Human whole-blood (1)H2O longitudinal relaxation with normal and high-relaxivity contrast reagents: influence of trans-cell-membrane water exchange

Evolving Characteristics of Gadolinium-Based Contrast Agents for MR Imaging: A Systematic Review of the Importance of Relaxivity

Gadolinium-based contrast agents (GBCAs) are widely and routinely used to enhance the diagnostic performance of magnetic resonance imaging and magnetic resonance angiography examinations. T1 relaxivity (r1) is the measure of their ability to increase signal intensity in tissues and blood on T1-weighted images at a given dose. Pharmaceutical companies have invested in the design and development of GBCAs with higher and higher T1 relaxivity values, and "high relaxivity" is a claim frequently used to promote GBCAs, with no clear definition of what "high relaxivity" means, or general concurrence about its clinical benefit. To understand whether higher relaxivity values translate into a material clinical benefit, well-designed, and properly powered clinical studies are necessary, while mere in vitro measurements may be misleading. This systematic review of relevant peer-reviewed literature provides high-quality clinical evidence showing that a difference in relaxivity of at least 40% between two GBCAs results in superior diagnostic efficacy for the higher-relaxivity agent when this is used at the same equimolar gadolinium dose as the lower-relaxivity agent, or similar imaging performance when used at a lower dose. Either outcome clearly implies a relevant clinical benefit. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.

Using Adaptive Imaging Parameters to Improve PEGylated Ultrasmall Iron Oxide Nanoparticles-Enhanced Magnetic Resonance Angiography

The PEGylated ultrasmall iron oxide nanoparticles (PUSIONPs) exhibit longer blood residence time and better biodegradability than conventional gadolinium-based contrast agents (GBCAs), enabling prolonged acquisitions in contrast-enhanced magnetic resonance angiography (CE-MRA) applications. The image quality of CE-MRA is dependent on the contrast agent concentration and the parameters of the pulse sequences. Here, a closed-form mathematical model is demonstrated and validated to automatically optimize the concentration, echo time (TE), repetition time (TR) and flip angle (FA). The pharmacokinetic studies are performed to estimate the dynamic intravascular concentrations within 12 h postinjection, and the adaptive concentration-dependent sequence parameters are determined to achieve optimal signal enhancement during a prolonged measurement window. The presented model is tested on phantom and in vivo rat images acquired from a 3T scanner. Imaging results demonstrate excellent agreement between experimental measurements and theoretical predictions, and the adaptive sequence parameters obtain better signal enhancement than the fixed ones. The low-dose PUSIONPs (0.03 mmol kg-1 and 0.05 mmol kg-1) give a comparable signal intensity to the high-dose one (0.10 mmol kg-1) within 2 h postinjection. The presented mathematical model provides guidance for the optimization of the concentration and sequence parameters in PUSIONPs-enhanced MRA, and has great potential for further clinical translation.

Human brain clearance imaging: Pathways taken by magnetic resonance imaging contrast agents after administration in cerebrospinal fluid and blood

Over the last decade, it has become evident that cerebrospinal fluid (CSF) plays a pivotal role in brain solute clearance through perivascular pathways and interactions between the brain and meningeal lymphatic vessels. Whereas most of this fundamental knowledge was gained from rodent models, human brain clearance imaging has provided important insights into the human system and highlighted the existence of important interspecies differences. Current gold standard techniques for human brain clearance imaging involve the injection of gadolinium-based contrast agents and monitoring their distribution and clearance over a period from a few hours up to 2 days. With both intrathecal and intravenous injections being used, which each have their own specific routes of distribution and thus clearance of contrast agent, a clear understanding of the kinetics associated with both approaches, and especially the differences between them, is needed to properly interpret the results. Because it is known that intrathecally injected contrast agent reaches the blood, albeit in small concentrations, and that similarly some of the intravenously injected agent can be detected in CSF, both pathways are connected and will, in theory, reach the same compartments. However, because of clear differences in relative enhancement patterns, both injection approaches will result in varying sensitivities for assessment of different subparts of the brain clearance system. In this opinion review article, the "EU Joint Programme - Neurodegenerative Disease Research (JPND)" consortium on human brain clearance imaging provides an overview of contrast agent pharmacokinetics in vivo following intrathecal and intravenous injections and what typical concentrations and concentration-time curves should be expected. This can be the basis for optimizing and interpreting contrast-enhanced MRI for brain clearance imaging. Furthermore, this can shed light on how molecules may exchange between blood, brain, and CSF.

