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Gerhalter T, Schilling F, Zeitouni N, Linz P, Baudin PY, Kannenkeril D, Kopp C, Dahlmann A, Schmieder R, Uder M, Nagel AM, Gast LV. Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques. Eur Radiol Exp 2024; 8:61. [PMID: 38773044 PMCID: PMC11109078 DOI: 10.1186/s41747-024-00461-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/20/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Clinical magnetic resonance imaging (MRI) studies often use Cartesian gradient-echo (GRE) sequences with ~2-ms echo times (TEs) to monitor apparent total sodium concentration (aTSC). We compared Cartesian GRE and ultra-short echo time three-dimensional (3D) radial-readout sequences for measuring skeletal muscle aTSC. METHODS We retrospectively evaluated 211 datasets from 112 volunteers aged 62.3 ± 12.1 years (mean ± standard deviation), acquired at 3 T from the lower leg. For 23Na MRI acquisitions, we used a two-dimensional Cartesian GRE sequence and a density-adapted 3D radial readout sequence with cuboid field-of-view (DA-3D-RAD-C). We calibrated the 23Na MR signal using reference tubes either with or without agarose and subsequently performed a relaxation correction. Additionally, we employed a six-echo 1H GRE sequence and a multi-echo spin-echo sequence to calculate proton density fat fraction (PDFF) and water T2. Paired Wilcoxon signed-rank test, Cohen dz for paired samples, and Spearman correlation were used. RESULTS Relaxation correction effectively reduced the differences in muscle aTSC between the two acquisition and calibration methods (DA-3D-RAD-C using NaCl/agarose references: 20.05 versus 19.14 mM; dz = 0.395; Cartesian GRE using NaCl/agarose references: 19.50 versus 18.82 mM; dz = 0.427). Both aTSC of the DA-3D-RAD-C and Cartesian GRE acquisitions showed a small but significant correlation with PDFF as well as with water T2. CONCLUSIONS Different 23Na MRI acquisition and calibration approaches affect aTSC values. Applying relaxation correction is advised to minimize the impact of sequence parameters on quantification, and considering additional fat correction is advisable for patients with increased fat fractions. RELEVANCE STATEMENT This study highlights relaxation correction's role in improving sodium MRI accuracy, paving the way for better disease assessment and comparability of measured sodium signal in patients. KEY POINTS • Differences in MRI acquisition methods hamper the comparability of sodium MRI measurements. • Measured sodium values depend on used MRI sequences and calibration method. • Relaxation correction during postprocessing mitigates these discrepancies. • Thus, relaxation correction enhances accuracy of sodium MRI, aiding its clinical use.
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Affiliation(s)
- Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Felix Schilling
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Nour Zeitouni
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Peter Linz
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Pierre-Yves Baudin
- NMR laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France
| | - Dennis Kannenkeril
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Kopp
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anke Dahlmann
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Roland Schmieder
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
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Suarez-Ortegón MF, Zea-León MDP, Astudillo-Gironza AM, Garzón S, Portela GF, Villarreal-Nieto OD. Sweat Rate, Sweat Sodium Losses, and Body Composition in Professional Male Soccer Players in Southwest Colombia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:113. [PMID: 38256373 PMCID: PMC10819496 DOI: 10.3390/medicina60010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Background and Objective: Dehydration and hyperhydration impact athletes' performance. Exploring the fluid balance concerning body composition might help estimate individual hydration requirements. This area of research, particularly regarding sodium losses, has been relatively understudied. We evaluated the sweat rate (SR), sweat sodium losses, and their relationship with body composition in professional soccer players in Cali, Colombia. Materials and Methods: Thirty-two male players, aged 24.3 (±5.2) years, from the Colombian main soccer league, underwent high-intensity training at 32 °C (with a relative humidity of 79%). The outcome variables included SR, calculated using weight loss and fluid intake; forearm sweat sodium concentration (FSCC), measured through the direct ion-selective electrode method; and estimated the predicted whole sweat sodium loss (PWSSL) in mmol. Predictor variables (body mass, fat, and muscle masses) were estimated using the Deborah Kerr anthropometry method. The association between predictors and outcomes was assessed using linear regression. Results: The mean FSCC, PWSSL, and SR were 26.7 ± 11.3 mmol/L, 43 ± 15.9 mmol/L, and 1.7 ± 0.5 L/h, respectively. Body mass positively predicted FSCC in unadjusted and age/fat-mass-adjusted models [Beta 1.28, 95% confidence interval (CI) 0.39-2.18, p = 0.006], and continued related to FSCC after adjustment for muscle mass with marginal significance [Beta 0.85, 95% CI -0.02 to 1.73, p = 0.056]. Muscle mass was associated with the PWSSL in unadjusted and age/fat-mass-adjusted models [Beta 2.42, 95% CI 0.58-4.26, p = 0.012] and sustained an association with marginal statistical significance after adjustment for body mass [Beta 1.86, 95% CI -0.35 to 4.09, p = 0.097]. Conclusions: Under hot tropical weather conditions, FSCC was relatively low among the players. Body mass was better associated with the FSSC, and muscle mass better related to the PWSSL. Body and muscle masses could be regarded as potential factors to be explored in the estimation of individual sodium needs. However, further studies are required to validate and contrast our findings.
