Feasibility and optimization of19F MRI on a clinical 3T with a large field-of-view torso coil

PURPOSE

The purpose of this work is to: 1) demonstrate fluorine-19 (19F) MRI on a 3T clinical system with a large field-of-view (FOV) multi-channel torso coil 2) demonstrate an example parameter selection optimization for a 19F agent to maximize the SNR-efficiency for SPGR, bSSFP, and phase-cycled bSSFP (bSSFP-C), and 3) validate detection feasibility in ex vivo tissues. Methods: Measurements were conducted on a 3.0T Discovery MR750w MRI (GE Healthcare, USA) with an 8-channel 1H/19F torso coil (MRI Tools, Germany). Numerical simulations were conducted for perfluoropolyether (PFPE) to determine the theoretical parameters to maximize SNR-efficiency for the sequences. Theoretical parameters were experimentally verified, and the sensitivity of the sequences was compared with a 10-minute acquisition time with a 3.125x3.125x3mm3 in-plane resolution. Feasibility of a bSSFP-C was also demonstrated in phantom and ex vivo tissues. Results: Flip angles (FA) of 12 and 64 degrees maximized the signal for SPGR and bSSFP, and validation of optimal FA and receiver bandwidth showed close agreement with numerical simulations. Sensitivities of 2.47, 5.81, and 4.44 ms^(-0.5) mM^(-1) and empirical detection limits of 20.3, 1.5, and 6.2 mM were achieved for SPGR, bSSFP, and bSSFP-C, respectively. bSSFP and bSSFP-C achieved 1.8-fold greater sensitivity over SPGR (p<0.01). Conclusion: bSSFP-C was able to improve sensitivity relative to simple SPGR and reduce both bSSFP banding effects and imaging time. The sequence was used to demonstrate the feasibility of 19F MRI at clinical FOVs and field strengths within ex-vivo tissues.

Cardiovascular Molecular Imaging With Fluorine-19 MRI: The Road to the Clinic

Fluorine-19 (19F) magnetic resonance imaging is a unique quantitative molecular imaging modality that makes use of an injectable fluorine-containing tracer that generates the only visible 19F signal in the body. This hot spot imaging technique has recently been used to characterize a wide array of cardiovascular diseases and seen a broad range of technical improvements. Concurrently, its potential to be translated to the clinical setting is being explored. This review provides an overview of this emerging field and demonstrates its diagnostic potential, which shows promise for clinical translation. We will describe 19F magnetic resonance imaging hardware, pulse sequences, and tracers, followed by an overview of cardiovascular applications. Finally, the challenges on the road to clinical translation are discussed.

Molecular Design of Magnetic Resonance Imaging Agents Binding to Amyloid Deposits

The ability to detect and monitor amyloid deposition in the brain using non-invasive imaging techniques provides valuable insights into the early diagnosis and progression of Alzheimer's disease and helps to evaluate the efficacy of potential treatments. Magnetic resonance imaging (MRI) is a widely available technique offering high-spatial-resolution imaging. It can be used to visualize amyloid deposits with the help of amyloid-binding diagnostic agents injected into the body. In recent years, a number of amyloid-targeted MRI probes have been developed, but none of them has entered clinical practice. We review the advances in the field and deduce the requirements for the molecular structure and properties of a diagnostic probe candidate. These requirements make up the base for the rational design of MRI-active small molecules targeting amyloid deposits. Particular attention is paid to the novel cryo-EM structures of the fibril aggregates and their complexes, with known binders offering the possibility to use computational structure-based design methods. With continued research and development, MRI probes may revolutionize the diagnosis and treatment of neurodegenerative diseases, ultimately improving the lives of millions of people worldwide.

