Review Article
X-nuclei imaging: Current state, technical challenges, and future directions
Ruomin Hu MS,
Dennis Kleimaier MS,
Matthias Malzacher PhD,
Michaela A.U. Hoesl MS,
Nadia K. Paschke MS,
Lothar R. Schad PhD,
Corresponding Author
Ruomin Hu MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Address reprint requests to: R.H., Computer Assisted Clinical Medicine, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. E-mail: [email protected]Search for more papers by this authorDennis Kleimaier MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorMatthias Malzacher PhD
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorMichaela A.U. Hoesl MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorNadia K. Paschke MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorLothar R. Schad PhD
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorRuomin Hu MS,
Dennis Kleimaier MS,
Matthias Malzacher PhD,
Michaela A.U. Hoesl MS,
Nadia K. Paschke MS,
Lothar R. Schad PhD,
Corresponding Author
Ruomin Hu MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Address reprint requests to: R.H., Computer Assisted Clinical Medicine, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. E-mail: [email protected]Search for more papers by this authorDennis Kleimaier MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorMatthias Malzacher PhD
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorMichaela A.U. Hoesl MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorNadia K. Paschke MS
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorLothar R. Schad PhD
Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
Search for more papers by this authorAbstract
1H imaging is concerned with contrast generation among anatomically distinct soft tissues. X-nuclei imaging, on the other hand, aims to reveal the underlying changes in the physiological processes on a cellular level. Advanced clinical MR hardware systems improved 1H image quality and simultaneously enabled X-nuclei imaging. Adaptation of 1H methods and optimization of both sequence design and postprocessing protocols launched X-nuclei imaging past feasibility studies and into clinical studies. This review outlines the current state of X-nuclei MRI, with the focus on 23Na, 35Cl, 39K, and 17O. Currently, various aspects of technical challenges limit the possibilities of clinical X-nuclei MRI applications. To address these challenges, quintessential physical and technical concepts behind different applications are presented, and the advantages and drawbacks are delineated. The working process for methods such as quantification and multiquantum imaging is shown step-by-step. Clinical examples are provided to underline the potential value of X-nuclei imaging in multifaceted areas of application. In conclusion, the scope of the latest technical advance is outlined, and suggestions to overcome the most fundamental hurdles on the way into clinical routine by leveraging the full potential of X-nuclei imaging are presented.
Level of Evidence: 1
Technical Efficacy Stage: 3
J. Magn. Reson. Imaging 2020;51:355–376.
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