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Affiliation(s)
- Milton Fabian Suarez-Ortegón
- Departamento de Alimentación y Nutrición, Facultad de Ciencias de La Salud, Pontificia Universidad Javeriana Seccional Cali, Cali 760021, Colombia;
| | - Maria del Pilar Zea-León
- Departamento de Alimentación y Nutrición, Facultad de Ciencias de La Salud, Pontificia Universidad Javeriana Seccional Cali, Cali 760021, Colombia;
| | | | - Silverio Garzón
- Departamento de Ciencias Básicas, Facultad de Ciencias de La Salud, Pontificia Universidad Javeriana Seccional Cali, Cali 760021, Colombia;
| | | | - Oscar Daniel Villarreal-Nieto
- Departamento de Alimentación y Nutrición, Facultad de Ciencias de La Salud, Pontificia Universidad Javeriana Seccional Cali, Cali 760021, Colombia;
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Baker RR, Muthurangu V, Rega M, Montalt‐Tordera J, Rot S, Solanky BS, Gandini Wheeler‐Kingshott CAM, Walsh SB, Steeden JA. 2D sodium MRI of the human calf using half-sinc excitation pulses and compressed sensing. Magn Reson Med 2024; 91:325-336. [PMID: 37799019 PMCID: PMC10962573 DOI: 10.1002/mrm.29841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Sodium MRI can be used to quantify tissue sodium concentration (TSC) in vivo; however, UTE sequences are required to capture the rapidly decaying signal. 2D MRI enables high in-plane resolution but typically has long TEs. Half-sinc excitation may enable UTE; however, twice as many readouts are necessary. Scan time can be minimized by reducing the number of signal averages (NSAs), but at a cost to SNR. We propose using compressed sensing (CS) to accelerate 2D half-sinc acquisitions while maintaining SNR and TSC. METHODS Ex vivo and in vivo TSC were compared between 2D spiral sequences with full-sinc (TE = 0.73 ms, scan time ≈ 5 min) and half-sinc excitation (TE = 0.23 ms, scan time ≈ 10 min), with 150 NSAs. Ex vivo, these were compared to a reference 3D sequence (TE = 0.22 ms, scan time ≈ 24 min). To investigate shortening 2D scan times, half-sinc data was retrospectively reconstructed with fewer NSAs, comparing a nonuniform fast Fourier transform to CS. Resultant TSC and image quality were compared to reference 150 NSAs nonuniform fast Fourier transform images. RESULTS TSC was significantly higher from half-sinc than from full-sinc acquisitions, ex vivo and in vivo. Ex vivo, half-sinc data more closely matched the reference 3D sequence, indicating improved accuracy. In silico modeling confirmed this was due to shorter TEs minimizing bias caused by relaxation differences between phantoms and tissue. CS was successfully applied to in vivo, half-sinc data, maintaining TSC and image quality (estimated SNR, edge sharpness, and qualitative metrics) with ≥50 NSAs. CONCLUSION 2D sodium MRI with half-sinc excitation and CS was validated, enabling TSC quantification with 2.25 × 2.25 mm2 resolution and scan times of ≤5 mins.