Real-time monitoring of enzyme-catalyzed phosphoribosylation of anti-influenza prodrug favipiravir by time-lapse nuclear magnetic resonance spectroscopy

Favipiravir (brand name Avigan), a widely known anti-influenza prodrug, is metabolized by endogenous enzymes of host cells to generate the active form, which exerts inhibition of viral RNA-dependent RNA polymerase activity; first, favipiravir is converted to its phosphoribosylated form, favipiravir-ribofuranosyl-5'-monophosphate (favipiravir-RMP), by hypoxanthine-guanine phosphoribosyltransferase (HGPRT). Because this phosphoribosylation reaction is the rate-determining step in the generation of the active metabolite, quantitative and real-time monitoring of the HGPRT-catalyzed reaction is essential to understanding the pharmacokinetics of favipiravir. However, assay methods enabling such monitoring have not been established. ¹⁹ F- or ³¹ P-based nuclear magnetic resonance (NMR) are powerful techniques for observation of intermolecular interactions, chemical reactions, and metabolism of molecules of interest, given that NMR signals of the heteronuclei sensitively reflect changes in the chemical environment of these moieties. Here, we demonstrated direct, sensitive, target-selective, nondestructive, and real-time observation of HGPRT-catalyzed conversion of favipiravir to favipiravir-RMP by performing time-lapse ¹⁹ F-NMR monitoring of the fluorine atom of favipiravir. In addition, we showed that ³¹ P-NMR can be used for real-time observation of the identical reaction by monitoring phosphorus atoms of the phosphoribosyl group of favipiravir-RMP and of the pyrophosphate product of that reaction. Furthermore, we demonstrated that NMR approaches permit the determination of general parameters of enzymatic activity such as V_max and K_m . This method not only can be widely employed in enzyme assays, but also may be of use in the screening and development of new favipiravir-analog antiviral prodrugs that can be phosphoribosylated more efficiently by HGPRT, which would increase the intracellular concentration of the drug's active form. The techniques demonstrated in this study would allow more detailed investigation of the pharmacokinetics of fluorinated drugs, and might significantly contribute to opening new avenues for widespread pharmaceutical studies.

Feasibility of Dynamic Inhaled Gas MRI-Based Measurements Using Acceleration Combined with the Stretched Exponential Model

Dynamic inhaled gas (³He/¹²⁹Xe/¹⁹F) MRI permits the acquisition of regional fractional-ventilation which is useful for detecting gas-trapping in lung-diseases such as lung fibrosis and COPD. Deninger's approach used for analyzing the wash-out data can be substituted with the stretched-exponential-model (SEM) because signal-intensity is attenuated as a function of wash-out-breath in ¹⁹F lung imaging. Thirteen normal-rats were studied using ³He/¹²⁹Xe and ¹⁹F MRI and the ventilation measurements were performed using two 3T clinical-scanners. Two Cartesian-sampling-schemes (Fast-Gradient-Recalled-Echo/X-Centric) were used to test the proposed method. The fully sampled dynamic wash-out images were retrospectively under-sampled (acceleration-factors (AF) of 10/14) using a varying-sampling-pattern in the wash-out direction. Mean fractional-ventilation maps using Deninger's and SEM-based approaches were generated. The mean fractional-ventilation-values generated for the fully sampled k-space case using the Deninger method were not significantly different from other fractional-ventilation-values generated for the non-accelerated/accelerated data using both Deninger and SEM methods (p > 0.05 for all cases/gases). We demonstrated the feasibility of the SEM-based approach using retrospective under-sampling, mimicking AF = 10/14 in a small-animal-cohort from the previously reported dynamic-lung studies. A pixel-by-pixel comparison of the Deninger-derived and SEM-derived fractional-ventilation-estimates obtained for AF = 10/14 (≤16% difference) has confirmed that even at AF = 14, the accuracy of the estimates is high enough to consider this method for prospective measurements.

