylor MD, Hadley JR. Sodium MRI radiofrequency coils for body imaging. NMR IN BIOMEDICINE 2016; 29:107-118. [PMID: 26417667 DOI: 10.1002/nbm.3392] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 06/05/2023]
Abstract
The proliferation of high-field whole-body systems, advances in gradient performance and refinement of signal-to-noise ratio (SNR)-efficient short-TE sequences suitable for sodium imaging have led to a resurgence of interest in sodium imaging for body applications. With this renewed interest has come increased demand for SNR-efficient sodium coils. Efficient coils can significantly increase SNR in sodium imaging, allowing higher resolutions and/or shorter scan times. In this work, we focus on body imaging applications of sodium MRI, and review developments in MRI radiofrequency (RF) coil topologies for sodium imaging. We first provide a brief discussion of RF coil design considerations in sodium imaging. This is followed by an overview of common coil topologies, their advantages and disadvantages, and examples of each.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical and Computer Engineering, Brigham Young University, Provo, UT, USA
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Joshua D Kaggie
- Department of Physics, University of Utah, Salt Lake City, UT, USA
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Meredith D Taylor
- Department of Electrical and Computer Engineering, Brigham Young University, Provo, UT, USA
| | - J Rock Hadley
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
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[Functional MRI 2.0. ²³Na and CEST imaging]. Radiologe 2016; 56:159-69. [PMID: 26796336 DOI: 10.1007/s00117-015-0071-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In recent years the purely morphological magnetic resonance imaging (MRI) has been increasingly flanked by so-called functional imaging methods, such as diffusion-weighted imaging (DWI), to obtain additional information about tissue or pathological processes. This review article presents two MR techniques that can detect physiological processes in the human body. In contrast to all other functional MR imaging techniques, which are based on hydrogen protons, the first technique presented (X-nuclei imaging) uses the spin of other nuclei for imaging and consequently allows a completely different insight into the human body. In this article X-nuclei imaging is focused on sodium ((23)Na) MRI because it currently represents the main focus of research in this field due to the favorable MR properties of sodium. The second MR technique presented is the relatively novel chemical exchange saturation transfer (CEST) imaging that can detect exchange processes between protons in metabolites and protons in free water. The first part of this article introduces the basic technical principles, problems, advantages and disadvantages of these two MR techniques, whereas the second part highlights the potential clinical applications. Examples illustrate several potential applications in neuroimaging (e. g. stroke and tumors), musculoskeletal imaging (e. g. osteoarthritis and degenerative processes) and abdominal imaging (e. g. kidneys and hypertension). Both techniques inherently contain an incredible potential for future imaging but are still on the threshold of clinical use and are currently under evaluation in many university centers.
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Perspectives of Novel Imaging Techniques for Staging, Therapy Response Assessment, and Monitoring of Surveillance in Lung Cancer: Summary of the Dresden 2013 Post WCLC-IASLC State-of-the-Art Imaging Workshop. J Thorac Oncol 2015; 10:237-49. [DOI: 10.1097/jto.0000000000000412] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Dose-dependent changes in renal (1)H-/(23)Na MRI after adjuvant radiochemotherapy for gastric cancer. Strahlenther Onkol 2014; 191:356-64. [PMID: 25445156 DOI: 10.1007/s00066-014-0787-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Combined radiochemotherapy (RCT) for gastric cancer with three-dimensional conformal radiotherapy (3D-CRT) results in ablative doses to the upper left kidney, while image-guided intensity-modulated radiotherapy (IG-IMRT) allows kidney sparing despite improved target coverage. Renal function in long-term gastric cancer survivors was evaluated with 3T functional magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) and (23)Na imaging. PATIENTS AND METHODS Five healthy volunteers and 13 patients after radiotherapy were included: 11×IG-IMRT; 1×3D-CRT; 1× "positive control" with stereotactic body radiotherapy (SBRT) of a metastasis between the spleen/left kidney. Radiation