Tissue characterization of intracranial tumors by magnetization transfer and spin-lattice relaxation parameters in vivo

Comparison of amide proton transfer imaging and magnetization transfer imaging in revealing glioma grades and proliferative activities: a histogram analysis

PURPOSE

Comprehensive understanding glioma metabolic characters is of great help for patient management. We aimed to compare amide proton transfer imaging (APTw) and magnetization transfer imaging (MT) in predicting glioma malignancy and reflecting tumor proliferation.

METHODS

Thirty low-grade gliomas (LGGs) and 39 high-grade gliomas (HGGs) were prospectively included, of which 58 samples Ki-67 levels were quantified. Anatomical MRI, APTw, and MT were scanned, and magnetization transfer ratio (MTR) and asymmetric magnetic transfer ratio at 3.5 ppm (MTR_asym(3.5ppm)) were calculated. ROIs were semi-automatically drawn with ImageJ, from which histogram features, including 5th, 25th, 50th, mean, 70th, 90th, and 95th percentiles were extracted. The independent t test was used to test differences in LGGs and HGGs, and correlations between histogram features and tumor grades, Ki-67 were revealed by Spearman's rank or Pearson's correlation analysis.

RESULTS

The maximum correlation coefficient (R) values of APTw were 0.526 (p < 0.001) with tumor grades and 0.397 (p < 0.001) with Ki-67 at 90th percentiles, while only 5th and 25th percentiles of MT significantly correlated with tumor grades. Moreover, APTw features were significantly different in LGGs and HGGs, except 5th percentile. The most significantly different feature was 95th percentile, providing the excellent AUC of 0.808. However, the best feature in MTR was 5th percentiles with AUC of 0.703. Combing 5th and 95th of APTw achieved highest AUC Of 0.837.

CONCLUSIONS

Both APTw and MT provide quantitative information for tumor metabolite imaging. However, APTw supplys more specific information in reflecting glioma biological behaviors than MT, and well differentiates glioma malignancy.

Amid proton transfer (APT) and magnetization transfer (MT) MRI contrasts provide complimentary assessment of brain tumors similarly to proton magnetic resonance spectroscopy imaging (MRSI)

OBJECTIVES

Using MRSI as comparison, we aimed to explore the difference between amide proton transfer (APT) MRI and conventional semi-solid magnetization transfer ratio (MTR) MRI, and to investigate if molecular APT and structural MTR can provide complimentary information in assessing brain tumors.

METHODS

Seventeen brain tumor patients and 17 age- and gender-matched volunteers were included and scanned with anatomical MRI, APT and MT-weighted MRI, and MRSI. Multi-voxel choline (Cho) and N-acetylaspartic acid (NAA) signals were quantified from MRSI and compared with MTR and MTR_asym(3.5ppm) contrasts averaged from corresponding voxels. Correlations between contrasts were explored voxel-by-voxel by pooling values from all voxels into Pearson's correlation analysis. Differences in correlation coefficients were tested with the Z-test (set at p<0.05).

RESULTS

APT and MT provide good contrast and quantitative parameters in tumor imaging, as do the metabolite (Cho and NAA) maps. MTR_asym(3.5ppm) significantly correlated with MTR (R=-0.61, p<0.0001), Cho (R=0.568, p<0.0001) and NAA (R=-0.619, p<0.0001) in tumors, and MTR also significantly correlated with Cho (R=-0.346, p<0.0001) and NAA (R=0.624, p<0.0001). In healthy volunteers, MTR_asym(3.5ppm) was non-significantly correlated with MTR (R=-0.049, p=0.239), Cho (R=0.030, p=0.478) and NAA (R=-0.083, p=0.046). Significant correlations were found among MTR with Cho (R=0.199, p<0.0001) and NAA (R=0.263, p<0.0001) in the group of healthy volunteers with lower correlation R values than those in tumor patients.

CONCLUSIONS

APT and MT could provide independent and supplementary information for the comprehensive assessment of molecular and structural changes due to brain tumor cancerogenesis.