Enhanced detection of paramagnetic fluorine-19 magnetic resonance imaging agents using zero echo time sequence and compressed sensing

Fluorine-19 (19 F) magnetic resonance imaging (MRI) is an emerging technique offering specific detection of labeled cells in vivo. Lengthy acquisition times and modest signal-to-noise ratio (SNR) makes three-dimensional spin-density-weighted 19 F imaging challenging. Recent advances in tracer paramagnetic metallo-perfluorocarbon (MPFC) nanoemulsion probes have shown multifold SNR improvements due to an accelerated 19 F T1 relaxation rate and a commensurate gain in imaging speed and averages. However, 19 F T2 -reduction and increased linewidth limit the amount of metal additive in MPFC probes, thus constraining the ultimate SNR. To overcome these barriers, we describe a compressed sampling (CS) scheme, implemented using a "zero" echo time (ZTE) sequence, with data reconstructed via a sparsity-promoting algorithm. Our CS-ZTE scheme acquires k-space data using an undersampled spherical radial pattern and signal averaging. Image reconstruction employs off-the-shelf sparse solvers to solve a joint total variation and l 1 -norm regularized least square problem. To evaluate CS-ZTE, we performed simulations and acquired 19 F MRI data at 11.7 T in phantoms and mice receiving MPFC-labeled dendritic cells. For MPFC-labeled cells in vivo, we show SNR gains of ~6.3 × with 8-fold undersampling. We show that this enhancement is due to three mechanisms including undersampling and commensurate increase in signal averaging in a fixed scan time, denoising attributes from the CS algorithm, and paramagnetic reduction of T1 . Importantly, 19 F image intensity analyses yield accurate estimates of absolute quantification of 19 F spins. Overall, the CS-ZTE method using MPFC probes achieves ultrafast imaging, a substantial boost in detection sensitivity, accurate 19 F spin quantification, and minimal image artifacts.

19 F MRI Nanotheranostics for Cancer Management: Progress and Prospects

Fluorine magnetic resonance imaging (¹⁹ F MRI) is a promising imaging technique for cancer diagnosis because of its excellent soft tissue resolution and deep tissue penetration, as well as the inherent high natural abundance, almost no endogenous interference, quantitative analysis, and wide chemical shift range of the ¹⁹ F nucleus. In recent years, scientists have synthesized various ¹⁹ F MRI contrast agents. By further integrating a wide variety of nanomaterials and cutting-edge construction strategies, magnetically equivalent ¹⁹ F atoms are super-loaded and maintain satisfactory relaxation efficiency to obtain high-intensity ¹⁹ F MRI signals. In this review, the nuclear magnetic resonance principle underlying ¹⁹ F MRI is first described. Then, the construction and performance of various fluorinated contrast agents are summarized. Finally, challenges and future prospects regarding the clinical translation of ¹⁹ F MRI nanoprobes are considered. This review will provide strategic guidance and panoramic expectations for designing new cancer theranostic regimens and realizing their clinical translation.

Compressed sensing with signal averaging for improved sensitivity and motion artifact reduction in fluorine-19 MRI

Fluorine-19 (19 F) MRI of injected perfluorocarbon emulsions (PFCs) allows for the non-invasive quantification of inflammation and cell tracking, but suffers from a low signal-to-noise ratio and extended scan time. To address this limitation, we tested the hypotheses that a 19 F MRI pulse sequence that combines a specific undersampling regime with signal averaging has both increased sensitivity and robustness against motion artifacts compared with a non-averaged fully sampled pulse sequence, when both datasets are reconstructed with compressed sensing. As a proof of principle, numerical simulations and phantom experiments were performed on selected variable ranges to characterize the point spread function of undersampling patterns, as well as the vulnerability to noise of undersampling and reconstruction parameters with paired numbers of x signal averages and acceleration factor x (NAx-AFx). The numerical simulations demonstrated that a probability density function that uses 25% of the samples to fully sample the k-space central area allowed for an optimal balance between limited blurring and artifact incoherence. At all investigated noise levels, the Dice similarity coefficient (DSC) strongly depended on the regularization parameters and acceleration factor. In phantoms, the motion robustness of an NA8-AF8 undersampling pattern versus NA1-AF1 was evaluated with simulated and real motion patterns. Differences were assessed with the DSC, which was consistently higher for the NA8-AF8 compared with the NA1-AF1 strategy, for both simulated and real cyclic motion patterns (P < 0.001). Both strategies were validated in vivo in mice (n = 2) injected with perfluoropolyether. Here, the images displayed a sharper delineation of the liver with the NA8-AF8 strategy than with the NA1-AF1 strategy. In conclusion, we validated the hypotheses that in 19 F MRI the combination of undersampling and averaging improves both the sensitivity and the robustness against motion artifacts.