doses were documented for the upper/middle/lower kidney subvolumes. Late toxicity was evaluated based on CTC criteria, questionnaire, and creatinine values. Morphological sequences, DWI images, and (23)Na images were acquired using a (1)H/(23)Na-tuned body-coil before/after intravenous water load (WL). Statistics for [(23)Na] (concentration) and apparent diffusion coefficient (ADC) values were calculated for upper/middle/lower renal subvolumes. Corticomedullary [(23)Na] gradients and [(23)Na] differences after WL were determined. RESULTS No major morphological alteration was detected in any patient. Minor scars were observed in the cranial subvolume of the left kidney of the 3D-CRT and the whole kidney of the control SBRT patient. All participants presented a corticomedullary [(23)Na] gradient. After WL, a significant physiological [(23)Na] gradient decrease (p < 0.001) was observed in all HV and IG-IMRT patients. In the cranial left kidney of the 3D-CRT patient and the positive control SBRT patient, the decrease was nonsignificant (p = 0.01, p = 0.02). ADC values were altered nonsignificantly in all renal subvolumes (all participants). Renal subvolumes with doses ≥ 35 Gy showed a reduced change of the [(23)Na] gradient after WL (p = 0.043). No participants showed clinical renal impairment. CONCLUSIONS Functional parameters of renal (23)Na MRI after gastric IG-IMRT are identical to those of healthy volunteers, in contrast to renal subvolumes after ablative doses in the control and 3D-CRT patient. While kidney doses to the cortex below 20-25 Gy in fractional doses of ~ 1 Gy in IG-IMRT (combined with intensified chemotherapy) do not seem to cause significant MRI morphological or functional alterations, doses of > 35 Gy in 1.5-2 Gy fractions clearly result in impairment.
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Zöllner FG, Kalayciyan R, Chacón-Caldera J, Zimmer F, Schad LR. Pre-clinical functional Magnetic Resonance Imaging part I: The kidney. Z Med Phys 2014; 24:286-306. [DOI: 10.1016/j.zemedi.2014.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 01/10/2023]
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Farag A, Peterson JC, Szekeres T, Bauman G, Chin J, Romagnoli C, Bartha R, Scholl TJ. Unshielded asymmetric transmit-only and endorectal receive-only radiofrequency coil for23Na MRI of the prostate at 3 tesla. J Magn Reson Imaging 2014; 42:436-45. [DOI: 10.1002/jmri.24798] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/23/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Adam Farag
- Imaging Research Laboratories, Robarts Research Institute, Western University; London ON Canada, N6A 5B7
| | | | - Trevor Szekeres
- Imaging Research Laboratories, Robarts Research Institute, Western University; London ON Canada, N6A 5B7
| | - Glenn Bauman
- Department of Medical Biophysics; Western University; London ON Canada, N6A 5C1
- London Regional Cancer Program; London ON Canada, N6A 4L6
| | - Joseph Chin
- London Regional Cancer Program; London ON Canada, N6A 4L6
| | - Cesare Romagnoli
- Imaging Research Laboratories, Robarts Research Institute, Western University; London ON Canada, N6A 5B7
| | - Robert Bartha
- Imaging Research Laboratories, Robarts Research Institute, Western University; London ON Canada, N6A 5B7
- Department of Medical Biophysics; Western University; London ON Canada, N6A 5C1
| | - Timothy J. Scholl
- Imaging Research Laboratories, Robarts Research Institute, Western University; London ON Canada, N6A 5B7
- Department of Medical Biophysics; Western University; London ON Canada, N6A 5C1
- Ontario Institute for Cancer Research; Toronto ON Canada, M5G 1L7
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Haneder S, Ong MML, Budjan JM, Schmidt R, Konstandin S, Morelli JN, Schad LR, Schoenberg SO, Kerl UH. 23Na-magnetic resonance imaging of the human lumbar vertebral discs: in vivo measurements at 3.0 T in healthy volunteers and patients with low back pain. Spine J 2014; 14:1343-50. [PMID: 24472875 DOI: 10.1016/j.spinee.2014.01.