Catalina S. Arteaga de Castro1, Hans J.M. Hoogduin1, Vitaliy Khlebnikov1, Peter R. Luijten1, Dennis W.J. Klomp1, and Moritz Zaiss2
1Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands, 2Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
Synopsis
The feasibility of selective NOE- and amide-CEST
detection in the prostate at 7T was investigated with a multi-transmit system.
Both effects can be acquired simultaneously due to the increased sensitivity
and spectral resolution available at 7T. Fitted NOE- and amide-CEST were
reproducible within experiments. NOE-CEST was found to be more pronounced than
amide-CEST in small and whole prostate ROIs and the peripheral zone showed the
lowest amide- and NOE-CEST effects.Introduction
Multi-parametric MR (spectroscopic) imaging of
the human prostate has shown to be able to differentiate cancerous from normal
tissue[1].
However, correlation of MRI features obtained from DCE, T2, DWI and MRSI to
Gleason scores coincides with relatively low specificity, hence limiting their
applicability in treatment guidance. Other contrast mechanisms such as chemical
exchange saturation transfer (CEST) have been explored for differentiation of
tumor types in prostate cancer. In particular, the amide-CEST and nuclear
Overhauser effected (NOE) part of the Z-spectra have shown altered contrasts in
tumor. Recently, CEST techniques in prostate cancer were explores at 3T[2], indeed showing altered amide-CEST
effects in tumors versus healthy prostate tissue, albeit with very high
standard deviations. In addition, due to limited spectral resolution, NOEs and
downfield amide signals get mixed. In this work, we show that going to higher
field strengths such as 7 Tesla, increased spectral resolution and sensitivity
allows for selective detection of amide- and NOE-CEST independently. We present
how a multi-transmit system enables reproducible measurements of amide-CEST and
NOE-CEST selectively at 7T. This is to our knowledge the first selective CEST
approach in the body and the first detection of a NOE-CEST in the prostate.
Methods
Four male volunteers were scanned at a 7T MR
scanner (Philips, Best, The Netherlands) with an array of 8 transmit receive fractionated
dipole antennas[3]
(MR Coils, Drunen, The Netherlands) that were positioned symmetrically around
the pelvis. A multi-transmit system was used for B1+
shimming. Amplitude and phase shimming was done to maximize the B1+
and homogeneity in the prostate. After B1 shimming, T2-weigthed
images were obtained for anatomy localization. Whole prostate CEST was acquired
using a single slice 2D gradient echo (TE/TR=1.23/15 ms, 220x4x393mm FOV,
4x4x4mm voxel, 135 sec acquisition time, SENSE 1) with 80 saturation pulses (gaussian
shape, 25 ms duration and 1uT B1 amplitude each) and a 30 ms interval. At least
16 offset frequencies were acquired to sweep 8 ppm around the water
frequency. Four measurements were
acquired after each other to assess the stability and reproducibility of the
measurement. An additional measurement with 4 averages was also acquired to
investigate increased SNR influence. Data analysis was performed with
home-built MATLAB (R2014b, The Mathworks, Inc. ©) scripts that include Lorentzian
fitting of water, amides, NOEs. Pixel and regions of interest (ROI) analysis
were compared: including the complete prostate and smaller ROIs in the central
gland and the peripheral zone.
Results and Discussion
Figure 1 shows an axial T2-weighted slice for
anatomy localization and the associated B1 map for that slice (the CEST
measurements were also acquired in the same slice). After RF shimming the B1
values within the prostate had variations below 25%. Figure 2 shows the
stability of the four repeated measurements and a fifth measurement with 4
averages. Z-spectra are reproducible and remain stable within experiments. The
standard deviation for the repeated measurements stays below 10% and below 5%
for the data set with 4 NSA as expected, for both small and big ROI (fig 2 a,
b). The available sensitivity at 7T also made possible to create amide- and NOE-CEST
maps per voxel to show the heterogeneity in the prostate (figure 3). Part of
the heterogeneity in the CEST maps can be explained by the remaining B1+
heterogeneity (figure 1 b) which accounted for up to 25% changes. The remaining
contrast in the amide- and NOE-CEST maps are inherent of the prostate. For the first time, fitted NOE- and amide-CEST
effects were individually detected in the prostate for big (complete prostate)
and small (central gland and peripheral zone) ROIs (fig. 4). Lower amide- and NOE-CEST
effects are found for the peripheral zone when compared to the central gland.
Conclusion
Selective detection of amide- and
NOE-CEST are feasible at 7T in combination with a multi-transmit system in the
prostate. The CEST sensitivity at the 7T field strength enables generation of amide-
and NOE maps. Fitted amide- and NOE-CEST show inherent lower effects in the
peripheral zone when compared to the central gland, which may be used to
increase the specificity of grading prostate cancer.
Acknowledgements
No acknowledgement found.References
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2. Jia, G., et al., Amide proton transfer MR imaging of prostate
cancer: A preliminary study. Journal of Magnetic Resonance Imaging, 2011. 33(3): p. 647-654.
3. Raaijmakers, A.J.E., et al., The fractionated dipole antenna: A new
antenna for body imaging at 7 Tesla. Magnetic Resonance in Medicine, 2015.