Efficacy of Whole-Blood Model of Gadolinium-Based Contrast Agent Relaxivity in Predicting Vascular MR Signal Intensity In Vivo

BACKGROUND

Previous in vitro studies have described sub-linear longitudinal and heightened transverse H2O relaxivities of gadolinium-based contrast agents (GBCAs) in blood due to their extracellular nature. However, in vivo validation is lacking.

PURPOSE

Validate theory describing blood behavior of R1 and R2* in an animal model.

STUDY TYPE

Prospective, animal.

ANIMAL MODEL

Seven swine (54-65 kg).

FIELD STRENGTH/SEQUENCE

1.5 T; time-resolved 3D spoiled gradient-recalled echo (SPGR) and quantitative Look-Locker and multi-echo fast field echo sequences.

ASSESSMENT

Seven swine were each injected three times with 0.1 mmol/kg intravenous doses of one of three GBCAs: gadoteridol, gadobutrol, and gadobenate dimeglumine. Injections were randomized for rate (1, 2, and 3 mL/s) and order, during which time-resolved aortic 3D SPGR imaging was performed concurrently with aortic blood sampling via an indwelling catheter. Time-varying [GBCA] was measured by mass spectrometry of sampled blood. Predicted signal intensity (SI) was determined from a model incorporating sub-linear R1 and R2* effects (whole-blood model) and simpler models incorporating linear R1, with and without R2* effects. Predicted SIs were compared to measured aortic SI.

STATISTICAL TESTS

Linear correlation (coefficient of determination, R2) and mean errors were compared across the SI prediction models.

RESULTS

There was an excellent correlation between predicted and measured SI across all injections and swine when accounting for the non-linear dependence of R1 and high blood R2* (regression slopes 0.91-1.04, R2 ≥ 0.91). Simplified models (linear R1 with and without R2* effects) showed poorer correlation (slopes 0.67-0.85 and 0.54-0.64 respectively, both R2 ≥ 0.89) and higher averaged mean absolute and mean square errors (128.4 and 177.4 vs. 42.0, respectively, and 5506 and 11,419 vs. 699, respectively).

DATA CONCLUSION

Incorporating sub-linear R1 and high first-pass R2* effects in arterial blood models allows accurate SPGR SI prediction in an in vivo animal model, and might be utilized when modeling MR blood SI.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY: Stage 1.

A Magnetic Resonance Imaging-Chemical Exchange Saturation Transfer (MRI-CEST) Method for the Detection of Water Cycling across Cellular Membranes

Water cycling across the membrane transporters is considered a hallmark of cellular metabolism and it could be of high diagnostic relevance in the characterization of tumors and other diseases. The method relies on the response of intracellular proton exchanging molecules to the presence of extracellular Gd-based contrast agents (GBCAs). Paramagnetic GBCAs enhances the relaxation rate of water molecules in the extracellular compartment and, through membrane exchange, the relaxation enhancement is transferred to intracellular molecules. The effect is detected at the MRI-CEST (Magnetic Resonance Imaging - Chemical Exchange Saturation Transfer) signal of intracellular proton exchanging molecules. The magnitude of the change in the CEST response reports on water cycling across the membrane. The method has been tested on Red Blood Cells and on orthotopic murine models of breast cancer with different degree of malignancy (4T1, TS/A and 168FARN). The distribution of voxels reporting on membrane permeability fits well with the cells' aggressiveness and acts as an early reporter to monitor therapeutic treatments.

Fast-field-cycling NMR at very low magnetic fields: water molecular dynamic biomarkers of glioma cell invasion and migration

Our objective was to study NMR relaxometry of glioma invasion/migration at very low field (<2 mT) by fast-field-cycling NMR (FFC-NMR) and to decipher the pathophysiological processes of glioma that are responsible for relaxation changes in order to open a new diagnostic method that can be extended to imaging. The phenotypes of two new glioma mouse models, Glio6 and Glio96, were characterized by T_2w -MRI, HE histology, Ki-67 immunohistochemistry (IHC) and CXCR4 RT-qPCR, and were compared with the U87 model. R₁ dispersions of glioma tissues were acquired at low field (0.1 mT-0.8 T) ex vivo and were fitted with Lorentzian and power-law models to extract FFC biomarkers related to the molecular dynamics of water. In order to decipher relaxation changes, three main invasion/migration pathophysiological processes were studied: hypoxia, H₂ O₂ function and the water-channel aquaporin-4 (AQP4). Glio6 and Glio96 were characterized with invasion/migration phenotype and U87 with high cell proliferation as a solid glioma. At very low field, invasion/migration versus proliferation was characterized by a decrease in the relaxation-rate constant (ΔR₁  ≈ -32% at 0.1 mT) and correlation time (≈-40%). These decreases corroborated the AQP4-IHC overexpression (Glio6/Glio96: +92%/+46%), suggesting rapid transcytolemmal water exchange, which was confirmed by the intracellular water-lifetime τ_IN decrease (Δτ_IN  ≈ -30%). In functional experiments, AQP4 expression, τ_IN and the relaxation-rate constant at very low field were all found to be sensitive to hypoxia and to H₂ O₂ stimuli. At very low field the role of water exchanges in relaxation modulation was confirmed, and for the first time it was linked to the glioma invasion/migration and to its main pathophysiological processes: hypoxia, H₂ O₂ redox signaling and AQP4 expression. The method appears appropriate to evaluate the effect of drugs that can target these pathophysiological mechanisms. Finally, FFC-NMR operating at low field is demonstrated to be sensitive to invasion glioma phenotype and can be straightforwardly extended to FFC-MRI as a new cancer invasion imaging method in the clinic.