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Affiliation(s)
- Rebecca R. Baker
- UCL Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUK
| | - Vivek Muthurangu
- UCL Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUK
| | - Marilena Rega
- Institute of Nuclear MedicineUniversity College HospitalLondonUK
| | | | - Samuel Rot
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain SciencesUniversity College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Bhavana S. Solanky
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain SciencesUniversity College LondonLondonUK
| | - Claudia A. M. Gandini Wheeler‐Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain SciencesUniversity College LondonLondonUK
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Digital Neuroscience Research UnitIRCCS Mondino FoundationPaviaItaly
| | | | - Jennifer A. Steeden
- UCL Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUK
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Gast LV, Platt T, Nagel AM, Gerhalter T. Recent technical developments and clinical research applications of sodium ( 23Na) MRI. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2023; 138-139:1-51. [PMID: 38065665 DOI: 10.1016/j.pnmrs.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 12/18/2023]
Abstract
Sodium is an essential ion that plays a central role in many physiological processes including the transmembrane electrochemical gradient and the maintenance of the body's homeostasis. Due to the crucial role of sodium in the human body, the sodium nucleus is a promising candidate for non-invasively assessing (patho-)physiological changes. Almost 10 years ago, Madelin et al. provided a comprehensive review of methods and applications of sodium (23Na) MRI (Madelin et al., 2014) [1]. More recent review articles have focused mainly on specific applications of 23Na MRI. For example, several articles covered 23Na MRI applications for diseases such as osteoarthritis (Zbyn et al., 2016, Zaric et al., 2020) [2,3], multiple sclerosis (Petracca et al., 2016, Huhn et al., 2019) [4,5] and brain tumors (Schepkin, 2016) [6], or for imaging certain organs such as the kidneys (Zollner et al., 2016) [7], the brain (Shah et al., 2016, Thulborn et al., 2018) [8,9], and the heart (Bottomley, 2016) [10]. Other articles have reviewed technical developments such as radiofrequency (RF) coils for 23Na MRI (Wiggins et al., 2016, Bangerter et al., 2016) [11,12], pulse sequences (Konstandin et al., 2014) [13], image reconstruction methods (Chen et al., 2021) [14], and interleaved/simultaneous imaging techniques (Lopez Kolkovsky et al., 2022) [15]. In addition, 23Na MRI topics have been covered in review articles with broader topics such as multinuclear MRI or ultra-high-field MRI (Niesporek et al., 2019, Hu et al., 2019, Ladd et al., 2018) [16-18]. During the past decade, various research groups have continued working on technical improvements to sodium MRI and have investigated its potential to serve as a diagnostic and prognostic tool. Clinical research applications of 23Na MRI have covered a broad spectrum of diseases, mainly focusing on the brain, cartilage, and skeletal muscle (see Fig. 1). In this article, we aim to provide a comprehensive summary of methodological and hardware developments, as well as a review of various clinical research applications of sodium (23Na) MRI in the last decade (i.e., published from the beginning of 2013 to the end of 2022).
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Tanja Platt
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Engelke K, Chaudry O, Gast L, Eldib MAB, Wang L, Laredo JD, Schett G, Nagel AM. Magnetic resonance imaging techniques for the quantitative analysis of skeletal muscle: State of the art. J Orthop Translat 2023; 42:57-72. [PMID: 37654433 PMCID: PMC10465967 DOI: 10.1016/j.jot.2023.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/04/2023] [Accepted: 07/19/2023] [Indexed: 09/02/2023] Open
Abstract
Background Magnetic resonance imaging (MRI) is the dominant 3D imaging modality to quantify muscle properties in skeletal muscle disorders, in inherited and acquired muscle diseases, and in sarcopenia, in cachexia and frailty. Methods This review covers T1 weighted and Dixon sequences, introduces T2 mapping, diffusion tensor imaging (DTI) and non-proton MRI. Technical concepts, strengths, limitations and translational aspects of these techniques are discussed in detail. Examples of clinical applications are outlined. For comparison 31P-and 13C-MR Spectroscopy are also addressed. Results MRI technology provides a rich toolset to assess muscle deterioration. In addition to classical measures such as muscle atrophy using T1 weighted imaging and fat infiltration using Dixon sequences, parameters characterizing inflammation from T2 maps, tissue sodium using non-proton MRI techniques or concentration or fiber architecture using diffusion tensor imaging may be useful for an even earlier diagnosis of the impairment of muscle quality. Conclusion Quantitative MRI provides new options for muscle research and clinical applications. Current limitations that also impair its more widespread use in clinical trials are lack of standardization, ambiguity of image segmentation and analysis approaches, a multitude of outcome parameters without a clear strategy which ones to use and the lack of normal data.
