Chemical exchange saturation transfer (CEST) MRI is an increasingly applied non-invasive imaging technique with a fast growing body of evidence regarding its diagnostic value, especially in neuroradiology. This class will discuss principle applications of both endogenous and exogenous CEST methods at clinical and ultra-high static field strengths. This will include applications for initial diagnosis and disease characterization (e.g. stroke, cancer, neurodegenerative diseases), outcome prediction, and early therapy response monitoring. Furthermore, an overview of applications in organs systems outside the central nervous system will be given. Difficulties regarding the clinical translation of CEST MRI will be discussed.
- To point out limitations of conventional MRI.
- To identify clinical key applications of CEST MRI.
- To demonstrate how CEST MRI could add important and clinically valuable information in diagnostic work-up.
- Describe how and when these methods potentially can replace GBCA administration.
- To point out challenges in the process of clinical translation.
PURPOSE
To discuss principle applications of both endogenous and exogenous CEST methods at clinical and ultra-high static field strengths.Endogenous and exogenous CEST methods, such as (i) APT-w MRI, (ii) glucose-enhanced MRI based on CEST or chemical exchange sensitive spin-lock (CESL), (iii) pH-weighted imaging approaches with CEST, and (iv) relaxation-compensated multi-pool CEST MRI.
DISCUSSION and CONCLUSION
CEST MRI contributes information on the subcellular protein level through its sensitivity to low-concentration metabolites. The full diagnostic potential of both endogenous and exogenous CEST methods still needs to be investigated. To translate promising research findings into clinical translation, fast and robust techniques are needed, including the whole process of data acquisition, analysis, and interpretation.