Relationship Between Simulated Gadolinium-Based Contrast Agent Injection Profile and Achievable Resolution Metrics in Contrast-Enhanced Magnetic Resonance Angiography

BACKGROUND

Contrast bolus variation during contrast-enhanced magnetic resonance angiography (CE-MRA) acquisition may lead to vessel blurring.

PURPOSE

To combine knowledge of how contrast signal intensity (SI) evolves for different injection strategies with anatomically familiar parametric computer models to measure and visually assess the effects of a wide range of variables on modeled CE-MRA, and in doing so develop contrast rate injection guidelines.

STUDY TYPE

Computer modeling.

PHANTOM

Digital three-dimensional phantom consisting of orthogonal "aorta," 7 mm diameter "renal arteries" (with 57% and 86% diameter stenoses), and 7 mm diameter "superior mesenteric artery" (with 57% diameter stenosis).

FIELD STRENGTH/SEQUENCE

One millimeter in-plane resolution arterial CE-MRA imaging at 3 T.

ASSESSMENT

"Background" (time invariant) and "vascular" (time varying) components of the phantom were each Fourier transformed into the spatial frequency domain, the latter modulated by the SI evolution of a contrast bolus of varying "plateau" lengths and "tail" heights. Data are presented as surface plots of stenosis measurement error and blurring vs. a reference-standard injection.

STATISTICAL TESTS

Descriptive.

RESULTS

Shorter plateau lengths and lower tail heights resulted in increased measured stenosis error and blurring vs. the reference standard. Under a 44-second acquisition, full width half maximum stenosis error of the 86% stenosis with 25% plateau length and 25% tail height is 24% as compared to that from the reference standard. As plateau length and tail height approach 100%, stenosis error and blurring approach a floor defined by the MR acquisition's limitations.

DATA CONCLUSION

We propose that to achieve minimal degradation with CE-MRA, one can create a contrast bolus with either 60% plateau and 50% tail height or 80% plateau with any tail. These considerations may well prove to be of practical importance, possibly via manipulating the tail by means of multiphasic contrast injections.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY: Stage 1.

Observation of Reduced Homeostatic Metabolic Activity and/or Coupling in White Matter Aging

BACKGROUND AND PURPOSE

Transvascular water exchange plays a key role in the functional integrity of the blood-brain barrier (BBB). In white matter (WM), a variety of imaging modalities have demonstrated age-related changes in structure and metabolism, but the extent to which water exchange is altered remains unclear. Here, we investigated the cumulative effects of healthy aging on WM capillary water exchange.

METHODS

A total of 38 healthy adults (aged 36-80 years) were studied using 7T dynamic contrast enhanced MRI. Blood volume fraction (v_b ) and capillary water efflux rate constant (k_po ) were determined by fitting changes in the ¹ H₂ O longitudinal relaxation rate constant (R₁ ) during contrast agent bolus passage to a two-compartment exchange model. WM volume was determined by morphometric analysis of structural images.

RESULTS

R₁ values and WM volume showed similar trajectories of age-related decline. Among all subjects, v_b and k_po averaged 1.7 (±0.5) mL/100 g of tissue and 2.1 (±1.1) s^-1 , respectively. While v_b showed minimal changes over the 40-year-age span of participants, k_po declined 0.06 s^-1 (ca. 3%) per year (r = -.66; P < .0005), from near 4 s^-1 at age 30 to ca. 2 s^-1 at age 70. The association remained significant after controlling for WM volume.

