Samuel Rot1,2, Aaron Oliver-Taylor3, Xavier Golay3,4, Bhavana Solanky1, and Claudia AM Gandini Wheeler-Kingshott1,5,6
1NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom, 2Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom, 3Gold Standard Phantoms, London, United Kingdom, 4Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom, 5Department of Brain & Behavioural Sciences, University of Pavia, Pavia, Italy, 6Brain Connectivity Centre Research Department, IRCCS Mondino Foundation, Pavia, Italy
Synopsis
Accuracy in quantitative 23Na
(sodium) MRI is
impacted by the quality of the signal calibration phantom. Agarose phantoms,
the current benchmark, exhibit various unfavourable qualities. To move towards
standardisation in 23Na-MRI, the objective was to develop a
synthetic, polymer-based calibration phantom for traceable, reliable and
accurate quantification in 23Na-MRI. Crosslinked polyacrylamide gel
(PAG) was selected as the most suitable choice, for its bi-exponential 23Na
T2 decay. Here, we present the T1, T2 properties and 23Na-MRI
data of prototype PAG phantoms at different 23Na
concentrations. PAG emerges as a reliable choice to replace the ubiquitous agarose
gel phantom.
Introduction
23Na
(sodium) ions are essential in many physiological processes in the human body1, and 23Na-MRI
has been shown to provide a unique insight into such (patho)physiology2. Due to its
quadrupolar 3/2-spin nucleus, 23Na MR-signal decay is rapid and sensitive
to molecular environment3, e.g. exhibiting bi-exponential
T2 in brain tissue4,5.
Accurate quantification of concentration
in 23Na-MRI relies on the quality of the calibration phantom:
ideally, it must (a) share
similar relaxation properties to tissue, (b)
exhibit structural homogeneity, (c) be consistent across batches, (d) stable
over time.
Typically, agarose gel is used
for 23Na-MRI calibration phantoms6.
Although it fulfils characteristics (a) and (b), it can be challenging to
prepare to a consistent, high standard. As evaporation occurs throughout preparation at high temperatures, the sodium concentration will
rise by an unknown amount. Further, as agarose is a naturally derived substance,
its molecular structure (therefore T1/T2 values) could be inconsistent across
batches. Agarose may also deteriorate with time7.
Combined, this poses a challenge in achieving accuracy and traceability in
longitudinal or multi-centre quantitative 23Na-MRI studies. We
believe there is a need for a new class of robust sodium phantoms, paving the
way towards standardising 23Na-MRI quantification.
Here, we assess the
suitability of crosslinked polyacrylamide gel (PAG) phantoms by characterising the T1, T2 parameters and stability over
time, for different sodium concentrations. We also present 23Na-MRI
imaging data.Methods
Preparation
PAG was prepared at a 10% monomer concentration, of which 25% was bis-acrylamide crosslinker. For synthesis, monomers were combined with
ammonium persulfate and the polymerisation initiator,
Tetramethylethylenediamine (TEMED). 7 samples were prepared at sodium concentrations of 10mM-150mM and doped with nickel chloride (NiCl2, of 0.3mM-4.5mM) for 1H contrast.
Fig. 1 gives an overview of sample compositions, including actual
concentrations, which were evaluated volumetrically after polymerisation.
Acquisition
Phantoms
were scanned on a 3.0T Ingenia CX system (Philips Healthcare, Best, The
Netherlands) with a single-channel birdcage sodium coil (RAPID Biomedical GmbH,
Germany). Vials were in a holder containing potassium chloride solution for
coil loading and shimming.
To measure relaxation
parameters, a non-localised free induction decay pulse-acquire spectroscopy protocol
was utilised, with time to acquisition=0.25ms; TR=200ms; readout=86ms; BW=6000Hz;
no. acquisition samples=512; averages=400. For T1 measurement, a 180º inversion
pulse was prepended, with inversion times spaced logarithmically from 5ms-120ms.
