Clinical applications of chemical exchange saturation transfer (CEST) MRI

J Magn Reson Imaging. 2018 Jan;47(1):11-27. doi: 10.1002/jmri.25838. Epub 2017 Aug 9.

Abstract

Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) has been developed and employed in multiple clinical imaging research centers worldwide. Selective radiofrequency (RF) saturation pulses with standard 2D and 3D MRI acquisition schemes are now routinely performed, and CEST MRI can produce semiquantitative results using magnetization transfer ratio asymmetry (MTRasym ) analysis while accounting for B0 inhomogeneity. Faster clinical CEST MRI acquisition methods and more quantitative acquisition and analysis routines are under development. Endogenous biomolecules with amide, amine, and hydroxyl groups have been detected during clinical CEST MRI studies, and exogenous CEST agents have also been administered to patients. These CEST MRI tools show promise for contributing to assessments of cerebral ischemia, neurological disorders, lymphedema, osteoarthritis, muscle physiology, and solid tumors. This review summarizes the salient features of clinical CEST MRI protocols and critically evaluates the utility of CEST MRI for these clinical imaging applications.

Level of evidence: 5 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:11-27.

Keywords: CEST; MRI; clinical imaging applications.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Animals
  • Brain / diagnostic imaging*
  • Brain Neoplasms / diagnostic imaging
  • Contrast Media / chemistry
  • Disease Models, Animal
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Image Interpretation, Computer-Assisted
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Lymphedema / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Molecular Imaging
  • Muscle, Skeletal / diagnostic imaging
  • Nervous System Diseases / diagnostic imaging
  • Osteoarthritis / diagnostic imaging
  • Phantoms, Imaging
  • Radio Waves
  • Stroke / diagnostic imaging*

Substances

  • Contrast Media