Internal Structure of Thermoresponsive Physically Crosslinked Nanogel of Poly[N-(2-hydroxypropyl)methacrylamide]-Block-Poly[N-(2,2-difluoroethyl)acrylamide], Prominent 19F MRI Tracer

Fluorine-19 MRI is a promising noninvasive diagnostic method. However, the absence of a nontoxic fluorine-19 MRI tracer that does not suffer from poor biodistribution as a result of its strong fluorophilicity is a constant hurdle in the widespread applicability of this otherwise versatile diagnostic technique. The poly[N-(2-hydroxypropyl)methacrylamide]-block-poly[N-(2,2-difluoroethyl)acrylamide] thermoresponsive copolymer was proposed as an alternative fluorine-19 MRI tracer capable of overcoming such shortcomings. In this paper, the internal structure of self-assembled particles of this copolymer was investigated by various methods including 1D and 2D NMR, dynamic light scattering (DLS), small-angle X-ray scattering (SAXS) and small-angle neutron scattering (SANS). The elucidated structure appears to be that of a nanogel with greatly swollen hydrophilic chains and tightly packed thermoresponsive chains forming a network within the nanogel particles, which become more hydrophobic with increasing temperature. Its capacity to provide a measurable fluorine-19 NMR signal in its aggregated state at human body temperature was also investigated and confirmed. This capacity stems from the different fluorine-19 nuclei relaxation properties compared to those of hydrogen-1 nuclei.

Trimodal Cell Tracking In Vivo: Combining Iron- and Fluorine-Based Magnetic Resonance Imaging with Magnetic Particle Imaging to Monitor the Delivery of Mesenchymal Stem Cells and the Ensuing Inflammation

The therapeutic potential of mesenchymal stem cells (MSCs) is limited, as many cells undergo apoptosis following administration. In addition, the attraction of immune cells (predominately macrophages) to the site of implantation can lead to MSC rejection. We implemented a trimodal imaging technique to monitor the fate of transplanted MSCs and infiltrating macrophages in vivo. MSCs were labeled with an iron oxide nanoparticle (ferumoxytol) and then implanted within the hind limb muscle of 10 C57BI/6 mice. Controls received unlabeled MSCs (n = 5). A perfluorocarbon agent was administered intravenously for uptake by phagocytic macrophages in situ; 1 and 12 days later, the ferumoxytol-labeled MSCs were detected by proton (¹H) magnetic resonance imaging (MRI) and magnetic particle imaging (MPI). Perfluorocarbon-labeled macrophages were detected by fluorine-19 (¹⁹F) MRI. ¹H/¹⁹F MRI was acquired on a clinical scanner (3 T) using a dual-tuned surface coil and balanced steady-state free precession (bSSFP) sequence. The measured volume of signal loss and MPI signal declined over 12 days, which is consistent with the death and clearance of iron-labeled MSCs. ¹⁹F signal persisted over 12 days, suggesting the continuous infiltration of perfluorocarbon-labeled macrophages. Because MPI and ¹⁹F MRI signals are directly quantitative, we calculated estimates of the number of MSCs and macrophages present over time. The presence of MSCs and macrophages was validated with histology following the last imaging session. This is the first study to combine the use of iron- and fluorine-based MRI with MPI cell tracking.