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/12/2013] [Accepted: 01/17/2014] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT 1H magnetic resonance imaging (MRI) of the spine can rule out common causes of low back pain (LBP), such as disc protrusions or nerve root compression; however, no significant causal relation exists between morphology and the extent of symptoms. Functional MRI techniques, such as 23Na, may provide additional information, allowing indirect assessment of vertebral glycosaminoglycan concentrations, decreases in which are associated with early degenerative changes. PURPOSE To evaluate 23Na-MRI of asymptomatic healthy volunteers and symptomatic patients with LPB and correlate the results to the Pfirrmann classification of MRI disc morphology. STUDY DESIGN Retrospective cohort study at an academic medical center. PATIENT SAMPLE Two groups were studied: (1) 55 healthy volunteers (31 men, 24 women; mean age 28.8 years) and (2) 12 patients (6 men, 6 women; mean age: 35.3 years) with a recent history of LBP. METHODS Lumbar spines of the aforementioned groups were examined on a 3.0 T MRI scanner with morphological 1H and 23Na imaging. Intervertebral disc (IVD) 23Na at each level was normalized (23Nanorm). Distribution and differences between mean 23Nanorm corresponding to each Pfirrmann classification were evaluated in the two study groups (analysis of variance). Linear correlations between 23Nanorm, body mass index (BMI), and age were assessed (Pearson correlation coefficient). Gender-dependent differences were evaluated (paired t test). OUTCOME MEASURES Physiological measure: IVD 23Nanorm as determined by 23Na-MRI. RESULTS A normal distribution of 23Nanorm was confirmed for both groups (p=.072 and p=.073, respectively). The mean Pfirrmann score statistically significantly differed between them (p<.0001). 23Nanorm was statistically significantly reduced in degenerated IVDs (Pfirrmann scores 4+5) (p<.0001). No statistically significant differences were seen for the mean 23Nanorm of IVDs with the same Pfirrmann score in healthy volunteers and patients (.469<p<.967). Age (0.007<R2<0.202) and BMI (0.074<R2<0.288) showed either weak or no correlation to 23Nanorm. Mean 23Nanorm was significantly (p=.0002) greater in women relative to men. CONCLUSIONS The results underline the feasibility and robustness of 23Na-MRI of human IVDs and affirm, in a large cohort, decreases in 23Na IVD content seen with disc degeneration.
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Affiliation(s)
- Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Melissa M L Ong
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Johannes M Budjan
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - René Schmidt
- Department of Orthopedic and Traumatology, Alb-Fils Hospital Goeppingen, Eicherstr. 3, 73035 Goeppingen, Germany
| | - Simon Konstandin
- Computer Assisted Clinical Medicine, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - John N Morelli
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287-0006, USA
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Ulrich H Kerl
- Department of Neuroradiology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Moon CH, Furlan A, Kim JH, Zhao T, Shapiro R, Bae KT. Quantitative sodium MR imaging of native versus transplanted kidneys using a dual-tuned proton/sodium (1H/ 23Na) coil: initial experience. Eur Radiol 2014; 24:1320-6. [PMID: 24668008 DOI: 10.1007/s00330-014-3138-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 01/26/2014] [Accepted: 02/18/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare sodium ((23)Na) characteristics between native and transplanted kidneys using dual-tuned proton ((1)H)/sodium MRI. METHODS Six healthy volunteers and six renal transplant patients (3 normal function, 3 acute allograft rejection) were included. Proton/sodium MRI was obtained at 3 T using a dual-tuned coil. Signal to noise ratio (SNR), sodium concentration ([(23)Na]) and cortico-medullary sodium gradient (CMSG) were measured. Reproducibility of [(23)Na] measurement was also tested. SNR, [(23)Na] and CMSG of the native and transplanted kidneys were compared. RESULTS Proton and sodium images of kidneys were successfully acquired. SNR and [(23)Na] measurements of the native kidneys were reproducible at two different sessions. [(23)Na] and CMSG of the transplanted kidneys was significantly lower than those of the native kidneys: 153.5 ± 11.9 vs. 192.9 ± 9.6 mM (P = 0.002) and 8.9 ± 1.5 vs. 10.5 ± 0.9 mM/mm (P = 0.041), respectively. [(23)Na] and CMSG of the transplanted kidneys with normal function vs. acute rejection were not statistically different. CONCLUSIONS Sodium quantification of kidneys was reliably performed using proton/sodium MRI. [(23)Na] and CMSG of the transplanted kidneys were lower than those of the native kidneys, but without a statistically significant difference between patients with or without renal allograft rejection. KEY POINTS Dual-tuned proton/sodium RF coil enables co-registered proton and sodium MRI. Structural and sodium biochemical property can be acquired by dual-tuned proton/sodium MRI. Sodium and sodium gradient of kidneys can be measured by dual-tuned MRI. Sodium concentration was lower in transplanted kidneys than in native kidneys. Sodium gradient of transplanted kidneys was lower than for native kidneys.