Phantoms were imaged using a
UTE 3D-cones8,9 sequence with time to acquisition=0.22ms, TR=120ms, readout=7ms, averages=3, resolution=3mm
isotropic.
Analysis
To estimate T2 values, a multi-exponential signal model was fitted in MATLAB,
utilising Marino’s implementation10 of Provencher’s CONTIN11, a continuous fitting routine that approximates the inverse Laplace
transform. Mono-exponential T1
values were estimated by fitting the inversion recovery equation, including an
additional parameter to account for imperfect flip-angle optimisation. Images were segmented using ITK-Snap12. Results
PAG phantoms exhibit
bi-exponential 23Na T2 decay, with relaxation parameters ranging
from T2s=4-6ms, T2l=17-24ms, T1=27-32ms (see Fig. 3).
Fitted FID and IR signals for the 100mM sample are displayed in Fig. 2. T1, T2
values and T2 component ratios of sodium are stable
with sodium concentration and time, for concentrations above 25mM. Fig. 4 displays
1H and 23Na-MRI images of 4 PAG vials and a saline vial. The PAG calibration curve shows a linear relationship across mean intensities, passing through the saline control. Discussion
Results show PAG phantoms
fulfil the desired characteristics of 23Na-MRI
calibration phantoms:
(a) 23Na
relaxation parameters in PAG agree well with those reported in-vivo (0.5-4ms
for T2s, 15-30ms for T2l and 20-30ms for T14,13).
(b) PAG phantoms are structurally homogeneous and suitable for calibration, as
shown by 23Na and 1H images and their intensities in Fig. 4.
(c) Following standardised methodology, PAG phantoms are producible to an accurate, consistent standard.
The preparation of PAG was traceable from beginning to end, permitting error
propagation of the actual sodium concentrations, for metrology (Fig.
1).
(d) Longitudinal T2 values indicate no significant
changes over 6 months in samples above 25mM. Whilst PAG can degrade by depolymerisation if exposed
to certain conditions14, this is unlikely to
occur in an MR environment.
The molecular structure of PAG15 (illustrated in Fig. 5) makes it particularly suitable as a 23Na-MRI calibration
phantom, as it emulates the irregular molecular environments found in-vivo. Initial experiments (not presented) indicated that 23Na T2 may be controlled by varying acrylamide and crosslinker concentrations, but further investigation is
needed.
It must be noted that relaxation parameters (Fig. 3) deviate at lower concentrations (10mM-25mM). This could be a
systematic error, with possible sources including low SNR, or inconsistent
shimming, due to NiCl2
affecting the 1H signal. Alternatively, it may indicate a relationship between relaxation parameters and sodium concentration, as also demonstrated by Woessner in agarose gel16. At low concentrations, the interactions
between sodium ions and macromolecules which induce bi-exponential
T2 decay, may not occur frequently enough. Lastly, it cannot be ruled out that NiCl2 impacts sodium relaxation.Conclusion
Novel polyacrylamide gel (PAG) phantoms were tested for their suitability as alternatives to agarose in quantitative 23Na-MRI, by assessing relaxation parameters and imaging. Results show that crosslinked PAG yields the desired characteristics of a 23Na-MRI phantom, achieving stability and traceability, while still exhibiting favourable relaxation properties. Demonstrations and validations in-vivo, and design of a foam sample holder, will finalise development.Acknowledgements
SR is supported by the
EPSRC-funded UCL Centre for Doctoral Training in Intelligent, Integrated
Imaging in Healthcare (i4health) (EP/S021930/1) and the Department of Health’s
NIHR-funded Biomedical Research Centre at University College London Hospitals.
CGWK receives funding from the
UK MS Society (#77), Wings for Life (#169111), Horizon2020 (CDS-QUAMRI,
#634541), BRC (#BRC704/CAP/CGW). BS has received funding from Wings for Life.
The UK MS Society and the UCL-UCLH Biomedical Research Centre for ongoing support.
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