CONCLUSIONS

Previous studies have shown that k_po tracks Na⁺ , K⁺ -ATPase activity-dependent water exchange at the BBB and likely reflects neurogliovascular unit (NGVU) coupled metabolic activity. The age-related decline in k_po observed here is consistent with compromised NGVU metabolism in older individuals and the dysregulated cellular bioenergetics that accompany normal brain aging.

In vitro T2 relaxivities of the Gd-based contrast agents (GBCAs) in human blood at 1.5 and 3 T

BACKGROUND

The availability of data in the medical literature for the T₂ relaxivities of the Gd-based contrast agents (GBCAs) is limited. A comprehensive comparison between the agents available commercially (other than in Europe) is lacking, with no data available that most closely reflect the clinic, which is in human whole blood at body temperature.

PURPOSE

To complement the existing literature by determining T₂ relaxivity data for eight GBCAs in vitro.

MATERIAL AND METHODS

The relaxivities of eight GBCAs diluted in human whole blood at 1.5 and 3 T were determined at 37 ± 0.5 °C. Gd was in the range of 0-4 mM. Multi-echo sequences with variable echo times were acquired using a phantom containing a dilution series with each agent, and SigmaPlot 12.0 was used to calculate the R₂ relaxation rate and finally r₂. Statistical comparisons between agents and field strengths were conducted.

RESULTS

The relationship between R₂ vs. Gd was observed to be linear at 1.5 and 3 T, with a mild increase in r₂ from 1.5 to 3 T for all GBCAs. T₂ relaxivity data were compared with prior results. The GBCAs are closely clustered into two groups, with higher r₂ noted for the two lipophilic (those with partial hepatobiliary excretion) compounds.

CONCLUSION

The r₂ values at 1.5 and 3 T, determined for the eight GBCAs still clinically available (other than in Europe), provide a definitive baseline for future evaluations, including theoretical calculations of signal intensity and their clinical impact on T2-weighted scans.

Evaluation of four injection profiles for uniform contrast-enhanced signal intensity profiles in MR angiography

BACKGROUND

Gadolinium concentration variation during acquisition of contrast-enhanced MR angiography (CE-MRA) may lead to artifacts.

PURPOSE

To compare signal intensity (SI) profiles of four different contrast agent injection strategies during CE-MRA with the goal of minimizing SI variation during acquisition.

STUDY TYPE

Prospective.

SUBJECTS

Forty subjects randomized to receive one of four injection profiles of gadobenate dimeglumine (0.1 mmol/kg), either undiluted (0.5 M) or diluted to 40 ml total volume. Tested profiles: 1) nondiluted single-phase ("standard" NS; 1.6 ml/s), 2) diluted single-phase (DS; 1.6 ml/s), 3) diluted biphasic (DB; 9 ml @ 3.3 ml/s, 29 ml @ 1.4 ml/s), 4) patient-tailored protocol using linear prediction (DT).

FIELD STRENGTH/SEQUENCE

Time-resolved SI measured at 3T with spoiled gradient echo sequences having analogous parameters to those of CE-MRA.

ASSESSMENT

Plateau arrival time, rise time, duration, peak and tail SI, plateau quality (sum of squared residuals; SSR), average SI for each injection type derived were used.

STATISTICAL TEST

Two-tailed t-test.

RESULTS

Peak SI, arrival, and rise times were not significantly different between groups, excepting peak SI DB slightly > DS (P = 0.042). Duration of NS vs. the diluted groups was significantly shorter (all P < 0.0001), and DS duration was significantly shorter than that of DT and DB (NS 11.4 ± 3.5 vs. DS 22.9 ± 4.3, DB 25.4 ± 2.3, DT 28.3 ± 4.1 sec). Quality (SSR) of the 20-second plateau was significantly better for DS, DB, DT as compared with NS (all P < 0.001).

DATA CONCLUSION

Three different strategies to power-inject diluted gadobenate dimeglumine targeting a 20-second plateau produced SI profiles with longer duration, more consistent plateau, and no significant loss in peak SI. Such injection profiles may provide more uniform SI during CE-MRA, potentially reducing blurring artifacts.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1808-1816.

NMR shutter-speed elucidates apparent population inversion of 1 H2 O signals due to active transmembrane water cycling

Purpose

The desire to quantitatively discriminate the extra‐ and intracellular tissue ¹H₂O MR signals has gone hand‐in‐hand with the continual, historic increase in MRI instrument magnetic field strength [B₀]. However, recent studies have indicated extremely valuable, novel metabolic information can be readily accessible at ultra–low B₀. The two signals can be distinguished, and the homeostatic activity of the cell membrane sodium/potassium pump (Na⁺,K⁺,ATPase) detected. The mechanism allowing ¹H₂O MRI to do this is the newly discovered active transmembrane water cycling (AWC) phenomenon, which we found using paramagnetic extracellular contrast agents at clinical B₀ values. AWC is important because Na⁺,K⁺,ATPase can be considered biology’s most vital enzyme, and its in vivo steady‐state activity has not before been measurable, let alone amenable to mapping with high spatial resolution. Recent reports indicate AWC correlates with neuronal firing rate, with malignant tumor metastatic potential, and inversely with cellular reducing equivalent fraction. We wish to systematize the ways AWC can be precisely measured.

