Multimodal neuroimaging in humans at 9.4 T: a technological breakthrough towards an advanced metabolic imaging scanner

MRI Coil Development Strategies for Hybrid MR-PET Systems: A Review

Simultaneously operating MR-PET systems have the potential to provide synergetic multi-parametric information, and, as such, interest surrounding their use and development is increasing. However, despite the potential advantages offered by fully combined MR-PET systems, implementing this hybrid integration is technically laborious, and any factors degrading the quality of either modality must be circumvented to ensure optimal performance. In order to attain the best possible quality from both systems, most full MR-PET integrations tend to place the shielded PET system inside the MRI system, close to the target volume of the subject. The radiofrequency (RF) coil used in MRI systems is a key factor in determining the quality of the MR images, and, in simultaneous acquisition, it is generally positioned inside the PET system and PET imaging region, potentially resulting in attenuation and artefacts in the PET images. Therefore, when designing hybrid MR-PET systems, it is imperative that consideration be given to the RF coils inside the PET system. In this review, we present current state-of-the-art RF coil designs used for hybrid MR-PET experiments and discuss various design strategies for constructing PET transparent RF coils.

Outstanding MRI contrast with dysprosium phosphate nanoparticles of tuneable size

The use of high-field magnets for magnetic resonance imaging (MRI) is expected to experience the fastest growth rate during the present decade. Although several CAs for MRI scanners using high magnetic fields have been reported, they are mostly based on fluoride matrices, which are known for their low chemical stability in aqueous suspensions. Chemically stable MRI CAs for high-field magnets are therefore needed to enable the advances in MRI technique. Herein, we synthesized uniform DyPO₄ nanoparticles (NPs) with tuneable sizes between 23 and 57 nm using homogeneous precipitation in butanol. The NPs were successfully functionalized with polyacrylic acid (PAA) and showed good colloidal stability in aqueous suspensions. Chemical stability was also assessed in PBS, showing negligible solubility. The effect of particle size on the transversal relaxivity value (r₂) was further explored at 9.4 T, finding a clear increase in r₂ with particle size. The r₂ value found for the largest NPs was 516 mM^-1 s^-1, which is, to the best of our knowledge, the highest r₂ value ever reported at 9.4 T for any Dy-based nanometric particles in the literature. Finally, the latter NPs were submitted to biosafety studies after polyethylene glycol (PEG) functionalization. Cell morphology, induction of necrotic/late apoptotic cells, and mitochondrial activity were thoroughly analyzed. The results clearly indicated negligible toxicity effects under the assayed conditions. Short- and long-term in vivo pharmacokinetics of the intravenously injected NPs were assessed by dynamic T₂-weighted MRI and quantitative T₂ mapping, revealing faster liver than spleen uptake, while no accumulation was observed in the kidneys. Finally, no histopathological changes were observed in any of the studied organs, including the liver, kidney, spleen, and lung, which provide further evidence of the biocompatibility of DyPO₄ NPs and, therefore, their suitability as bioimaging probes.

Mapping of whole-cerebrum resting-state networks using ultra-high resolution acquisition protocols

Resting‐state functional magnetic resonance imaging (fMRI) has been used in numerous studies to map networks in the brain that employ spatially disparate regions. However, attempts to map networks with high spatial resolution have been hampered by conflicting technical demands and associated problems. Results from recent fMRI studies have shown that spatial resolution remains around 0.7 × 0.7 × 0.7 mm³, with only partial brain coverage. Therefore, this work aims to present a novel fMRI technique that was developed based on echo‐planar‐imaging with keyhole (EPIK) combined with repetition‐time‐external (TR‐external) EPI phase correction. Each technique has been previously shown to be effective in enhancing the spatial resolution of fMRI, and in this work, the combination of the two techniques into TR‐external EPIK provided a nominal spatial resolution of 0.51 × 0.51 × 1.00 mm³ (0.26 mm³ voxel) with whole‐cerebrum coverage. Here, the feasibility of using half‐millimetre in‐plane TR‐external EPIK for resting‐state fMRI was validated using 13 healthy subjects and the corresponding reproducible mapping of resting‐state networks was demonstrated. Furthermore, TR‐external EPIK enabled the identification of various resting‐state networks distributed throughout the brain from a single fMRI session, with mapping fidelity onto the grey matter at 7T. The high‐resolution functional image further revealed mesoscale anatomical structures, such as small cerebral vessels and the internal granular layer of the cortex within the postcentral gyrus.

