PMID- 29191206 OWN - NLM STAT- MEDLINE DCOM- 20180806 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 19 IP - 1 DP - 2017 Nov 30 TI - Optimized CEST cardiovascular magnetic resonance for assessment of metabolic activity in the heart. PG - 95 LID - 10.1186/s12968-017-0411-1 [doi] LID - 95 AB - BACKGROUND: Previous studies have linked cardiac dysfunction to loss of metabolites in the creatine kinase system. Chemical exchange saturation transfer (CEST) is a promising metabolic cardiovascular magnetic resonance (CMR) imaging technique and has been applied in the heart for creatine mapping. However, current limitations include: (a) long scan time, (b) residual cardiac and respiratory motion, and (c) B(0) field variations induced by respiratory motion. An improved CEST CMR technique was developed to address these problems. METHODS: Animals with chronic myocardial infarction (N = 15) were scanned using the proposed CEST CMR technique and a late gadolinium enhancement (LGE) sequence as reference. The major improvements of the CEST CMR technique are: (a) Images were acquired by single-shot FLASH, significantly increasing the scan efficiency. (b) All images were registered to reduce the residual motion. (c) The acquired Z-spectrum was analyzed using 3-pool-model Lorentzian-line fitting to generate CEST signal, reducing the impact of B(0) field shifting due to respiratory motion. Feasibility of the technique was tested in a porcine model with chronic myocardial infarction. CEST signal was measured in the scar, border zone and remote myocardium. Initial studies were performed in one patient. RESULTS: In all animals, healthy remote myocardial CEST signal was elevated (0.16 +/- 0.02) compared to infarct CEST signal (0.09 +/- 0.02, P < 0.001) and the border zone (0.12 +/- 0.02, P < 0.001). For both animal and patient studies, the hypointense regions in the CEST contrast maps closely match the bright areas in the LGE images. CONCLUSIONS: The proposed CEST CMR technique was developed to address long scan times, respiratory and cardiac motion, and B(0) field variations. Lower CEST signal in bright region of the LGE image is consistent with the fact that myocardial infarction has reduced metabolic activity. FAU - Zhou, Zhengwei AU - Zhou Z AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. AD - Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA. FAU - Nguyen, Christopher AU - Nguyen C AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. AD - Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA. AD - Harvard Medical School, Boston, MA, USA. FAU - Chen, Yuhua AU - Chen Y AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. AD - Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA. FAU - Shaw, Jaime L AU - Shaw JL AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. AD - Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA. FAU - Deng, Zixin AU - Deng Z AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. AD - Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA. FAU - Xie, Yibin AU - Xie Y AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. FAU - Dawkins, James AU - Dawkins J AD - Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. FAU - Marban, Eduardo AU - Marban E AD - Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. FAU - Li, Debiao AU - Li D AD - Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd. PACT Suite 400, Los Angeles, CA, 90048, USA. Debiao.Li@cshs.org. AD - Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA. Debiao.Li@cshs.org. AD - Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Debiao.Li@cshs.org. LA - eng GR - R21 EB024701/EB/NIBIB NIH HHS/United States PT - Journal Article DEP - 20171130 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 1BJ477IO2L (gadobutrol) RN - EC 2.7.3.2 (Creatine Kinase) RN - MU72812GK0 (Creatine) SB - IM MH - Animals MH - Biomarkers/metabolism MH - Case-Control Studies MH - Cicatrix/*diagnostic imaging/metabolism/pathology MH - Contrast Media/administration & dosage MH - Creatine/metabolism MH - Creatine Kinase/metabolism MH - Disease Models, Animal MH - *Energy Metabolism MH - Feasibility Studies MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Myocardial Infarction/*diagnostic imaging/metabolism/pathology MH - Myocardium/*metabolism/pathology MH - Organometallic Compounds/administration & dosage MH - Predictive Value of Tests MH - Swine MH - Swine, Miniature MH - Time Factors MH - Workflow PMC - PMC5707904 OTO - NOTNLM OT - CEST CMR OT - Cardiac CEST OT - Creatine OT - MRI OT - Metabolic imaging COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: For the animal studies, the protocol was approved by the local Institutional Animal Care and Usage Committee (IACUC) at Cedars-Sinai Medical Center. For the volunteer and patient studies, the protocol was approved by the Institutional Review Board (IRB). Written informed consent was obtained from each subject before the exam. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/12/02 06:00 MHDA- 2018/08/07 06:00 PMCR- 2017/11/30 CRDT- 2017/12/02 06:00 PHST- 2017/04/04 00:00 [received] PHST- 2017/11/20 00:00 [accepted] PHST- 2017/12/02 06:00 [entrez] PHST- 2017/12/02 06:00 [pubmed] PHST- 2018/08/07 06:00 [medline] PHST- 2017/11/30 00:00 [pmc-release] AID - S1097-6647(23)01129-8 [pii] AID - 411 [pii] AID - 10.1186/s12968-017-0411-1 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2017 Nov 30;19(1):95. doi: 10.1186/s12968-017-0411-1.