Evaluation of fluorine-19 magnetic resonance imaging of the lungs using octafluorocyclobutane in a rat model

PURPOSE

To test octafluorocyclobutane (OFCB) as an inhalation contrast agent for fluorine-19 MRI of the lung, and to compare the image quality of OFCB scans with perfluoropropane (PFP) scans THEORY AND METHODS: After normalizing for the number of signal averages, a theoretical comparison between the OFCB signal-to-noise ratio (SNR) and PFP SNR predicted the average SNR advantage of 90% using OFCB during gradient echo imaging. The OFCB relaxometry was conducted using single-voxel spectroscopy and spin-echo imaging. A comparison of OFCB and PFP SNRs was performed in vitro and in vivo. Five healthy Sprague-Dawley rats were imaged during single breath-hold and continuous breathing using a Philips Achieva 3.0T MRI scanner (Philips, Andover, MA). The scan time was constant for both gases. Statistical comparison between PFP and OFCB scans was conducted using a paired t test and by calculating the Bayes factor.

RESULTS

Spin-lattice (T₁ ) and effective spin-spin ( T 2 ∗ ) relaxation time constants of the pure OFCB gas were determined as 28.5 ± 1.2 ms and 10.5 ± 1.8 ms, respectively. Mixing with 21% of oxygen decreased T₁ by 30% and T 2 ∗ by 20%. The OFCB in vivo images showed 73% higher normalized SNR on average compared with images acquired using PFP. The statistical significance was shown by both paired t test and calculated Bayes factors. The experimental results agree with theoretical calculations within the error of the relaxation parameter measurements.

CONCLUSION

The quality of the lung images acquired using OFCB was significantly better compared with PFP scans. The OFCB images had higher a SNR and were artifact-free.

Performance of compressed sensing for fluorine-19 magnetic resonance imaging at low signal-to-noise ratio conditions

PURPOSE

To examine the performance of compressed sensing (CS) in reconstructing low signal-to-noise ratio (SNR) ¹⁹ F MR signals that are close to the detection threshold and originate from small signal sources with no a priori known location.

METHODS

Regularization strength was adjusted automatically based on noise level. As performance metrics, root-mean-square deviations, true positive rates (TPRs), and false discovery rates were computed. CS and conventional reconstructions were compared at equal measurement time and evaluated in relation to high-SNR reference data. ¹⁹ F MR data were generated from a purpose-built phantom and benchmarked against simulations, as well as from the experimental autoimmune encephalomyelitis mouse model. We quantified the signal intensity bias and introduced an intensity calibration for in vivo data using high-SNR ex vivo data.

RESULTS

Low-SNR ¹⁹ F MR data could be reliably reconstructed. Detection sensitivity was consistently improved and data fidelity was preserved for undersampling and averaging factors of α = 2 or = 3. Higher α led to signal blurring in the mouse model. The improved TPRs at α = 3 were comparable to a 2.5-fold increase in measurement time. Whereas CS resulted in a downward bias of the ¹⁹ F MR signal, Fourier reconstructions resulted in an unexpected upward bias of similar magnitude. The calibration corrected signal-intensity deviations for all reconstructions.

CONCLUSION

CS is advantageous whenever image features are close to the detection threshold. It is a powerful tool, even for low-SNR data with sparsely distributed ¹⁹ F signals, to improve spatial and temporal resolution in ¹⁹ F MR applications.

Optimization of steady-state free precession MRI for lung ventilation imaging with 19 F C3 F8 at 1.5T and 3T

PURPOSE

To optimize 19 F imaging pulse sequences for perfluoropropane (C3 F8 ) gas human lung ventilation MRI considering intrinsic in vivo relaxation parameters at both 1.5T and 3T.