KEY POINTS

• MTR _asym(3.5ppm) positively correlated with Cho while negatively with NAA in tumors. • MTR positively correlated with NAA while negatively with Cho in tumors. • Combining APT/MT provides molecular and structural information similarly to MRSI.

Optimizing MR Scan Design for Model-Based ${T}_{1}$ , ${T}_{2}$ Estimation From Steady-State Sequences

Rapid, reliable quantification of MR relaxation parameters T1 and T2 is desirable for many clinical applications. Steady-state sequences such as Spoiled Gradient-Recalled Echo (SPGR) and Dual-Echo Steady-State (DESS) are fast and well-suited for relaxometry because the signals they produce are quite sensitive to T1 and T2 variation. However, T1, T2 estimation with these sequences typically requires multiple scans with varied sets of acquisition parameters. This paper describes a systematic framework for selecting scan types (e.g., combinations of SPGR and DESS scans) and optimizing their respective parameters (e.g., flip angles and repetition times). The method is based on a Cramér-Rao Bound (CRB)-inspired min-max optimization that finds scan parameter combinations that robustly enable precise object parameter estimation. We apply this technique to optimize combinations of SPGR and DESS scans for T1, T2 relaxometry in white matter (WM) and grey matter (GM) regions of the human brain at 3T field strength. Phantom accuracy experiments show that SPGR/DESS scan combinations are in excellent agreement with reference measurements. Phantom precision experiments show that trends in T1,T2 pooled sample standard deviations reflect CRB-based predictions. In vivo experiments show that in WM and GM, T1 and T2 estimates from a pair of optimized DESS scans exhibit precision (but not necessarily accuracy) comparable to that of optimized combinations of SPGR and DESS scans. To our knowledge, T1 maps from DESS acquisitions alone are new. This example application illustrates that scan optimization may help reveal new parameter mapping techniques from combinations of established pulse sequences.

In Vivo Brain MR Imaging at Subnanoliter Resolution: Contrast and Histology

This article provides an overview of in vivo magnetic resonance (MR) imaging contrasts obtained for mammalian brain in relation to histological knowledge. Emphasis is paid to the (1) significance of high spatial resolution for the optimization of T1, T2, and magnetization transfer contrast, (2) use of exogenous extra- and intracellular contrast agents for validating endogenous contrast sources, and (3) histological structures and biochemical compounds underlying these contrasts and (4) their relevance to neuroradiology. Comparisons between MR imaging at subnanoliter resolution and histological data indicate that (a) myelin sheaths, (b) nerve cells, and (c) the neuropil are most responsible for observed MR imaging contrasts, while (a) diamagnetic macromolecules, (b) intracellular paramagnetic ions, and (c) extracellular free water, respectively, emerge as the dominant factors. Enhanced relaxation rates due to paramagnetic ions, such as iron and manganese, have been observed for oligodendrocytes, astrocytes, microglia, and blood cells in the brain as well as for nerve cells. Taken together, a plethora of observations suggests that the delineation of specific structures in high-resolution MR imaging of mammalian brain and the absence of corresponding contrasts in MR imaging of the human brain do not necessarily indicate differences between species but may be explained by partial volume effects. Second, paramagnetic ions are required in active cells in vivo which may reduce the magnetization transfer ratio in the brain through accelerated T1 recovery. Third, reductions of the magnetization transfer ratio may be more sensitive to a particular pathological condition, such as astrocytosis, microglial activation, inflammation, and demyelination, than changes in relaxation. This is because the simultaneous occurrence of increased paramagnetic ions (i.e., shorter relaxation times) and increased free water (i.e., longer relaxation times) may cancel T1 or T2 effects, whereas both processes reduce the magnetization transfer ratio.

