Dynamic glucose enhanced imaging using direct water saturation

• Published in: Magnetic resonance in medicine Vol. 94; no. 1; pp. 15 - 27
• Main Authors: Knutsson, Linda, Yadav, Nirbhay N., Mohammed Ali, Sajad, Kamson, David Olayinka, Demetriou, Eleni, Seidemo, Anina, Blair, Lindsay, Lin, Doris D., Laterra, John, Zijl, Peter C. M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2025; John Wiley and Sons Inc
• Subjects: Adult; Algorithms; Annan fysik; Blood; Brain; Brain - diagnostic imaging; Brain cancer; Brain Neoplasms - diagnostic imaging; Brain tumors; Cerebrospinal fluid; CEST; Clinical Medicine; Deep learning; direct saturation (DS); dynamic glucose enhanced (DGE) MRI; Female; Fysik; glucoCEST; Glucose; Glucose - administration & dosage; Glucose - chemistry; Glucose - metabolism; Gray Matter - diagnostic imaging; Humans; Hyperglycemia; Image acquisition; Image Processing, Computer-Assisted - methods; Imaging Methodology; Klinisk medicin; Lesions; Line broadening; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical and Health Sciences; Medical imaging; Medicin och hälsovetenskap; Natural Sciences; Naturvetenskap; Neuroimaging; Other Physics Topics; Perfusion; Physical Sciences; Radiologi och bildbehandling; Radiology and Medical Imaging; Rapid Communication; Substantia alba; Substantia grisea; Tumors; Water - chemistry; White Matter - diagnostic imaging; Z‐spectra; dynamic glucose enhanced (DGE) MRI; glucoCEST; CEST; Z‐spectra; direct saturation (DS)
• ISSN: 0740-3194; 1522-2594; 1522-2594
• DOI: 10.1002/mrm.30447

Purpose Dynamic glucose enhanced (DGE) MRI studies employ CEST or spin lock (CESL) to study glucose uptake. Currently, these methods are hampered by low effect size and sensitivity to motion. To overcome this, we propose to utilize exchange‐based linewidth (LW) broadening of the direct water saturation (DS) curve of the water saturation spectrum (Z‐spectrum) during and after glucose infusion (DS‐DGE MRI). Methods To estimate the glucose‐infusion‐induced LW changes (ΔLW), Bloch‐McConnell simulations were performed for normoglycemia and hyperglycemia in blood, gray matter (GM), white matter (WM), CSF, and malignant tumor tissue. Whole‐brain DS‐DGE imaging was implemented at 3 T using dynamic Z‐spectral acquisitions (1.2 s per offset frequency, 38 s per spectrum) and assessed on four brain tumor patients using infusion of 35 g of D‐glucose. To assess ΔLW, a deep learning‐based Lorentzian fitting approach was used on voxel‐based DS spectra acquired before, during, and post‐infusion. Area‐under‐the‐curve (AUC) images, obtained from the dynamic ΔLW time curves, were compared qualitatively to perfusion‐weighted imaging parametric maps. Results In simulations, ΔLW was 1.3%, 0.30%, 0.29/0.34%, 7.5%, and 13% in arterial blood, venous blood, GM/WM, malignant tumor tissue, and CSF, respectively. In vivo, ΔLW was approximately 1% in GM/WM, 5% to 20% for different tumor types, and 40% in CSF. The resulting DS‐DGE AUC maps clearly outlined lesion areas. Conclusions DS‐DGE MRI is highly promising for assessing D‐glucose uptake. Initial results in brain tumor patients show high‐quality AUC maps of glucose‐induced line broadening and DGE‐based lesion enhancement similar and/or complementary to perfusion‐weighted imaging.