Methods

We present a theoretical longitudinal relaxation analysis of considerable scope: it spans the low‐ and high–field situations.

Results

We show the NMR shutter‐speed organizing principle is pivotal in understanding how trans–membrane steady–state water exchange kinetics are manifest throughout the range. Our findings illuminate an aspect, apparent population inversion, which is crucial in understanding ultra‐low field results.

Conclusions

Without an appreciation of apparent population inversion, significant misinterpretations of future data are likely. These could have unfortunate diagnostic consequences.

Relaxivity of Ferumoxytol at 1.5 T and 3.0 T

OBJECTIVES

The aim of this study was to determine the relaxation properties of ferumoxytol, an off-label alternative to gadolinium-based contrast agents, under physiological conditions at 1.5 T and 3.0 T.

MATERIALS AND METHODS

Ferumoxytol was diluted in gradually increasing concentrations (0.26-4.2 mM) in saline, human plasma, and human whole blood. Magnetic resonance relaxometry was performed at 37°C at 1.5 T and 3.0 T. Longitudinal and transverse relaxation rate constants (R1, R2, R2*) were measured as a function of ferumoxytol concentration, and relaxivities (r1, r2, r2*) were calculated.

RESULTS

A linear dependence of R1, R2, and R2* on ferumoxytol concentration was found in saline and plasma with lower R1 values at 3.0 T and similar R2 and R2* values at 1.5 T and 3.0 T (1.5 T: r1saline = 19.9 ± 2.3 smM; r1plasma = 19.0 ± 1.7 smM; r2saline = 60.8 ± 3.8 smM; r2plasma = 64.9 ± 1.8 smM; r2*saline = 60.4 ± 4.7 smM; r2*plasma = 64.4 ± 2.5 smM; 3.0 T: r1saline = 10.0 ± 0.3 smM; r1plasma = 9.5 ± 0.2 smM; r2saline = 62.3 ± 3.7 smM; r2plasma = 65.2 ± 1.8 smM; r2*saline = 57.0 ± 4.7 smM; r2*plasma = 55.7 ± 4.4 smM). The dependence of relaxation rates on concentration in blood was nonlinear. Formulas from second-order polynomial fittings of the relaxation rates were calculated to characterize the relationship between R1blood and R2 blood with ferumoxytol.

CONCLUSIONS

Ferumoxytol demonstrates strong longitudinal and transverse relaxivities. Awareness of the nonlinear relaxation behavior of ferumoxytol in blood is important for ferumoxytol-enhanced magnetic resonance imaging applications and for protocol optimization.

Using 1H2O MR to measure and map sodium pump activity in vivo

The cell plasma membrane Na⁺,K⁺-ATPase [NKA] is one of biology's most [if not the most] significant enzymes. By actively transporting Na⁺ out [and K⁺ in], it maintains the vital trans-membrane ion concentration gradients and the membrane potential. The forward NKA reaction is shown in the Graphical Abstract [which is elaborated in the text]. Crucially, NKA does not operate in isolation. There are other transporters that conduct K⁺ back out of [II, Graphical Abstract] and Na⁺ back into [III, Graphical Abstract] the cell. Thus, NKA must function continually. Principal routes for ATP replenishment include mitochondrial oxidative phosphorylation, glycolysis, and creatine kinase [CrK] activity. However, it has never been possible to measure, let alone map, this integrated, cellular homeostatic NKA activity in vivo. Active trans-membrane water cycling [AWC] promises a way to do this with ¹H₂O MR. Inthe Graphical Abstract, the AWC system is characterized by active contributions totheunidirectional rate constants for steady-state water efflux and influx, respectively, k_io(a) and k_oi(a). The discovery, validation, and initial exploration of active water cycling are reviewed here. Promising applications in cancer, cardiological, and neurological MRI are covered. This initial work employed paramagnetic Gd(III)chelate contrast agents [CAs]. However, the significant problems associated with in vivo CA use are also reviewed. A new analysis of water diffusion-weighted MRI [DWI] is presented. Preliminary results suggest a non-invasive way to measure the cell number density [ρ (cells/μL)], the mean cell volume [V (pL)], and the cellular NKA metabolic rate [^cMR_NKA(fmol(ATP)/s/cell)] with high spatial resolution. These crucial cell biology properties have not before been accessible invivo. Furthermore, initial findings indicate their absolute values can be determined.