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Affiliation(s)
- Klaus Engelke
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
- Institute of Medical Physics (IMP), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
- Clario Inc, Germany
| | - Oliver Chaudry
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Lena Gast
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | | | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Jean-Denis Laredo
- Service d’Imagerie Médicale, Institut Mutualiste Montsouris & B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris-Cité, Paris, France
| | - Georg Schett
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Armin M. Nagel
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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Gast LV, Baier LM, Meixner CR, Chaudry O, Engelke K, Uder M, Nagel AM, Heiss R. MRI of Potassium and Sodium Enables Comprehensive Analysis of Ion Perturbations in Skeletal Muscle Tissue After Eccentric Exercise. Invest Radiol 2023; 58:265-272. [PMID: 36374200 PMCID: PMC9997635 DOI: 10.1097/rli.0000000000000931] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aims were to investigate if potassium ( 39 K) magnetic resonance imaging (MRI) can be used to analyze changes in the apparent tissue potassium concentration (aTPC) in calf muscle tissue after eccentric exercise and in delayed-onset muscle soreness, and to compare these to corresponding changes in the apparent tissue sodium concentration (aTSC) measured with sodium ( 23 Na) MRI. MATERIALS AND METHODS Fourteen healthy subjects (7 female, 7 male; 25.0 ± 2.8 years) underwent 39 K and 23 Na MRI at a 7 T MR system, as well as 1 H MRI at a 3 T MR system. Magnetic resonance imaging data and blood samples were collected at baseline (t0), directly after performing eccentric exercise (t1) and 48 hours after exercise (t2). Self-reported muscle soreness was evaluated using a 10-cm visual analog scale for pain (0, no pain; 10, worst pain) at t0, t1, and t2. Quantification of aTPC/aTSC was performed after correcting the measured 39 K/ 23 Na signal intensities for partial volume and relaxation effects using 5 external reference phantoms. Edema volume and 1 H T 2 relaxation times were determined based on the 1 H MRI data. Participants were divided according to their increase in creatine kinase (CK) level into high (CK t2 ≥ 10·CK t0 ) and low CK (CK t2 < 10·CK t0 ) subjects. RESULTS Blood serum CK and edema volume were significantly increased 48 hours after exercise compared with baseline ( P < 0.001). Six participants showed a high increase in blood serum CK level at t2 relative to baseline, whereas 8 participants had only a low to moderate increase in blood serum CK. All participants reported increased muscle soreness both at rest and when climbing stairs at t1 (0.4 ± 0.7; 1.4 ± 1.2) and t2 (1.6 ± 1.4; 4.8 ± 1.9) compared with baseline (0 ± 0; 0 ± 0). Moreover, aTSC was increased at t1 in exercised muscles of all participants (increase by 57% ± 24% in high CK, 73% ± 33% in low CK subjects). Forty-eight hours after training, subjects with high increase in blood serum CK still showed highly increased aTSC (increase by 79% ± 57% compared with t0). In contrast, aTPC at t2 was elevated in exercised muscles of low CK subjects (increase by 19% ± 11% compared with t0), in which aTSC had returned to baseline or below. Overall, aTSC and aTPC showed inverse evolution, with changes in aTSC being approximately twice as high as in aTPC. CONCLUSIONS Our results showed that 39 K MRI is able to detect changes in muscular potassium concentrations caused by eccentric exercise. In combination with 23 Na MRI, this enables a more holistic analysis of tissue ion concentration changes.
