Synopsis
CEST MRI can provide valuable
molecular level information in vivo, but its translation to routine clinics is
hindered by long imaging times. Regional average CEST measurements often
suffice for quantitative evaluation, diagnosis, and treatment assessment, while
allowing much shorter scan times. Recently, the spectroscopy with linear
algebraic modeling (SLAM) method was adapted for CEST MRI in two dimensions
(2D), directly obtaining compartmental-average measurements manifold faster
than conventional CEST. Here, the SLAM CEST method is extended from 2D to 3D,
and applied to patients with brain tumors with acceleration factors of up to
98-fold.Purpose
Chemical
Exchange Saturation Transfer (CEST) MRI (1) can be valuable in numerous human applications
(2-6), but is currently time-consuming since it requires
multiple acquisitions of saturated and unsaturated images. On the other hand, many
human applications of CEST, such as tumor grading (2, 3), studies of Parkinson’s disease (6) and creatine kinetics (7), use compartmental average CEST indices
from a few regions of interest. Recently, the Spectroscopy with Linear
Algebraic Modeling (SLAM) method (8-10) was adapted to provide direct, ultrafast measures of compartmental
average CEST parameters in two dimensions (2D). Approximately 9-fold and up to
45-fold acceleration factors (R) were
demonstrated for Amide Proton Transfer (APT) (11) imaging, and whole z-spectrum
measurements (12), respectively. Here, the SLAM CEST
method is extended from 2D to 3D whole-brain MRI with up to 98-fold
acceleration for APT imaging. Slice-by-slice and volumetric strategies for reconstructing
3D SLAM CEST indices are presented.
Methods
Consenting patients with brain tumors were
recruited for 3D SLAM CEST studies on a 3T Philips MRI system using a
32-channel receive coil. CEST MRI was performed with 0.8s and 2µT block
saturation pulses and saturation frequencies of ±3, ±3.5, ±3.5 and ±4ppm, as
well as an unsaturation reference (13, 14). A 3D turbo spin echo (TSE) sequence was used for image readout
(FOV=212x186x66mm; resolution=2.2x2.2x4.4 mm; turbo factor=55; SENSE factor=2x1
in the phase-encoding and slice-encoding directions, respectively). A 3D TSE WASSR
sequence (15) was acquired for B0 correction, along with anatomical
T2-weighted, FLAIR, and T1-weighted (T1w) MRI.
When applicable, gadolinium (Gd)-based contrast agents were injected
intravenously before and after T1w MRI as part of an institutionally
approved clinical research protocol.
For SLAM CEST
reconstruction, each CEST slice was first co-registered with an anatomical
image (typically, post-Gd T1w MRI) based on recorded acquisition
geometry parameters, and segmented into five compartments (1: contrast-enhanced
tumor; 2: contralateral brain; 3: “rest of the brain”; 4: scalp; and 5:
background as shown in Figs. 1 and 4). Segmentation was done two ways: (i)
slice-by-slice treating different slices independently; and (ii) volumetrically
with the segmentation of all slices connected. Compartmental average APT-weighted
(APTw) indices were then directly reconstructed by the SLAM CEST method with
the segmentation and B0 correction incorporated (12), using a subset of the central k-space raw data from the conventional
CEST MRI scans. For slice-by-slice SLAM, the acceleration was only in the
phase-encoding direction. For volumetric SLAM, the acceleration was in both
phase-encoding and slice-encoding directions.
Results were compared with a standard CEST MRI reconstruction
in which the raw k-space data was Fourier transformed
(FT) and unfolded in the phase-encoding direction using the SENSE (16) method. After B0 correction,
compartmental-average FT APTw indices, were computed by averaging individual voxel
measurements in the segmented regions in both slice-by-slice and volumetric
fashions.
Results
Fig. 1 shows segmented, co-registered, post-Gd T1w
images from a brain tumor patient with 5 compartments. Fig. 2 shows color-coded
compartmental APTw results for the contrast-enhanced tumor, contralateral brain
and “rest of the brain” compartments, from slice-by-slice SLAM with an
acceleration factor of R=8 (part b)
and FT (R=1, part a), respectively. The
SLAM results agree with standard FT (part b vs. part a), yielding APTw values
of 2.4% vs. 2.3% respectively, in the tumor compartment (red arrows).
Fig. 3 demonstrates volumetric SLAM with R=35 (part b) and R=98 (part c) while still producing results in agreement with
standard FT APTw (part a). The APTw values in the contrast-enhanced tumor
compartment (red arrow) are 1.97%, 1.80% and 1.62% for FT, and SLAM with R=35 and R=98, respectively. Note that the tumor compartment has identical
values in the two slices displayed using the volumetric strategy, which is
different from the slice-by-slice strategy.
Fig. 4 presents a case where the
contrast-enhanced tumor compartment is much smaller than the one shown in Figs.
1-3. As seen with the application of SLAM to conventional spectroscopy (8-10), a smaller compartment
size typically limits the acceleration factor with higher-order phase-encodes
providing improved accuracy. Here, for the tumor compartment (#1, red arrow),
slice-by-slice SLAM with R=6 yields APTw
measurements of 2.1% compared to 2.3% with FT APTw (12).
Conclusion
By extending the SLAM CEST
method from 2D to 3D, CEST measurements can be accelerated up to 98-fold faster
than those achieved with regular FT CEST, yielding compartment-average results consistent
with those of standard FT. The 3D SLAM CEST method can be flexibly implemented with
slice-by-slice or volumetric segmentation in 3T MRI scanners to facilitate
clinical applications.
Acknowledgements
Funding Support: NIH Grant R01 EB007829, CA166171, EB009731, NS083435References
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