Comparison of [18F]Fluoroethyltyrosine PET and Sodium MRI in Cerebral Gliomas: a Pilot Study

PURPOSE

Positron emission tomography (PET) using O-(2-[¹⁸F]fluoroethyl)-L-tyrosine ([¹⁸F]FET) improves the diagnostics of cerebral gliomas compared with conventional magnetic resonance imaging (MRI). Sodium MRI is an evolving method to assess tumor metabolism. In this pilot study, we explored the relationship of [¹⁸F]FET-PET and sodium MRI in patients with cerebral gliomas in relation to the mutational status of the enzyme isocitrate dehydrogenase (IDH).

PROCEDURES

Ten patients with untreated cerebral gliomas and one patient with a recurrent glioblastoma (GBM) were investigated by dynamic [¹⁸F]FET-PET and sodium MRI using an enhanced simultaneous single-quantum- and triple-quantum-filtered imaging of ²³Na (SISTINA) sequence to estimate total (NaT), weighted non-restricted (NaNR, mainly extracellular), and restricted (NaR, mainly intracellular) sodium in tumors and normal brain tissue. [¹⁸F]FET uptake and sodium parameters in tumors with a different IDH mutational status were compared. After biopsy or resection, histology and the IDH mutational status were determined neuropathologically.

RESULTS

NaT (p = 0.05), tumor-to-brain ratios (TBR) of NaT (p = 0.02), NaNR (p = 0.003), and the ratio of NaT/NaR (p < 0.001) were significantly higher in IDH-mutated than in IDH-wild-type gliomas (n = 5 patients each) while NaR was significantly lower in IDH-mutated gliomas (p = 0.01). [¹⁸F]FET parameters (TBR, time-to-peak) were not predictive of IDH status in this small cohort of patients. There was no obvious relationship between sodium distribution and [¹⁸F]FET uptake. The patient with a recurrent GBM exhibited an additional radiation injury with strong abnormalities in sodium MRI.

CONCLUSIONS

Sodium MRI appears to be more strongly related to the IDH mutational status than are [¹⁸F]FET-PET parameters. A further evaluation of the combination of the two methods in a larger group of high- and low-grade gliomas seems promising.

Optimization of high-channel count, switch matrices for multinuclear, high-field MRI

Modern magnetic resonance imaging systems are equipped with a large number of receive connectors in order to optimally support a large field-of-view and/or high acceleration in parallel imaging using high-channel count, phased array coils. Given that the MR system is equipped with a limited number of digitizing receivers and in order to support operation of multinuclear coil arrays, these connectors need to be flexibly routed to the receiver outside the RF shielded examination room. However, for a number of practical, economic and safety reasons, it is better to only route a subset of the connectors. This is usually accomplished with the use of switch matrices. These exist in a variety of topologies and differ in routing flexibility and technological implementation. A highly flexible implementation is a crossbar topology that allows to any one input to be routed to any one output and can use single PIN diodes as active elements. However, in this configuration, long open-ended transmission lines can potentially remain connected to the signal path leading to high transmission losses. Thus, especially for high-field systems compensation mechanisms are required to remove the effects of open-ended transmission line stubs. The selection of a limited number of lumped element reactance values to compensate for the for the effect of transmission line stubs in large-scale switch matrices capable of supporting multi-nuclear operation is non-trivial and is a combinatorial problem of high order. Here, we demonstrate the use of metaheuristic approaches to optimize the circuit design of these matrices that additionally carry out the optimization of distances between the parallel transmission lines. For a matrix with 128 inputs and 64 outputs a realization is proposed that displays a worst-case insertion loss of 3.8 dB.

