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T1\varrho-based dynamic glucose-enhanced (DGE\varrho) MRI at 3 T: method development and early clinical experience in the human brain
{Purpose: The aim of this study was to translate the T1$\varrho$-based dynamic glucose-enhanced (DGE$\varrho$) 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\textendashbrain barrier breakdown, a significant glucose uptake could be observed with a DGE$\varrho$ effect strength in the range of 0.4\textpercent 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 DGE$\varrho$ imaging was optimized for clinical field strengths of 3 T, and a robust protocol was established for broader application. Early experience shows that DGE$\varrho$ seems possible at 3 T and could not only be attributed to motion artifacts. Observed DGE$\varrho$ maps showed unique patterns, partly matching with the T1-ce tumor ring enhancement. However, effect sizes are small and careful clinical application is necessary.}
@article{item_3074274, title = {{T1$\varrho$-based dynamic glucose-enhanced (DGE$\varrho$) MRI at 3 T: method development and early clinical experience in the human brain}}, journal = {{Magnetic Resonance in Medicine}}, abstract = {{Purpose: The aim of this study was to translate the T1$\varrho$-based dynamic glucose-enhanced (DGE$\varrho$) 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\textendashbrain barrier breakdown, a significant glucose uptake could be observed with a DGE$\varrho$ effect strength in the range of 0.4\textpercent 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 DGE$\varrho$ imaging was optimized for clinical field strengths of 3 T, and a robust protocol was established for broader application. Early experience shows that DGE$\varrho$ seems possible at 3 T and could not only be attributed to motion artifacts. Observed DGE$\varrho$ maps showed unique patterns, partly matching with the T1-ce tumor ring enhancement. However, effect sizes are small and careful clinical application is necessary.}}, volume = {82}, number = {5}, pages = {1832--1847}, publisher = {Wiley-Liss}, address = {New York}, year = {2019}, slug = {item_3074274}, author = {Herz, K and Lindig, T and Deshmane, A and Schittenhelm, J and Skardelly, M and Bender, B and Ernemann, U and Scheffler, K and Zaiss, M} }