Linda Knutsson1
1Medical Radiation Physics, Lund University, Sweden
Synopsis
A relatively new field of MRI is Chemical Exchange Saturation Transfer (CEST). In this talk basic principles of CEST MRI will be introduced and several examples will be presented to illustrate the potential of using CEST for clinical diagnosis and prognosis in gliomas.
Target Audience
Trainees, radiologists, physicists, and basic scientists.Outcome
As a result of attending the talk, participants should be able to explain the techniques and clinical use of CEST in gliomasPurpose
A relatively new field of MRI is Chemical Exchange Saturation Transfer (CEST). It combines the principles of MR spectroscopy and MRI by using the interaction of the exchangeable protons to probe molecules with the water protons to achieve large sensitivity enhancements (several orders of magnitude) for the imaging of molecular information with MRI sensitivity. In CEST MRI both paramagnetic and diamagnetic probes can be used, however for clinical translation diamagnetic agents is often needed, since it has lower toxicity and it is more applicable for regulatory approval and patient acceptance. In this talk basic principles of CEST MRI will be introduced to provide insight into the type of molecules that can be studied and the sensitivity of this approach. In addition the main contributions to the in vivo saturation spectrum (Z-spectrum) will be explained. Several examples will be presented to illustrate the potential of using CEST for clinical diagnosis and prognosis.
1) Imaging of endogenous proteins, especially the use of amide proton transfer weighted (APTw) MRI for brain tumor diagnosis, including separation of high and low grade, judging progression versus pseudoprogression and the effect of IDH status.
2) Use of simple diamagnetic probes such as D-Glucose and its polymers for imaging tissue perfusion, membrane permeability and metabolism.
3) Novel approaches for the future.Acknowledgements
No acknowledgement found.References
1) van Zijl PC, Yadav NN. Chemical exchange saturation transfer (CEST): what is in a name and what isn't? Magn Reson Med. 2011 Apr;65(4):927-48
2) Zhou J, Heo HY, Knutsson L, van Zijl PCM, Jiang S. APT-weighted MRI: Techniques, current neuro applications, and challenging issues. J Magn Reson Imaging. 2019 Jan 20. doi: 10.1002/jmri.26645. [Epub ahead of print] Review.
3) Jones KM, Pollard AC, Pagel MD. Clinical applications of chemical exchange saturation transfer (CEST) MRI. J Magn Reson Imaging. 2018 Jan;47(1):11-27
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5) Jiang S, Eberhart CG, Zhang Y, Heo HY, Wen Z, Blair L, Qin H, Lim M, Quinones-Hinojosa A, Weingart JD, Barker PB, Pomper MG, Laterra J, van Zijl PCM, Blakeley JO, Zhou J.Amide proton transfer-weighted magnetic resonance image-guided stereotactic biopsy in patients with newly diagnosed gliomas.Eur J Cancer. 2017 Sep;83:9-18