An in vivo multimodal feasibility study in a rat brain tumour model using flexible multinuclear MR and PET systems

Background

In addition to the structural information afforded by ¹H MRI, the use of X-nuclei, such as sodium-23 (²³Na) or phosphorus-31 (³¹P), offers important complementary information concerning physiological and biochemical parameters. By then combining this technique with PET, which provides valuable insight into a wide range of metabolic and molecular processes by using of a variety of radioactive tracers, the scope of medical imaging and diagnostics can be significantly increased. While the use of multimodal imaging is undoubtedly advantageous, identifying the optimal combination of these parameters to diagnose a specific dysfunction is very important and is advanced by the use of sophisticated imaging techniques in specific animal models.

Methods

In this pilot study, rats with intracerebral 9L gliosarcomas were used to explore a combination of sequential multinuclear MRI using a sophisticated switchable coil set in a small animal 9.4 T MRI scanner and, subsequently, a small animal PET with the tumour tracer O-(2-[¹⁸F]-fluoroethyl)-L-tyrosine ([¹⁸F]FET). This made it possible for in vivo multinuclear MR-PET experiments to be conducted without compromising the performance of either multinuclear MR or PET.

Results

High-quality in vivo images and spectra including high-resolution ¹H imaging, ²³Na-weighted imaging, detection of ³¹P metabolites and [¹⁸F]FET uptake were obtained, allowing the characterisation of tumour tissues in comparison to a healthy brain. It has been reported in the literature that these parameters are useful in the identification of the genetic profile of gliomas, particularly concerning the mutation of the isocitrate hydrogenase gene, which is highly relevant for treatment strategy.

Conclusions

The combination of multinuclear MR and PET in, for example, brain tumour models with specific genetic mutations will enable the physiological background of signal alterations to be explored and the identification of the optimal combination of imaging parameters for the non-invasive characterisation of the molecular profile of tumours.

Potential of Sodium MRI as a Biomarker for Neurodegeneration and Neuroinflammation in Multiple Sclerosis

In multiple sclerosis (MS), experimental and ex vivo studies indicate that pathologic intra- and extracellular sodium accumulation may play a pivotal role in inflammatory as well as neurodegenerative processes. Yet, in vivo assessment of sodium in the microenvironment is hard to achieve. Here, sodium magnetic resonance imaging (²³NaMRI) with its non-invasive properties offers a unique opportunity to further elucidate the effects of sodium disequilibrium in MS pathology in vivo in addition to regular proton based MRI. However, unfavorable physical properties and low in vivo concentrations of sodium ions resulting in low signal-to-noise-ratio (SNR) as well as low spatial resolution resulting in partial volume effects limited the application of ²³NaMRI. With the recent advent of high-field MRI scanners and more sophisticated sodium MRI acquisition techniques enabling better resolution and higher SNR, ²³NaMRI revived. These studies revealed pathologic total sodium concentrations in MS brains now even allowing for the (partial) differentiation of intra- and extracellular sodium accumulation. Within this review we (1) demonstrate the physical basis and imaging techniques of ²³NaMRI and (2) analyze the present and future clinical application of ²³NaMRI focusing on the field of MS thus highlighting its potential as biomarker for neuroinflammation and -degeneration.

Development and Implementation of a PIN-Diode Controlled, Quadrature-Enhanced, Double-Tuned RF Coil for Sodium MRI

Sodium (²³Na) MRI provides complementary cellular and metabolic information. However, the intrinsic MR sensitivity of ²³Na is considerably lower compared with that of the proton, making it difficult to measure MR-detectable sodium signals. It is therefore important to maintain the signal-to-noise ratio (SNR) of the sodium signal as high as possible. Double-tuned coils are often employed in combinationwith a ¹H coil, providing structural images and B₀ shimming capability. The double-tuned coil design can be achieved with the use of two geometrically decoupled coils whose B₁ field directions are perpendicular to each other. This can be used to design quadrature-driven, single-nucleus coils to improve SNR, and additionally, this coil can also be utilized as a linear-driven double-resonant mode. Here, we have developed and evaluateda quadrature-enhanced, double-tuned coil. The novel coil uses PIN-diode switches, inserted only in the loop coil, to shift the resonance frequency between ¹H and ²³Na so that ²³Na signals can be acquired in quadrature and the capability of using ¹H function remains. Consequently, the ²³Na SNR values obtained with the double-tuned coil are nearly 33% and 17% higher in comparison with geometrically identical single-tuned coils. SNR plots also show the superiority of double-tuned coil in ²³Na.

