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T1ρ-based dynamic glucose-enhanced (DGEρ) MRI at 3 T: method development and early clinical experience in the human brain.

Abstract

PURPOSE

The aim of this study was to translate the T1 ρ-based dynamic glucose-enhanced (DGEρ) experiment from ultrahigh magnetic field strengths to a clinical field strength of 3 T. Although the protocol would seem to be as simple as gadolinium-enhanced imaging, several obstacles had to be addressed, including signal-to-noise ratio (SNR), robustness of contrast, and postprocessing, especially motion correction.

METHODS

Spin-lock based presaturation and a 3D gradient-echo snapshot readout were optimized for 3 T with regard to robustness, chemical exchange saturation transfer effect strength, and SNR. Postprocessing steps, including dynamic B0 and motion correction, were analyzed and optimized in 7 healthy volunteers. The final protocol, including glucose injection, was applied to 3 glioblastoma patients.

RESULTS

With appropriate postprocessing, motion-related artifacts could be drastically reduced, and an SNR of approximately 90 could be achieved for a single dynamic measurement. In 2 patients with blood-brain barrier breakdown, a significant glucose uptake could be observed with a DGEρ effect strength in the range of 0.4% of the water signal. Thorough analysis of possible residual motion revealed that the statistical evidence can decrease when tested against pseudo effects attributed to uncorrected motion.

CONCLUSION

DGEρ imaging was optimized for clinical field strengths of 3 T, and a robust protocol was established for broader application. Early experience shows that DGEρ seems possible at 3 T and could not only be attributed to motion artifacts. Observed DGEρ maps showed unique patterns, partly matching with the T1 -ce tumor ring enhancement. However, effect sizes are small and careful clinical application is necessary.

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  • Authors+Show Affiliations

    ,

    Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany. IMPRS for Cognitive and Systems Neuroscience, University of Tübingen, Tübingen, Germany.

    ,

    Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany. Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.

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    Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.

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    Department of Neuropathology, University Hospital Tübingen, Tübingen, Germany.

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    Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany.

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    Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.

    ,

    Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany.

    ,

    Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany. Department of Biomedical Magnetic Resonance, University Hospital Tübingen, Tübingen, Germany.

    Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31231853

    Citation

    Herz, Kai, et al. "T1ρ-based Dynamic Glucose-enhanced (DGEρ) MRI at 3 T: Method Development and Early Clinical Experience in the Human Brain." Magnetic Resonance in Medicine, 2019.
    Herz K, Lindig T, Deshmane A, et al. T1ρ-based dynamic glucose-enhanced (DGEρ) MRI at 3 T: method development and early clinical experience in the human brain. Magn Reson Med. 2019.
    Herz, K., Lindig, T., Deshmane, A., Schittenhelm, J., Skardelly, M., Bender, B., ... Zaiss, M. (2019). T1ρ-based dynamic glucose-enhanced (DGEρ) MRI at 3 T: method development and early clinical experience in the human brain. Magnetic Resonance in Medicine, doi:10.1002/mrm.27857.
    Herz K, et al. T1ρ-based Dynamic Glucose-enhanced (DGEρ) MRI at 3 T: Method Development and Early Clinical Experience in the Human Brain. Magn Reson Med. 2019 Jun 23; PubMed PMID: 31231853.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - T1ρ-based dynamic glucose-enhanced (DGEρ) MRI at 3 T: method development and early clinical experience in the human brain. AU - Herz,Kai, AU - Lindig,Tobias, AU - Deshmane,Anagha, AU - Schittenhelm,Jens, AU - Skardelly,Marco, AU - Bender,Benjamin, AU - Ernemann,Ulrike, AU - Scheffler,Klaus, AU - Zaiss,Moritz, Y1 - 2019/06/23/ PY - 2019/02/12/received PY - 2019/04/17/revised PY - 2019/05/21/accepted PY - 2019/6/25/entrez KW - CESL KW - CEST KW - DGEρ KW - chemical exchange saturation transfer KW - dynamic glucose enhancement KW - glucoCEST JF - Magnetic resonance in medicine JO - Magn Reson Med N2 - PURPOSE: The aim of this study was to translate the T1 ρ-based dynamic glucose-enhanced (DGEρ) experiment from ultrahigh magnetic field strengths to a clinical field strength of 3 T. Although the protocol would seem to be as simple as gadolinium-enhanced imaging, several obstacles had to be addressed, including signal-to-noise ratio (SNR), robustness of contrast, and postprocessing, especially motion correction. METHODS: Spin-lock based presaturation and a 3D gradient-echo snapshot readout were optimized for 3 T with regard to robustness, chemical exchange saturation transfer effect strength, and SNR. Postprocessing steps, including dynamic B0 and motion correction, were analyzed and optimized in 7 healthy volunteers. The final protocol, including glucose injection, was applied to 3 glioblastoma patients. RESULTS: With appropriate postprocessing, motion-related artifacts could be drastically reduced, and an SNR of approximately 90 could be achieved for a single dynamic measurement. In 2 patients with blood-brain barrier breakdown, a significant glucose uptake could be observed with a DGEρ effect strength in the range of 0.4% of the water signal. Thorough analysis of possible residual motion revealed that the statistical evidence can decrease when tested against pseudo effects attributed to uncorrected motion. CONCLUSION: DGEρ imaging was optimized for clinical field strengths of 3 T, and a robust protocol was established for broader application. Early experience shows that DGEρ seems possible at 3 T and could not only be attributed to motion artifacts. Observed DGEρ maps showed unique patterns, partly matching with the T1 -ce tumor ring enhancement. However, effect sizes are small and careful clinical application is necessary. SN - 1522-2594 UR - https://www.unboundmedicine.com/medline/citation/31231853/T1ρ-based_dynamic_glucose-enhanced_(DGEρ)_MRI_at_3_T:_method_development_and_early_clinical_experience_in_the_human_brain L2 - https://doi.org/10.1002/mrm.27857 DB - PRIME DP - Unbound Medicine ER -