Contributors to contrast between glioma and brain tissue in chemical exchange saturation transfer sensitive imaging at 3 Tesla

Off-resonance saturation transfer images have shown intriguing differences in intensity in glioma compared to normal brain tissues. Interpretation of these differences is complicated, however, by the presence of multiple sources of exchanging magnetization including amide, amine, and hydroxyl protons, asymmetric magnetization transfer contrast (MTC) from macromolecules, and various protons with resonances in the aliphatic spectral region. We report a study targeted at separating these components and identifying their relative contributions to contrast in glioma. Off-resonance z-spectra at several saturation powers and durations were obtained from 6 healthy controls and 8 patients with high grade glioma. Results indicate that broad macromolecular MTC in normal brain tissue is responsible for the majority of contrast with glioma. Amide exchange could be detected with lower saturation power than has previously been reported in glioma, but it was a weak signal source with no detectable contrast from normal brain tissue. At higher saturation powers, amine proton exchange was a major contributor to the observed signal but showed no significant difference from normal brain. Robust acquisition strategies that effectively isolate the contributions of broad macromolecular MTC asymmetry from amine exchange were demonstrated that may provide improved contrast between glioma and normal tissue.

Comparison of the magnetization transfer ratio and fluid-attenuated inversion recovery imaging signal intensity in differentiation of various cystic intracranial mass lesions and its correlation with biological parameters

PURPOSE

To compare the signal intensity on the fluid attenuated inversion recovery (FLAIR) sequence and magnetization transfer ratios (MTRs) for the differentiation of abscesses from non-abscess cystic brain lesions, and to correlate these MR parameters with the viscosity, viable cell density and total protein concentration of the cystic fluid.

MATERIALS AND METHODS

Signal intensity on FLAIR and MTRs from the cystic cavity of lesions were calculated from 33 patients (brain abscess (N = 12) and non-abscess (N = 21)). The fluid from the lesion was aspirated at the time of surgery, and the viscosity, viable cell density, and total protein concentration were measured.

RESULTS

Signal intensity on FLAIR correlated significantly with the total protein concentration in abscess (r = 0.60, P < 0.05) and non-abscess lesions (r = 0.41, P < 0.05). However, there was no significant difference (P > 0.05) in the FLAIR signal intensity of the abscess (318.8 +/- 75) and non-abscess group (258 +/- 47). The MTR of the brain abscesses (13 +/- 0.95) was significantly higher (P < 0.05) than that of the non-abscess group (3.5 +/- 0.3). A significant correlation was observed between MTR and viscosity (r = 0.75, P < 0.05), total protein concentration (r = 0.60, P < 0.05), and cell density (r = 0.70, P < 0.05) in brain abscess, and viscosity (r = 0.81, P < 0.05) and total protein concentration (r = 0.41, P < 0.05) in non-abscess lesions.

CONCLUSION

It is possible to differentiate brain abscesses from non-abscess cystic lesions using MT imaging. The MTR correlates significantly with the viscosity, viable cell density, and total protein concentration in brain abscess, and with viscosity and total protein concentration in non-abscess lesions. FLAIR signal intensity correlates significantly only with the total protein concentration in abscess and non-abscess lesions.

Magnetization transfer ratio and volumetric analysis of the brain in macrocephalic patients with neurofibromatosis type 1

The purpose of the study was to evaluate brain myelination by measuring the magnetization transfer ratio (MTR) and to measure grey (GMV) and white matter volume (WMV) in macrocephalic children with neurofibromatosis type 1 (NF1). Seven NF1 patients (aged 0.65-16.67 years) and seven age- and gender-matched controls were studied. A three-dimensional (3D) gradient echo sequence with and without magnetization transfer (MT) prepulse was used for MTR assessment. Volume measurements of GM and WM were performed by applying segmentation techniques on T2-weighted turbo spin echo images (T2WI). MTR of unidentified bright objects (UBOs) on T2WI in cerebellar white matter (52.8+/-3.3), cerebral peduncles (48.5+/-1.5), hippocampus (52.6+/-1.1), internal capsule (55.7+/-0.3), globus pallidus (52.7+/-3.9), and periventricular white matter (52.6+/-1.2) was lower than in the corresponding areas of controls (64.6+/-2.5, 60.8+/-1.3, 56.4+/-0.9, 64.7+/-1.9, 59.2+/-2.3, 63.6+/-1.7, respectively; p<0.05). MTR of normal-appearing brain tissue in patients was not significantly different than in controls. Surface area (mm(2)) of the corpus callosum (809.1+/-62.8), GMV (cm(3)) (850.7+/-42.9), and white matter volume (WMV) (cm(3)) (785.1+/-85.2) were greater in patients than in controls (652.5+/-52.6 mm(2), 611.2+/-92.1 cm(3), 622.5+/-108.7 cm(3), respectively; p<0.05). To conclude, macrocephaly in NF1 patients is related to increased GMV and WMV and corpus callosum enlargement. MTR of UBOs is lower than that of normal brain tissue.