Fast, Na+ /K+ pump driven, steady-state transcytolemmal water exchange in neuronal tissue: A study of rat brain cortical cultures

PURPOSE

Water homeostasis and transport play important roles in brain function (e.g., ion homeostasis, neuronal excitability, cell volume regulation, etc.). However, specific mechanisms of water transport across cell membranes in neuronal tissue have not been completely elaborated.

METHODS

The kinetics of transcytolemmal water exchange were measured in neuronal tissue using simultaneous, real-time fluorescence and nuclear magnetic resonance (NMR) measurements of perfused, active brain organotypic cortical cultures. Perfusion with a paramagnetic MRI contrast agent, gadoteridol, allows NMR determination of the unidirectional rate constant for steady-state cellular water efflux (k_io ), and the mole fraction of intracellular water ( pi), related to the average cell volume (V). Changes in intracellular calcium concentration [Cai2+] were used as a proxy for neuronal activity and were monitored by fluorescence imaging.

RESULTS

The k_io value, averaged over all cultures (N = 99) at baseline, was 2.02 (±1.72) s^-1 , indicating that on average, the equivalent of the entire intracellular water volume turns over twice each second. To probe possible molecular pathways, the specific Na⁺ -K⁺ -ATPase (NKA) inhibitor, ouabain (1 mM), was transiently introduced into the perfusate. This caused significant transient changes (N = 8): [Cai2+] rose ∼250%, V rose ∼89%, and k_io fell ∼45%, with a metabolically active k_io contribution probably eliminated by ouabain saturation.

CONCLUSIONS

These results suggest that transcytolemmal water exchange in neuronal tissue involves mechanisms affected by NKA activity as well as passive pathways. The active pathway may account for half of the basal homeostatic water flux. Magn Reson Med 79:3207-3217, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Quantification and biodistribution of iron oxide nanoparticles in the primary clearance organs of mice using T1 contrast for heating

PURPOSE

To use contrast based on longitudinal relaxation times (T₁ ) or rates (R₁ ) to quantify the biodistribution of iron oxide nanoparticles (IONPs), which are of interest for hyperthermia therapy, cell targeting, and drug delivery, within primary clearance organs.

METHODS

Mesoporous silica-coated IONPs (msIONPs) were intravenously injected into 15 naïve mice. Imaging and mapping of the longitudinal relaxation rate constant at 24 h or 1 week postinjection were performed with an echoless pulse sequence (SWIFT). Alternating magnetic field heating measurements were also performed on ex vivo tissues.

RESULTS

Signal enhancement from positive T₁ contrast caused by IONPs was observed and quantified in vivo in liver, spleen, and kidney at concentrations up to 3.2 mg Fe/(g tissue wt.) (61 mM Fe). In most cases, each organ had a linear correlation between the R₁ and the tissue iron concentration despite variations in intra-organ distribution, degradation, and IONP surface charge. Linear correlation between R₁ and volumetric SAR in hyperthermia therapy was observed.

CONCLUSION

The linear dependence between R₁ and tissue iron concentration in major organs allows quantitative monitoring of IONP biodistribution in a dosage range relevant to magnetic hyperthermia applications, which falls into the concentration gap between CT and conventional MRI techniques. Magn Reson Med 78:702-712, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Relative sensitivities of DCE-MRI pharmacokinetic parameters to arterial input function (AIF) scaling

Dynamic-Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) has been used widely for clinical applications. Pharmacokinetic modeling of DCE-MRI data that extracts quantitative contrast reagent/tissue-specific model parameters is the most investigated method. One of the primary challenges in pharmacokinetic analysis of DCE-MRI data is accurate and reliable measurement of the arterial input function (AIF), which is the driving force behind all pharmacokinetics. Because of effects such as inflow and partial volume averaging, AIF measured from individual arteries sometimes require amplitude scaling for better representation of the blood contrast reagent (CR) concentration time-courses. Empirical approaches like blinded AIF estimation or reference tissue AIF derivation can be useful and practical, especially when there is no clearly visible blood vessel within the imaging field-of-view (FOV). Similarly, these approaches generally also require magnitude scaling of the derived AIF time-courses. Since the AIF varies among individuals even with the same CR injection protocol and the perfect scaling factor for reconstructing the ground truth AIF often remains unknown, variations in estimated pharmacokinetic parameters due to varying AIF scaling factors are of special interest. In this work, using simulated and real prostate cancer DCE-MRI data, we examined parameter variations associated with AIF scaling. Our results show that, for both the fast-exchange-limit (FXL) Tofts model and the water exchange sensitized fast-exchange-regime (FXR) model, the commonly fitted CR transfer constant (K(trans)) and the extravascular, extracellular volume fraction (ve) scale nearly proportionally with the AIF, whereas the FXR-specific unidirectional cellular water efflux rate constant, kio, and the CR intravasation rate constant, kep, are both AIF scaling insensitive. This indicates that, for DCE-MRI of prostate cancer and possibly other cancers, kio and kep may be more suitable imaging biomarkers for cross-platform, multicenter applications. Data from our limited study cohort show that kio correlates with Gleason scores, suggesting that it may be a useful biomarker for prostate cancer disease progression monitoring.