Hybrid MR-PET of brain tumours using amino acid PET and chemical exchange saturation transfer MRI

PURPOSE

PET using radiolabelled amino acids has become a promising tool in the diagnostics of gliomas and brain metastasis. Current research is focused on the evaluation of amide proton transfer (APT) chemical exchange saturation transfer (CEST) MR imaging for brain tumour imaging. In this hybrid MR-PET study, brain tumours were compared using 3D data derived from APT-CEST MRI and amino acid PET using O-(2-¹⁸F-fluoroethyl)-L-tyrosine (¹⁸F-FET).

METHODS

Eight patients with gliomas were investigated simultaneously with ¹⁸F-FET PET and APT-CEST MRI using a 3-T MR-BrainPET scanner. CEST imaging was based on a steady-state approach using a B₁ average power of 1μT. B₀ field inhomogeneities were corrected a Prametric images of magnetisation transfer ratio asymmetry (MTR_asym) and differences to the extrapolated semi-solid magnetisation transfer reference method, APT# and nuclear Overhauser effect (NOE#), were calculated. Statistical analysis of the tumour-to-brain ratio of the CEST data was performed against PET data using the non-parametric Wilcoxon test.

RESULTS

A tumour-to-brain ratio derived from APT# and ¹⁸F-FET presented no significant differences, and no correlation was found between APT# and ¹⁸F-FET PET data. The distance between local hot spot APT# and ¹⁸F-FET were different (average 20 ± 13 mm, range 4-45 mm).

CONCLUSION

For the first time, CEST images were compared with ¹⁸F-FET in a simultaneous MR-PET measurement. Imaging findings derived from¹⁸F-FET PET and APT CEST MRI seem to provide different biological information. The validation of these imaging findings by histological confirmation is necessary, ideally using stereotactic biopsy.

Proton and multinuclear magnetic resonance spectroscopy in the human brain at ultra-high field strength: A review

Magnetic Resonance Spectroscopy (MRS) allows for a non-invasive and non-ionizing determination of in vivo tissue concentrations and metabolic turn-over rates of more than 20 metabolites and compounds in the central nervous system of humans. The aim of this review is to give a comprehensive overview about the advantages, challenges and advances of ultra-high field MRS with regard to methodological development, discoveries and applications from its beginnings around 15 years ago up to the current state. The review is limited to human brain and spinal cord application at field strength of 7T and 9.4T and includes all relevant nuclei (¹H, ³¹P, ¹³C).

Design and construction of a novel 1H/19F double-tuned coil system using PIN-diode switches at 9.4T

A double-tuned ¹H/¹⁹F coil using PIN-diode switches was developed and its performance evaluated. The is a key difference from the previous developments being that this design used a PIN-diode switch in series with an additionally inserted inductor in parallel to one of the capacitors on the loop. The probe was adjusted to ¹⁹F when the reverse bias voltage was applied (PIN-diode OFF), whilst it was switched to ¹H when forward current was flowing (PIN-diode ON). S-parameters and Q-factors of single- and double-tuned coils were examined and compared with/without a phantom on the bench. Imaging experiments were carried out on a 9.4T preclinical scanner. All coils were tuned at resonance frequencies and matched well. It is shown that the Q-ratio and SNR of double-tuned coil at ¹⁹F frequency are nearly as good as those of a single-tuned coil. Since the operating frequency was tuned to ¹⁹F when the PIN-diodes were turned off, losses due to PIN-diodes were substantially lower resulting in the provision of excellent image quality of X-nuclei.