METHODS

Optimization of the imaging parameters for both 3D spoiled gradient (SPGR) and steady-state free precession (SSFP) 19 F imaging sequences with inhaled 79% C3 F8% and 21% oxygen was performed. Phantom measurements were used to validate simulations of SNR. In vivo parameter mapping and sequence optimization and comparison was performed by imaging the lungs of a healthy adult volunteer. T1 and T2* mapping was performed in vivo to optimize sequence parameters for in vivo lung MRI. The performance of SSFP and SPGR was then evaluated in vivo at 1.5T and 3T.

RESULTS

The in vivo T2* of C3 F8 was shown to be dependent upon lung inflation level (2.04 ms ± 36% for residual volume and 3.14 ms ± 28% for total lung capacity measured at 3T), with lower T2* observed near the susceptibility interfaces of the diaphragm and around pulmonary blood vessels. Simulation and phantom measurements indicate that a factor of ~2-3 higher SNR can be achieved with SSFP when compared with optimized SPGR. In vivo lung imaging showed a 1.7 factor of improvement in SNR achieved at 1.5T, while the theoretical improvement at 3T was not attained due to experimental SAR constraints, shorter in vivo T1 , and B0 inhomogeneity.

CONCLUSION

SSFP imaging provides increased SNR in lung ventilation imaging of C3 F8 demonstrated at 1.5T with optimized SSFP similar to the SNR that can be obtained at 3T with optimized SPGR.

A chemical shift encoding (CSE) approach for spectral selection in fluorine-19 MRI

PURPOSE

To develop a chemical shift encoding (CSE) approach for fluorine-19 MRI of perfluorocarbons in the presence of multiple known fluorinated chemical species.

THEORY AND METHODS

A multi-echo CSE technique is applied for spectral separation of the perfluorocarbon perfluoro-15-crown-5-ether (PFCE) and isoflurane (ISO) based on their chemical shifts at 4.7 T. Cramér-Rao lower bound analysis is used to identify echo combinations with optimal signal-to-noise performance. Signal contributions are fit with a multispectral fluorine signal model using a non-linear least squares estimation reconstruction directly from k-space data. This CSE approach is tested in fluorine-19 phantoms and in a mouse with a 2D and 3D spoiled gradient-echo acquisition using multiple echo times determined from Cramér-Rao lower bound analysis.

RESULTS

Cramér-Rao lower bound analysis for PFCE and ISO separation shows signal-to-noise performance is maximized with a 0.33 ms echo separation. A linear behavior (R²  = 0.987) between PFCE signal and known relative PFCE volume is observed in CSE reconstructed images using a mixed PFCE/ISO phantom. Effective spatial and spectral separation of PFCE and ISO is shown in phantoms and in vivo.

CONCLUSION

Feasibility of a gradient-echo CSE acquisition and image reconstruction approach with optimized noise performance is demonstrated through fluorine-19 MRI of PFCE with effective removal of ISO signal contributions. Magn Reson Med 79:2183-2189, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Visualization of macrophage recruitment in head and neck carcinoma model using fluorine-19 magnetic resonance imaging

PURPOSE

To evaluate the role of infiltrating macrophages in murine models of single and double mutation head and neck tumors using a novel fluorine-19 (¹⁹ F) MRI technology.

METHODS

Tumor cell lines single-hit/SCC4 or double-hit/Cal27, with mutations of TP53 and TP53 & FHIT, respectively, were injected bilaterally into the flanks of (n = 10) female mice. With tumors established, perfluorocarbon nanoemulsion was injected intravenously, which labels in situ predominantly monocytes and macrophages. Longitudinal spin density-weighted ¹⁹ F MRI data enabled quantification of the macrophage burden in tumor and surrounding tissue.