Magnetization transfer ratio measurements of the brain in children with tuberous sclerosis complex

BACKGROUND

Magnetization transfer contrast and magnetization transfer ratio (MTR) in brain are mainly related to the presence of myelin. Neuropathological studies of brain lesions in tuberous sclerosis complex (TSC) have demonstrated disordered myelin sheaths.

OBJECTIVE

To evaluate the MTR of the brain in children with TSC and to compare with that in controls.

MATERIALS AND METHODS

Four patients (aged 0.41-8.4 years, mean 2.5 years) with TSC and four age- and sex-matched controls were evaluated with classic MR sequences and with a three-dimensional gradient-echo sequence without and with magnetization transfer pre-pulse. The MTR was calculated as: (SI(0)-SI(m))/SI(0)x100%, where SI(m) refers to signal intensity from an image acquired with a magnetization transfer pre-pulse and SI(0) the signal intensity from the image acquired without a magnetization transfer pre-pulse.

RESULTS

The MTR values of cortical tubers (44.1+/-4.1), of subependymal nodules (51.6+/-4.8) and of white matter lesions (52.4+/-1.8) were significantly lower than those of cortex (58.7+/-3.53), of basal ganglia (caudate nucleus 58.2+/-2.8, putamen 59.6+/-2.5, thalamus 61.3+/-2.4) and of white matter (64.2+/-2.5) in controls (P<0.001). The MTR of normal-appearing white matter (61.2+/-3.0) in patients was lower than that of white matter in controls (P<0.01). The MTR of cortex and basal ganglia in patients was not significantly different from that in controls.

CONCLUSIONS

MTR measurements not only provide semiquantitative information for TSC lesions but also reveal more extensive disease.

Changes in Magnetization Transfer MRI Correlate with Spreading Depression–Induced Astroglial Reactivity and Increased Protein Expression in Mice

OBJECTIVE

Gliosis refers to a range of glial cell transformations that vary according to specific brain pathologic states. Disease, however, is not a prerequisite for gliosis because glial reactivity may also be seen in regions of increased physiologic activity. Our study tests the hypothesis that high-field-strength magnetization transfer MRI is a sensitive technique for detecting transient glial reactivity after experimental spreading depression, a relatively benign perturbation unaccompanied by cell injury.

MATERIALS AND METHODS

Unilateral neocortical spreading depression was elicited in mouse cerebral hemispheres and confirmed by transcranial blood flow and extracellular potential measurements. After 3 days, mice were imaged at 4 T using magnetization transfer techniques. Astroglial reactivity was determined immunohistochemically, and protein expression in control and experimental hemispheres was compared using proteomic techniques.

RESULTS

Sixteen ([mean +/- SD] +/- 3) spreading depressions (n = 10) were recorded in experimental hemispheres. Spreading depression was never observed in control hemispheres. At 3 days, an 8% decrease (p < 0.05, n = 4) in magnetization transfer signal intensity was measured in experimental hemispheres, which was associated with a 37% increase (p < 0.001, n = 4) in the intensity of glial fibrillary acidic protein staining. Proteomic analysis performed 3 days after the induction of spreading depression showed upregulation of at least 56 proteins, including extracellular and intracellular elements.

CONCLUSION

Magnetization transfer at 4.0-T MRI is a sensitive method for detecting glial reactivity and changes in protein expression not associated with cell injury. These results suggest magnetization transfer MRI techniques may have potential for detecting glial reactivity in physiologic processes such as learning and in early disease states.