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Affiliation(s)
- Chan Hong Moon
- Department of Radiology, University of Pittsburgh, 200 Lothrop Street, Presby South tower Suite 3950, Pittsburgh, PA, 15213, USA
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Gai ND, Rochitte C, Nacif MS, Bluemke DA. Optimized three-dimensional sodium imaging of the human heart on a clinical 3T scanner. Magn Reson Med 2014; 73:623-32. [PMID: 24639022 DOI: 10.1002/mrm.25175] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 01/14/2014] [Accepted: 01/20/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE Optimization of sequence and sequence parameters to allow three-dimensional (3D) sodium imaging of the entire human heart in vivo in a clinically reasonable time. THEORY AND METHODS A stack of spirals pulse sequence was optimized for cardiac imaging by considering factors such as spoiling, nutation angles, repetition time, echo time, T1/T2 relaxation, off-resonance, data acquisition window, motion, and segmented k-space acquisition. Simulations based on Bloch equations as well as the exact trajectory used for data acquisition provided the basis for choice of parameter combinations for sodium imaging. Sodium phantom scanning was used to validate the choice of parameters and for corroboration with simulations. In vivo cardiac imaging in six volunteers was also performed with an optimized sequence. RESULTS Phantom studies showed good correlation with simulation results. Images obtained from human volunteers showed that the heart can be imaged with a nominal resolution of 5 × 5 × 10 mm(3) and with a signal-to-noise ratio >15 (in the septum) in about 6-10 minutes. Long axis views of the reformatted human heart show true 3D imaging capability. CONCLUSION Optimization of the sequence and its parameters allowed in vivo 3D sodium imaging of the entire human heart in a clinically reasonable time.
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Affiliation(s)
- Neville D Gai
- Radiology & Imaging Sciences, National Institutes of Health, Bethesda, MD, USA
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Konstandin S, Schad LR. 30 Years of sodium/X-nuclei magnetic resonance imaging. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 27:1-4. [PMID: 24449020 DOI: 10.1007/s10334-013-0426-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/08/2013] [Accepted: 11/22/2013] [Indexed: 12/24/2022]
Abstract
In principle, all nuclei with nonzero spin can be employed for magnetic resonance imaging (MRI). Special scanner hardware and MR sequences are required to select the nucleus-specific frequency and to enable imaging with "sufficient" signal-to-noise ratio. This Special Issue starts with an overview of different nuclei that can be used for MRI today, followed by a review article about techniques required for imaging of quadrupolar nuclei with short relaxation times. Sequence developments to improve image quality and applications on different organs and diseases are presented for different nuclei ((23)Na, (35)Cl, (17)O, and (19)F), with a focus on imaging at natural abundance.