RESULTS

The average number of ¹⁹ F atoms within the tumors was twice as high in the Cal27 group compared with SCC4 (3.9 × 10¹⁹ and 2.0 × 10¹⁹¹⁹ F/tumor, respectively; P = 0.0034) two days after contrast injection, signifying increased tumor-associated macrophages in double-hit tumors. The difference was still significant 10 days after injection. Histology stains correlated with in vivo results, exhibiting numerous perfluorocarbon-labeled macrophages in double-hit tumors and to a lesser extent in single-hit tumors.

CONCLUSIONS

This study helps to establish ¹⁹ F MRI as a method for quantifying immune cells in the tumor microenvironment, allowing distinction between double and single-hit head and neck tumors. This technique would be extremely valuable in the clinic for pretreatment planning, prognostics, and post-treatment surveillance. Magn Reson Med 79:1972-1980, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Toward Hyperpolarized 19 F Molecular Imaging via Reversible Exchange with Parahydrogen

Fluorine-19 has high NMR detection sensitivity-similar to that of protons-owing to its large gyromagnetic ratio and high natural abundance (100 %). Unlike protons, however, fluorine-19 (¹⁹ F) has a negligible occurrence in biological objects, as well as a more sensitive chemical shift. As a result, in vivo ¹⁹ F NMR spectroscopy and MR imaging offer advantages of negligible background signal and sensitive reporting of the local molecular environment. Here we report on NMR hyperpolarization of ¹⁹ F nuclei using reversible exchange reactions with parahydrogen gas as the source of nuclear spin order. NMR signals of 3-fluoropyridine were enhanced by ≈100 fold, corresponding to 0.3 % ¹⁹ F nuclear spin polarization (at 9.4 T), using about 50 % parahydrogen. While future optimization efforts will likely significantly increase the hyperpolarization levels, we already demonstrate the utility of ¹⁹ F hyperpolarization for high-resolution hyperpolarized ¹⁹ F imaging and hyperpolarized ¹⁹ F pH sensing.

Fluorine-19 MRI Contrast Agents for Cell Tracking and Lung Imaging

Fluorine-19 (¹⁹F)-based contrast agents for magnetic resonance imaging stand to revolutionize imaging-based research and clinical trials in several fields of medical intervention. First, their use in characterizing in vivo cell behavior may help bring cellular therapy closer to clinical acceptance. Second, their use in lung imaging provides novel noninvasive interrogation of the ventilated airspaces without the need for complicated, hard-to-distribute hardware. This article reviews the current state of ¹⁹F-based cell tracking and lung imaging using magnetic resonance imaging and describes the link between the methods across these fields and how they may mutually benefit from solutions to mutual problems encountered when imaging ¹⁹F-containing compounds, as well as hardware and software advancements.

Clinical cell therapy imaging using a perfluorocarbon tracer and fluorine-19 MRI

PURPOSE

Cellular therapeutics are emerging as a treatment option for a host of serious human diseases. To accelerate clinical translation, noninvasive imaging of cell grafts in clinical trials can potentially be used to assess the initial delivery and behavior of cells.

METHODS

The use of a perfluorocarbon (PFC) tracer agent for clinical fluorine-19 ((19) F) MRI cell detection is described. This technology was used to detect immunotherapeutic dendritic cells (DCs) delivered to colorectal adenocarcinoma patients. Autologous DC vaccines were labeled with a PFC MRI agent ex vivo. Patients received DCs intradermally, and (19) F spin-density-weighted MRI at 3 Tesla (T) was used to observe cells.

RESULTS

Spin-density-weighted (19) F images at the injection site displayed DCs as background-free "hot-spot" images. (19) F images were acquired in clinically relevant scan times (<10 min). Apparent DC numbers could be quantified in two patients from the (19) F hot-spots and were observed to decrease by ∼50% at injection site by 24 h. From 3T phantom studies, the sensitivity limit for DC detection is estimated to be on the order of ∼10(5) cells/voxel in this study.

CONCLUSION

These results help to establish a clinically applicable means to track a broad range of cell types used in cell therapy.