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Affiliation(s)
| | | | | | - Oliver Chaudry
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Klaus Engelke
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | | | - Armin M. Nagel
- From the Institute of Radiology
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
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Manoj KM, Gideon DA, Bazhin NM, Tamagawa H, Nirusimhan V, Kavdia M, Jaeken L. Na,K-ATPase: A murzyme facilitating thermodynamic equilibriums at the membrane-interface. J Cell Physiol 2023; 238:109-136. [PMID: 36502470 DOI: 10.1002/jcp.30925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022]
Abstract
The redox metabolic paradigm of murburn concept advocates that diffusible reactive species (DRS, particularly oxygen-centric radicals) are mainstays of physiology, and not mere pathological manifestations. The murburn purview of cellular function also integrates the essential principles of bioenergetics, thermogenesis, homeostasis, electrophysiology, and coherence. In this context, any enzyme that generates/modulates/utilizes/sustains DRS functionality is called a murzyme. We have demonstrated that several water-soluble (peroxidases, lactate dehydrogenase, hemogoblin, etc.) and membrane-embedded (Complexes I-V in mitochondria, Photosystems I/II in chloroplasts, rhodopsin/transducin in rod cells, etc.) proteins serve as murzymes. The membrane protein of Na,K-ATPase (NKA, also known as sodium-potassium pump) is the focus of this article, owing to its centrality in neuro-cardio-musculo electrophysiology. Herein, via a series of critical queries starting from the geometric/spatio-temporal considerations of diffusion/mass transfer of solutes in cells to an update on structural/distributional features of NKA in diverse cellular systems, and from various mechanistic aspects of ion-transport (thermodynamics, osmoregulation, evolutionary dictates, etc.) to assays/explanations of inhibitory principles like cardiotonic steroids (CTS), we first highlight some unresolved problems in the field. Thereafter, we propose and apply a minimalist murburn model of trans-membrane ion-differentiation by NKA to address the physiological inhibitory effects of trans-dermal peptide, lithium ion, volatile anesthetics, confirmed interfacial DRS + proton modulators like nitrophenolics and unsaturated fatty acid, and the diverse classes of molecules like CTS, arginine, oximes, etc. These explanations find a pan-systemic connectivity with the inhibitions/uncouplings of other membrane proteins in cells.
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Affiliation(s)
- Kelath Murali Manoj
- Satyamjayatu: The Science & Ethics Foundation, Kulappully, Shoranur-2, Kerala, India
| | - Daniel A Gideon
- Satyamjayatu: The Science & Ethics Foundation, Kulappully, Shoranur-2, Kerala, India
| | - Nikolai M Bazhin
- Institute of Chemical Kinetics and Combustion, Russian Academy of Sciences, Novosibirsk, Russia
| | - Hirohisa Tamagawa
- Department of Mechanical Engineering, Gifu University, Gifu City, Japan
| | - Vijay Nirusimhan
- Satyamjayatu: The Science & Ethics Foundation, Kulappully, Shoranur-2, Kerala, India
| | - Mahendra Kavdia
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Laurent Jaeken
- Department of Industrial Sciences and Technology, Karel de Grote-Hogeschool, Antwerp University Association, Antwerp, Belgium
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8
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Gast LV, Baier LM, Chaudry O, Meixner CR, Müller M, Engelke K, Uder M, Heiss R, Nagel AM. Assessing muscle-specific potassium concentrations in human lower leg using potassium magnetic resonance imaging. NMR IN BIOMEDICINE 2023; 36:e4819. [PMID: 35994248 DOI: 10.1002/nbm.4819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
Noninvasively assessing tissue potassium concentrations (TPCs) using potassium magnetic resonance imaging (39 K MRI) could give valuable information on physiological processes connected to various pathologies. However, because of inherently low 39 K MR image resolution and strong signal blurring, a reliable measurement of the TPC is challenging. The aim of this work was to investigate the feasibility of a muscle-specific TPC determination with a focus on the influence of a varying residual quadrupolar interaction in human lower leg muscles. The quantification accuracy of a muscle-specific TPC determination was first assessed using simulated 39 K MRI data. In vivo 39 K and corresponding sodium (23 Na) MRI data of healthy lower leg muscles (n = 14, seven females) were acquired on a 7-T MR system using a double-resonant 23 Na/39 K birdcage Tx/Rx RF coil. Additional 1 H MR images were acquired on a 3-T MR system and used for tissue segmentation. Quantification of TPC was performed after a region-based partial volume correction (PVC) using five external reference phantoms. Simulations not only underlined the importance of PVC for correctly assessing muscle-specific TPC values, but also revealed the strong impact of a varying residual quadrupolar interaction between different muscle regions on the measured TPC. Using 39 K T2 * decay curves, we found significantly higher residual quadrupolar interaction in tibialis anterior muscle (TA; ωq = 194 ± 28 Hz) compared with gastrocnemius muscle (medial/lateral head, GM/GL; ωq = 151 ± 25 Hz) and soleus muscle (SOL; ωq = 102 ± 32 Hz). If considered in the PVC, TPC in individual muscles was similar (TPC = 98 ± 11/96 ± 14/99 ± 8/100 ± 12 mM in GM/GL/SOL/TA). Comparison with tissue sodium concentrations suggested that residual quadrupolar interactions might also influence the 23 Na MRI signal of lower leg muscles. A TPC determination of individual lower leg muscles is feasible and can therefore be applied in future studies. Considering a varying residual quadrupolar interaction for PVC of 39 K MRI data is essential to reliably assess potassium concentrations in individual muscles.