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Affiliation(s)
- Simon Konstandin
- Computer Assisted Clinical Medicine, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
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Haneder S, Juras V, Michaely HJ, Deligianni X, Bieri O, Schoenberg SO, Trattnig S, Zbýň Š. In vivo sodium (23Na) imaging of the human kidneys at 7 T: Preliminary results. Eur Radiol 2013; 24:494-501. [DOI: 10.1007/s00330-013-3032-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/02/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
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Konstandin S, Nagel AM. Measurement techniques for magnetic resonance imaging of fast relaxing nuclei. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 27:5-19. [PMID: 23881004 DOI: 10.1007/s10334-013-0394-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 12/24/2022]
Abstract
In this review article, techniques for sodium ((23)Na) magnetic resonance imaging (MRI) are presented. These techniques can also be used to image other nuclei with short relaxation times (e.g., (39)K, (35)Cl, (17)O). Twisted projection imaging, density-adapted 3D projection reconstruction, and 3D cones are preferred because of uniform k-space sampling and ultra-short echo times. Sampling density weighted apodization can be applied if intrinsic filtering is desired. This approach leads to an increased signal-to-noise ratio compared to postfiltered acquisition in cases of short readout durations relative to T 2 (*) relaxation time. Different MR approaches for anisotropic resolution are presented, which are important for imaging of thin structures such as myocardium, cartilage, and skin. The third part of this review article describes different methods to put more weighting either on the intracellular or the extracellular sodium signal by means of contrast agents, relaxation-weighted imaging, or multiple-quantum filtering.
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Affiliation(s)
- Simon Konstandin
- Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
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Haneder S, Michaely HJ, Konstandin S, Schad LR, Morelli JN, Krämer BK, Schoenberg SO, Lammert A. 3T Renal 23Na-MRI: effects of desmopressin in patients with central diabetes insipidus. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 27:47-52. [DOI: 10.1007/s10334-013-0377-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 03/12/2013] [Accepted: 03/13/2013] [Indexed: 12/01/2022]
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Haneder S, Konstandin S, Morelli JN, Schad LR, Schoenberg SO, Michaely HJ. Assessment of the renal corticomedullary (23)Na gradient using isotropic data sets. Acad Radiol 2013; 20:407-13. [PMID: 23498980 DOI: 10.1016/j.acra.2012.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 09/27/2012] [Accepted: 10/03/2012] [Indexed: 11/19/2022]
Abstract
RATIONALE AND OBJECTIVES (23)Na magnetic resonance imaging is a promising technique for the noninvasive imaging of renal function. Past investigations of the renal corticomedullary [(23)Na] gradient have relied on imaging only in the coronal plane and on cumbersome calculations of [(23)Na], which require the use of external phantoms. The aim of this study is therefore two-fold: to use an isotropic three-dimensional data set to compare coronal measurements of renal [(23)Na] relative to measurements obtained in planes along the corticomedullary gradients and to investigate cerebrospinal fluid (CSF) (23)Na signal as an internal reference standard, obviating the need for time-intensive [(23)Na] calculations. MATERIALS AND METHODS Nominal isotropic three-dimensional (23)Na MRI data sets were obtained in 14 healthy volunteers before and after a water load. Images were reconstructed in the coronal plane and in planes angled along the direction of the corticomedullary sodium gradients. [(23)Na] values and values of the corticomedullary [(23)Na] gradient were measured by placement of a linear region of interest along corticomedullary gradients in both the coronal/nonangled [(23)Na(non-ang)] and the angled [(23)Na(ang)] image reconstructions. CSF [(23)Na] was also acquired at multiple levels. Ratios of renal (23)Na and CSF (23)Na signal were calculated to construct a semiquantitative parameter, [(23)NaCSF]. Results of water stimulation as measured by [(23)NaCSF] and [(23)Na(ang)] were then compared. RESULTS Mean values of [(23)Na(ang)] were statistically significantly greater than those of [(23)Na(non-ang)] (P < .0001), although these values were linearly correlated (R = 0.553, P < .0001) and exhibited similar extents of decreases in absolute terms (P = .2) and in terms of the corticomedullary gradient following the water load. CSF [(23)Na] did not statistically significantly differ at any level after the water load (P > .5) but tended to increase in the cranial direction (P < .001). [(23)NaCSF] measures demonstrated analogous statistical properties to [(23)Na(ang)] before and after the water load. CONCLUSIONS Assessment of renal corticomedullary [(23)Na] gradients using isotropic data sets with image reconstructions along the gradients is likely more accurate than measurements in the coronal plane. Because CSF [(23)Na] differs based on anatomic levels, such measures are useful as an internal reference only if region of interest placement is consistent. With this caveat in mind, normalization of renal to CSF (23)Na signal provides a feasible, less cumbersome alternative to [(23)Na] calculations in intraindividual studies.
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Affiliation(s)
- Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor- Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
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