Magnetization transfer imaging of the canine brain: a review

Magnetization transfer imaging is a modality capable of examining the non-water components of brain tissue by examining the effects they have on water protons. It may be used qualitatively to increase the visibility of lesions seen during magnetic resonance angiography and following the administration of an intravenous paramagnetic contrast medium. Quantitatively, it can be used to examine the effect of pathology on magnetization transfer contrast, to provide a measurement of myelination, as well as to quantify disease progression in trauma, neoplasia, neurodegeneration and other disorders of the brain. This paper reviews the theory of magnetization transfer imaging, its applications, and provides an example of its use in examining the canine brain.

On- and off-resonance spin-lock MR imaging of normal human brain at 0.1 T: possibilities to modify image contrast

The aim of the present investigation was to determine spin lock (SL) relaxation parameters for the normal brain tissues and thus, to provide basis for optimizing the imaging contrast at 0.1 T. 68 healthy volunteers were included. On-resonance spin lock relaxation time (T1rho) and off-resonance spin lock relaxation parameters (T1rho(off), Me/Mo), MT parameters (T1sat, Ms/Mo), and T1, T2 were determined for the cortical gray matter, and for the frontal and parietal white matters. The T1rho for the frontal and parietal white matters ranged from 110 to 133 ms and from 122 to 155 ms with locking field strengths from 50 microT to 250 microT, respectively. Accordingly, the values for the gray matter ranged from 127 to 155 ms. With a locking field strength of 50 microT, T1rho(off) for the frontal and parietal white matters were from 114 to 217 ms and from 126 to 219 ms, and for the gray matter from 136 to 267 ms with the angle between the effective magnetic field (B(eff)) and the z-axis (theta) ranging from 60 degrees to 15 degrees, respectively. The T1rho of the white and gray matters increased significantly with increasing locking field amplitude (p < 0.001). The T1rho(off) decreased significantly with increasing theta (p < 0.001). T1rho and T1rho(off) with theta > or = 30 degrees were statistically significantly shorter in the frontal than in the parietal white matters (p < 0.05). The duration, amplitude and theta of the locking pulse provide additional parameters to optimize contrast in brain SL imaging.

Flip angle dependence of experimentally determined T1sat and apparent magnetization transfer rate constants

The purpose of this work was to develop a method for determining the T1sat and magnetization transfer (MT) rate constants by analyzing the slice-select flip angle dependent MT behavior of normal white and gray matter. The technique uses a high MT power, three-dimensional (3D) gradient-recalled echo (GRE) sequence, with a well chosen MT pulse frequency offset, such that the experimental conditions closely satisfy requisite assumptions for invoking a first order rate process for MT. Integral to this method is that the T1sat and MT ratio values are obtained under explicitly identical MT saturation conditions. The T1sat of white matter was found to be approximately 300 msec, and the MT rate constant was approximately 2.0 sec(-1). The T1sat of gray matter was approximately 500 msec, and the MT rate constant was 1.1 sec(-1). We also found a strong dependence of the MT rate constant on the slice-select flip angle used for the imaging sequence, independent of the MT saturation parameters. Strongly T1-weighted imaging sequences can result in the underestimation of the MT rate constant by 50%. Practical technical suggestions for quantitative MT experiments are put forth.

T1 rho dispersion imaging of head and neck tumors: a comparison to spin lock and magnetization transfer techniques

The potential of T1 rho dispersion, spin lock (SL), and magnetization transfer (MT) techniques to differentiate benign and malignant head and neck tumors was evaluated. Twenty-four patients with pathologically verified head and neck tumors were studied with a .1-T MR imager. T1 rho dispersion effect was defined as 1 -(intensity with lower locking field amplitude/intensity with higher locking field amplitude). T1 rho dispersion effects were higher for malignant than benign tumors (P = .001). With T1 rho dispersion effect .14 as the threshold, sensitivity for detecting a malignant tumor was 91%, specificity was 77%, and accuracy was 83%. A strong correlation between T1 rho dispersion effects and SL effects and between T1 rho dispersion effects and MT effects in the head and neck tumors was found (r = .87, P < .001 and r = .90, P < .001, respectively). High T1 rho dispersion effects are not specific indicators of malignancy, because chronic infections, some benign tumors, and malignancies may overlap. Low T1 rho dispersion effect values are characteristic of a benign tumor.