Jan-Rüdiger Schüre1, Junaid Rajput1, Eike Steidl2, Manoj Shrestha3, Ralf Deichmann3, Elke Hattingen2, Moritz Fabian1, Andreas Maier4, Armin Nagel5, and Moritz Zaiss1,4,6
1Institute of Neuroradiology, Erlangen, Germany, 2Institute of Neuroradiology, Frankfurt am Main, Germany, 3Brain Imaging Center, Frankfurt am Main, Germany, 4Department Artificial Intelligence in Biomedical Engineering, Erlangen, Germany, 5Institute of Radiology, Erlangen, Germany, 6Max-Planck Institute for Biological Cybernetics, Tübingen, Germany
Synopsis
Keywords: CEST / APT / NOE, CEST & MT, Cancer, pH, CEST, 31P, Neuronal Network
Motivation: The pH value is an important biomarker for many diseases. MRI-based 3D pH mapping for clinical routine would be an enormous benefit for diagnostics.
Goal(s): Prediction of intracellular 31P-pHi maps from 1H APTw-CEST MRI data using a voxel-wise neural network, aiming to improve brain tumor imaging.
Approach: Fifteen glioblastoma patients underwent 3T MRI with both APTw-CEST and 31P-MRS. A neural network trained on 11 patients data to correlate APTw-CEST features with 31P-derived pHi values, tested on 4 additional patients.
Results: The neural network's pHi predictions closely matched 31P-pHi maps, showing potential for high-resolution, non-invasive pHi mapping in brain tumors.
Impact: High resolution pH
imaging for better diagnosis of diseases (inflammation, stroke, tumor) and
therapy monitoring in clinical routine.
Introduction
The prediction of
the intracellular pH (pHi) plays an important role for e.g.
inflammation processes, stroke or tumor imaging. The conventional method for pHi
detection 31P-MRS however suffers from low resolution and long scan
times. Already in its first description in vivo, 1H amide-proton
transfer (APT) CEST imaging promised for pH-weighting1,2 on the
basis of high SNR proton MRI providing the advantage of a higher spatial
resolution and scan times below 2 minutes3. Such a 3D pH imaging is
traded as the biggest promise or the holy grail of CEST MRI and highly for
non-invasive characterization of different pathologies.
Despite clear pHi-related
changes of CEST signals in brain tissue4, previous comparison of 31P-pHi
maps and 1H-APTw-CEST images did not show clear spatial correlation in
brain tumors5,6. In the present work we aim to directly learn the 31P-pHi
map from APTw-CEST data by a voxel-wise neural network approach and brain tumor
data acquired with both methods.Methods
In total 15 glioblastoma
patients were scanned after written informed consent on a 3T Siemens PRISMA scanner
using a multislice EPI CEST readout7 (B1=1 µT, DC=50%,voxel
size = 3x3x4mm3) across 16 slices, and a 1 mm isotropic T1 mapping with a 20-channel phase-array head/neck 1H receive coil.31P data was acquired using a 3D CSI sequence (voxel size = 30x30x 25mm3) and a double-tuned 1H/31P coil.
A feedforward neural network (NN)
with three hidden layers and a probabilistic output layer that provides the
mean and uncertainty8 was realized in Python. The training was
performed voxel-wise with the following input parameters (Fig.1):
(i) CEST data (51 offsets, -8 to 8
ppm) in the form of B0-corrected Z-spectra,
(ii) the APT-weighted MTRasym(3:0.1:4
ppm), and
(iii)
quantitative T1 values.
Target data was the 31P-pHi
value in each voxel. See Fig.1 for illustration.
The training data set consists
of data from 11 patients with glioblastoma. For training all volumes were coregistered
and resliced to the CEST images. In order to exclude outliers from the phosphor
data near the skull, the coregistered data was filtered with an eroded mask, resulting
in a total number of 107786 spectra. All final images were resliced to a high-res
MPRAGE.
The model was tested on 4
additional patient datasets, which were not part of the training set. The
predicted pHi maps were additionally down-sampled to the original the
31P-pHi resolution, to be able to calculate the RMSE and analyze
the correlation.Results
The visual comparison in the
test data at low resolution shows surprising similarity of the deepCEST-pHi
prediction and the measured 31P-pHi in 4 different unseen
patients (Fig.2). The RMSE between target and down-sampled prediction was 0.08%, while the coefficient of determination was r=0.86. Applying the network to
the original APTw-CEST resolution reveals complex substructures that might indicate
tumor heterogeneity that is not visible in the 31P-pHi maps (Fig. 3
m-p). Interestingly, subject 4 showed no increased pHi in the deepCEST-pHi
prediction (l,p) in agreement with 31P-pHi (h).
The deepCEST-pHi
maps interestingly show novel features that are not visible in conventional CEST
MRI (APTw-MTRasym, APTw-AREX, quantitative T1) (Fig.3). Thus, the
deepCEST-pHi network seems to extract the pH-weighting of CEST
better from the data than conventional evaluation. Discussion
We herein show the feasibility
of predicting pHi maps from CEST data by a learning-based, 31P-informed
approach. Although the downsampled data match well the 31P-pHi
maps, the prediction shows slightly elevated pHi in normal appearing
white matter. This could be due to the lack of a healthy control group during
training. Surprisingly, the deepCEST-pHi shows different tumor
features that cannot be visualized by the MTRasym, AREX nor
quantitative T1 data, and provides more detailed features than the low
resolution 31P data, as it is inferred form the high resolution 1H
CEST data. The approach can be further improved as both, CEST input features
can be extended, and 31P targets can be acquired at higher
resolution. While detailed studies of causality and used CEST-features are
required, this preliminary result is highly promising for a non-invasive 3D and
high resolution MRI-based pHi mapping method, which could provide valuable
information for brain tumor diagnosis and therapy, as well as for other
diseases.Conclusion
A high resolution CEST–MRI–based pHi mapping in brain tumors
seems possible at 3T using the deepCEST-pHi neural network informed
by 31P target data. This paves the way for non-invasive 3D pHi
mapping at clinical MRI systems.Acknowledgements
No acknowledgement found.References
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