Human whole blood 1 H2 O transverse relaxation with gadolinium-based contrast reagents: Magnetic susceptibility and transmembrane water exchange

PURPOSE

To characterize transverse relaxation in oxygenated whole blood with extracellular gadolinium-based contrast reagents by experiment and simulation.

METHODS

Experimental measurements of transverse ¹ H₂ O relaxation from oxygenated whole human blood and plasma were made at 1.5 and 3.0 Tesla. Spin-echo refocused and free-induction decays are reported for blood and plasma samples containing four different contrast reagents (gadobenate, gadoteridol, gadofosveset, and gadobutrol), each present at concentrations ranging from 1 to 18 mM (i.e., mmol (contrast reagent (CR))/L (blood)). Monte Carlo simulations were conducted to ascertain the molecular mechanisms underlying relaxation. These consisted of random walks of water molecules in a large ensemble of randomly oriented erythrocytes. Bulk magnetic susceptibility (BMS) differences between the extra- and intracellular compartments were taken into account. All key parameters for these simulations were taken from independent published measurements: they include no adjustable variables.

RESULTS

Transverse relaxation is much more rapid in whole blood than in plasma, and the large majority of this dephasing is reversible by spin echo. Agreement between the experimental data and simulated results is remarkably good.

CONCLUSION

Extracellular field inhomogeneities alone make very small contributions, whereas the orientation-dependent BMS intracellular resonance frequencies lead to the majority of transverse dephasing. Equilibrium exchange of water molecules between the intra- and extracellular compartments plays a significant role in transverse dephasing. Magn Reson Med 77:2015-2027, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Re-evaluation of the water exchange lifetime value across red blood cell membrane

The water exchange lifetime (τ(i)) through red blood cell (RBC) membranes can be measured by analyzing the water protons bi-exponential T1 and T2 curves when RBCs are suspended in a medium supplemented with paramagnetic species. Since the seminal papers published in the early '70s of the previous century, paramagnetic Mn(2+) ions were used for doping the extracellular compartment in the RBCs suspension. The obtained τ(i) values fall in the range of 9.8-14 ms. Conversely, other physic-chemical measurements afforded longer τ(i) values. Herein, it is shown that the replacement of Mn(2+) with the highly stable, hydrophilic Gd(III) complexes used as paramagnetic magnetic resonance imaging (MRI) contrast agents led to measure τ(iI) values of 19.1 ± 0.65 ms at 25 ° C. The observed difference is ascribed to the occurrence of enhanced permeability of RBC membrane in the presence of Mn(2+) ions. This view finds support from the observation that an analogous behavior was shown in the presence of other divalent cations, such Ca(2+) and Zn(2+) ions. A possible role of scramblase has been hypothesized. Finally, τ(i) has been measured in presence of alcohols to show that the herein proposed method can detect minor changes in RBC membranes' stiffness upon the incorporation of aliphatic alcohols.

Mapping human brain capillary water lifetime: high-resolution metabolic neuroimaging