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Laura-Marie Baier
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Chaudry
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christian R Meixner
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Max Müller
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Klaus Engelke
- Department of Medicine 3, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rafael Heiss
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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9
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Zaric O, Beiglböck H, Janacova V, Szomolanyi P, Wolf P, Krebs M, Trattnig S, Krššák M, Juras V. Repeatability assessment of sodium ( 23Na) MRI at 7.0 T in healthy human calf muscle and preliminary results on tissue sodium concentrations in subjects with Addison's disease. BMC Musculoskelet Disord 2022; 23:925. [PMID: 36266679 PMCID: PMC9585786 DOI: 10.1186/s12891-022-05879-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To determine the relaxation times of the sodium nucleus, and to investigate the repeatability of quantitative, in vivo TSC measurements using sodium magnetic resonance imaging (23Na-MRI) in human skeletal muscle and explore the discriminatory value of the method by comparing TSCs between healthy subjects and patients with Addison's disease. MATERIALS AND METHODS In this prospective study, ten healthy subjects and five patients with Addison's disease were involved. 23Na-MRI data sets were acquired using a density-adapted, three-dimensional radial projection reconstruction pulse sequence (DA-3DPR) with a modification for the relaxation times measurements. Differences in TSC between muscle groups and between healthy participants were analysed using a nonparametric Friedman ANOVA test. An interclass correlation coefficient (ICC) was used as the repeatability index. Wilcoxon rank sum test was used for evaluation of differences in TSC between study participants. RESULTS The mean T1 in the gastrocnemius medialis (GM), the tibialis anterior (TA), and the soleus (S) was 25.9 ± 2.0 ms, 27.6 ± 2.0 ms, and 28.2 ± 2.0 ms, respectively. The mean short component of T2*, T2*short were GM: 3.6 ± 2.0 ms; TA: 3.2 ± 0.5 ms; and S: 3.0 ± 1.0 ms, and the mean long component of T2*, T2*long, were GM: 12.9 ± 0.9 ms; TA: 12.8 ± 0.7 ms; and S: 12.9 ± 2.0 ms, respectively. In healthy volunteers, TSC values in the GM were 19.9 ±0.1 mmol/L, 13.8 ±0.2 mmol/L in TA, and 12.6 ± 0.2 mmol/L in S, and were significantly different (p = 0.0005). The ICCs for GM, TA and S were 0.784, 0.818, 0.807, respectively. In patients with Addison's disease, TSC in GC, TA, and S were 10.2 ± 1.0 mmol/L, 8.4 ± 0.6 mmol/L, and 7.2 ± 0.1 mmol/L, respectively. CONCLUSIONS TSC quantification in a healthy subject's calf at 7.0 T is reliable; the technique is able to distinguish sodium level differences between muscles and between healthy subjects and Addison's disease patients.
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Affiliation(s)
- Olgica Zaric
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University GmbH (DPU), Krems an der Donau, Austria
| | - Hannes Beiglböck
- Department of Medicine III (Division of Endocrinology and Metabolism), Medical University of Vienna, Vienna, Austria
| | - Veronika Janacova
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Pavol Szomolanyi
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Peter Wolf
- Department of Medicine III (Division of Endocrinology and Metabolism), Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Department of Medicine III (Division of Endocrinology and Metabolism), Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria.
- Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria.
| | - Martin Krššák
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Department of Medicine III (Division of Endocrinology and Metabolism), Medical University of Vienna, Vienna, Austria
| | - Vladimir Juras
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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10
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Abstract
Purpose of Review The regulation of blood pressure is conventionally conceptualised into the product of “circulating blood volume” and “vasoconstriction components”. Over the last few years, however, demonstration of tissue sodium storage challenged this dichotomous view. Recent Findings We review the available evidence pertaining to this phenomenon and the early association made with blood pressure; we discuss open questions regarding its originally proposed hypertonic nature, recently challenged by the suggestion of a systemic, isotonic, water paralleled accumulation that mirrors absolute or relative extracellular volume expansion; we present the established and speculate on the putative implications of this extravascular sodium excess, in either volume-associated or -independent form, on blood pressure regulation; finally, we highlight the prevalence of high tissue sodium in cardiovascular, metabolic and inflammatory conditions other than hypertension. Summary We conclude on approaches to reduce sodium excess and on the potential of emerging imaging technologies in hypertension and other conditions.
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11
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Platt T, Ladd ME, Paech D. 7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging. Invest Radiol 2021; 56:705-725. [PMID: 34510098 PMCID: PMC8505159 DOI: 10.1097/rli.0000000000000820] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 12/15/2022]
Abstract
ABSTRACT Ultrahigh magnetic fields offer significantly higher signal-to-noise ratio, and several magnetic resonance applications additionally benefit from a higher contrast-to-noise ratio, with static magnetic field strengths of B0 ≥ 7 T currently being referred to as ultrahigh fields (UHFs). The advantages of UHF can be used to resolve structures more precisely or to visualize physiological/pathophysiological effects that would be difficult or even impossible to detect at lower field strengths. However, with these advantages also come challenges, such as inhomogeneities applying standard radiofrequency excitation techniques, higher energy deposition in the human body, and enhanced B0 field inhomogeneities. The advantages but also the challenges of UHF as well as promising advanced methodological developments and clinical applications that particularly benefit from UHF are discussed in this review article.
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Affiliation(s)
- Tanja Platt
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
| | - Mark E. Ladd
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
- Faculty of Physics and Astronomy
- Faculty of Medicine, University of Heidelberg, Heidelberg
- Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg
- Clinic for Neuroradiology, University of Bonn, Bonn, Germany
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12
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Caroli A, Remuzzi A, Lerman LO. Basic principles and new advances in kidney imaging. Kidney Int 2021; 100:1001-1011. [PMID: 33984338 DOI: 10.1016/j.kint.2021.04.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/12/2022]
Abstract
Over the past few years, clinical renal imaging has seen great advances, allowing assessments of kidney structure and morphology, perfusion, function and metabolism, and oxygenation, as well as microstructure and the interstitium. Medical imaging is becoming increasingly important in the evaluation of kidney physiology and pathophysiology, showing promise in management of patients with renal disease, in particular with regard to diagnosis, classification, and prediction of disease development and progression, monitoring response to therapy, detection of drug toxicity, and patient selection for clinical trials. A variety of imaging modalities, ranging from routine to advanced tools, are currently available to probe the kidney both spatially and temporally, particularly ultrasonography, computed tomography, positron emission tomography, renal scintigraphy, and multiparametric magnetic resonance imaging. Given that the range is broad and varied, kidney imaging techniques should be chosen based on the clinical question and the specific underlying pathologic mechanism, taking into account contraindications and possible adverse effects. Integration of various modalities providing complementary information will likely provide the greatest insight into renal pathophysiology. This review aims to highlight major recent advances in key tools that are currently available or potentially relevant for clinical kidney imaging, with a focus on non-oncological applications. The review also outlines the context of use, limitations, and advantages of various techniques, and highlights gaps to be filled with future development and clinical adoption.
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Affiliation(s)
- Anna Caroli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
| | - Andrea Remuzzi
- Department of Management, Information and Production Engineering, University of Bergamo, Dalmine (Bergamo), Italy
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
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