Design and implementation of a simple multinuclear MRI system for ultra high-field imaging of animals

Non-proton MRI has recently garnered gathering interest with the increased availability of ultra high-field MRI system. Assuming the availability of a broadband RF amplifier, performing multinuclear MR experiments essentially requires additional hardware, such as an RF resonator and a T/R switch for each nucleus. A double- or triple-resonant RF probe is typically constructed using traps or PIN-diode circuits, but this approach degrades the signal-to-noise ratio (SNR) and image quality compared to a single-resonant coil and this is a limiting factor. In this work, we have designed the required hardware for multinuclear MR imaging experiments employing six single-resonant coil sets and a purpose-built animal bed; these have been implemented into a home-integrated 9.4T preclinical MRI scanner. System capabilities are demonstrated by distinguishing concentration differences and sensitivity of X-nuclei imaging and spectroscopy without SNR penalty for any nuclei, no subject interruption and no degradation of the static shim conditions.

Non-invasive metabolic imaging of brain tumours in the era of precision medicine

The revolution in cancer genomics has uncovered a variety of clinically relevant mutations in primary brain tumours, creating an urgent need to develop non-invasive imaging biomarkers to assess and integrate this genetic information into the clinical management of patients. Metabolic reprogramming is a central hallmark of cancer, including brain tumours; indeed, many of the molecular pathways implicated in the pathogenesis of brain tumours result in reprogramming of metabolism. This relationship provides the opportunity to devise in vivo metabolic imaging modalities to improve diagnosis, patient stratification, and monitoring of treatment response. Metabolic phenomena, such as the Warburg effect and altered mitochondrial metabolism, can be leveraged to image brain tumours using techniques including PET and MRI. Moreover, genetic alterations, such as mutations affecting isocitrate dehydrogenase, are associated with unique metabolic signatures that can be detected using magnetic resonance spectroscopy. The need to translate our understanding of the molecular features of brain tumours into imaging modalities with clinical utility is growing; metabolic imaging provides a unique platform to achieve this objective. In this Review, we examine the molecular basis for metabolic reprogramming in brain tumours, and examine current non-invasive metabolic imaging strategies that can be used to interrogate these molecular characteristics with the ultimate goal of guiding and improving patient care.

Electrodynamics and radiofrequency antenna concepts for human magnetic resonance at 23.5 T (1 GHz) and beyond

OBJECTIVE

This work investigates electrodynamic constraints, explores RF antenna concepts and examines the transmission fields (B 1 (+) ) and RF power deposition of dipole antenna arrays for (1)H magnetic resonance of the human brain at 1 GHz (23.5 T).

MATERIALS AND METHODS

Electromagnetic field (EMF) simulations are performed in phantoms with average tissue simulants for dipole antennae using discrete frequencies [300 MHz (7.0 T) to 3 GHz (70.0 T)]. To advance to a human setup EMF simulations are conducted in anatomical human voxel models of the human head using a 20-element dipole array operating at 1 GHz.

RESULTS

Our results demonstrate that transmission fields suitable for (1)H MR of the human brain can be achieved at 1 GHz. An increase in transmit channel density around the human head helps to enhance B 1 (+) in the center of the brain. The calculated relative increase in specific absorption rate at 23.5 versus 7.0 T was below 1.4 (in-phase phase setting) and 2.7 (circular polarized phase setting) for the dipole antennae array.

CONCLUSION

The benefits of multi-channel dipole antennae at higher frequencies render MR at 23.5 T feasible from an electrodynamic standpoint. This very preliminary finding opens the door on further explorations that might be catalyzed into a 20-T class human MR system.

Imaging of sodium in the brain: a brief review

Sodium-based MRI plays a vital role in the study of metabolism and can unveil valuable information about emerging and existing pathology--in particular in the human brain. Sodium is the second most abundant MR active nucleus in living tissue and, due to its quadrupolar nature, has magnetic properties not common to conventional proton MRI, which can reveal further insights, such as information on the compartmental distribution of intra- and extracellular sodium. Nevertheless, the use of sodium nuclei for imaging comes at the expense of a lower sensitivity and significantly reduced relaxation times, making in vivo sodium studies feasible only at high magnetic field strength and by the use of dedicated pulse sequences. Hybrid imaging combining sodium MRI and positron emission tomography (PET) simultaneously is a novel and promising approach to access information on dynamic metabolism with much increased, PET-derived specificity. Application of this new methodology is demonstrated herein using examples from tumour imaging.