Shutter-speed analysis of dynamic-contrast-agent (CA)-enhanced normal, multiple sclerosis (MS), and glioblastoma (GBM) human brain data gives the mean capillary water molecule lifetime (τ(b)) and blood volume fraction (v(b); capillary density-volume product (ρ(†)V)) in a high-resolution (1)H2O MRI voxel (40 μL) or ROI. The equilibrium water extravasation rate constant, k(po) (τ(b)(-1)), averages 3.2 and 2.9 s(-1) in resting-state normal white matter (NWM) and gray matter (NGM), respectively (n = 6). The results (italicized) lead to three major conclusions. (A) k(po) differences are dominated by capillary water permeability (P(W)(†)), not size, differences. NWM and NGM voxel k(po) and v(b) values are independent. Quantitative analyses of concomitant population-averaged k(po), v(b) variations in normal and normal-appearing MS brain ROIs confirm P(W)(†) dominance. (B) P(W)(†) is dominated (>95%) by a trans(endothelial)cellular pathway, not the P(CA)(†) paracellular route. In MS lesions and GBM tumors, P(CA)(†) increases but P(W)(†) decreases. (C) k(po) tracks steady-state ATP production/consumption flux per capillary. In normal, MS, and GBM brain, regional k(po) correlates with literature MRSI ATP (positively) and Na(+) (negatively) tissue concentrations. This suggests that the P(W)(†) pathway is metabolically active. Excellent agreement of the relative NGM/NWM k(po)v(b) product ratio with the literature (31)PMRSI-MT CMR(oxphos) ratio confirms the flux property. We have previously shown that the cellular water molecule efflux rate constant (k(io)) is proportional to plasma membrane P-type ATPase turnover, likely due to active trans-membrane water cycling. With synaptic proximities and synergistic metabolic cooperativities, polar brain endothelial, neuroglial, and neuronal cells form "gliovascular units." We hypothesize that a chain of water cycling processes transmits brain metabolic activity to k(po), letting it report neurogliovascular unit Na(+),K(+)-ATPase activity. Cerebral k(po) maps represent metabolic (functional) neuroimages. The NGM 2.9 s(-1) k(po) means an equilibrium unidirectional water efflux of ~10(15) H2O molecules s(-1) per capillary (in 1 μL tissue): consistent with the known ATP consumption rate and water co-transporting membrane symporter stoichiometries.

Mathematical optimization of contrast concentration for T1-weighted spoiled gradient echo imaging

PURPOSE

To develop and validate closed form mathematical expressions that predict the optimal contrast agent concentration for the maximum T1-weighted spoiled gradient echo (SGRE) signal.

THEORY AND METHODS

Gadolinium and iron-based contrast agents can have significant transverse relaxivity that leads to signal dropout with increasing contrast agent concentration. A mathematical expression for the "optimal" contrast agent concentration where recovery of longitudinal magnetization is offset by increasing transverse signal decay was derived. Expressions for the maximum possible SGRE signal were also derived. Three phantoms were constructed, each with varying concentrations of one of the following three agents: gadoteridol, gadobenate dimeglumine, and ferumoxytol. After measuring the longitudinal and transverse relaxivity of the three agents, the SGRE signal was measured in the phantoms over a wide range of flip angles and echo times.

RESULTS

Excellent qualitative agreement between the SGRE signal behavior, optimal concentration, and optimal flip angle were observed between experimental measurements and theoretical predictions.

CONCLUSION

This work provides validated mathematical expressions for contrast enhanced T1-weighted SGRE imaging and may provide guidance for contrast dosing and injection protocols, as well as for novel pulse sequence design.

Intratumor mapping of intracellular water lifetime: metabolic images of breast cancer?

Shutter-speed pharmacokinetic analysis of dynamic-contrast-enhanced (DCE)-MRI data allows evaluation of equilibrium inter-compartmental water interchange kinetics. The process measured here - transcytolemmal water exchange - is characterized by the mean intracellular water molecule lifetime (τi). The τi biomarker is a true intensive property not accessible by any formulation of the tracer pharmacokinetic paradigm, which inherently assumes it is effectively zero when applied to DCE-MRI. We present population-averaged in vivo human breast whole tumor τi changes induced by therapy, along with those of other pharmacokinetic parameters. In responding patients, the DCE parameters change significantly after only one neoadjuvant chemotherapy cycle: while K(trans) (measuring mostly contrast agent (CA) extravasation) and kep (CA intravasation rate constant) decrease, τi increases. However, high-resolution, (1 mm)(2), parametric maps exhibit significant intratumor heterogeneity, which is lost by averaging. A typical 400 ms τi value means a trans-membrane water cycling flux of 10(13) H2O molecules s(-1)/cell for a 12 µm diameter cell. Analyses of intratumor variations (and therapy-induced changes) of τi in combination with concomitant changes of ve (extracellular volume fraction) indicate that the former are dominated by alterations of the equilibrium cell membrane water permeability coefficient, PW, not of cell size. These can be interpreted in light of literature results showing that τi changes are dominated by a PW (active) component that reciprocally reflects the membrane driving P-type ATPase ion pump turnover. For mammalian cells, this is the Na(+), K(+)-ATPase pump. These results promise the potential to discriminate metabolic and microenvironmental states of regions within tumors in vivo, and their changes with therapy.