Original Research

In Vivo Proton Exchange Rate (k_ex) MRI for the Characterization of Multiple Sclerosis Lesions in Patients

Haiqi Ye MS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

These authors contributed equally as co-first authors.

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Mehran Shaghaghi PhD,

Mehran Shaghaghi PhD

orcid.org/0000-0002-0278-9936

Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

These authors contributed equally as co-first authors.

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Qianlan Chen BS,

Qianlan Chen BS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Yan Zhang MS,

Yan Zhang MS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Sarah E. Lutz PhD,

Sarah E. Lutz PhD

Department of Anatomy and Cell Biology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

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Weiwei Chen MD, PhD,

Corresponding Author

Weiwei Chen MD, PhD

[email protected]

orcid.org/0000-0001-8014-2364

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Address reprint requests to: K.C., 1747 W Roosevelt Rd. Room 324, UI Health Westside Research Office Building, Chicago, IL, 60608-1264, USA. E-mail: [email protected], or W.C., Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. E-mail: [email protected]

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Kejia Cai PhD,

Corresponding Author

Kejia Cai PhD

[email protected]

Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA

Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA

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Haiqi Ye MS,

Haiqi Ye MS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

These authors contributed equally as co-first authors.

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Mehran Shaghaghi PhD,

Mehran Shaghaghi PhD

orcid.org/0000-0002-0278-9936

Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

These authors contributed equally as co-first authors.

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Qianlan Chen BS,

Qianlan Chen BS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Yan Zhang MS,

Yan Zhang MS

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Sarah E. Lutz PhD,

Sarah E. Lutz PhD

Department of Anatomy and Cell Biology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

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Weiwei Chen MD, PhD,

Corresponding Author

Weiwei Chen MD, PhD

[email protected]

orcid.org/0000-0001-8014-2364

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Kejia Cai PhD,

Corresponding Author

Kejia Cai PhD

[email protected]

Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA

Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA

Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA

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First published: 24 September 2020

https://doi.org/10.1002/jmri.27363

Citations: 4

Contract grant sponsor: National Institutes of Health; Contract grant numbers: R21EB023516, R01AG061114, R21AG053876; Contract grant sponsor: National Natural Science Foundation of China; Contract grant number: 81401390.

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Abstract

Background

Currently available radiological methods do not completely capture the diversity of multiple sclerosis (MS) lesion subtypes. This lack of information hampers the understanding of disease progression and potential treatment stratification. For example, inflammation persists in some lesions after gadolinium (Gd) enhancement resolves. Novel metabolic and molecular imaging methods may improve the current assessments of MS pathophysiology.

Purpose

To compare the in vivo proton exchange rate (k_ex) MRI with Gd-enhanced MRI for characterizing MS lesions.

Study Type

Retrospective.

Subjects

Sixteen consecutively diagnosed relapsing-remitting multiple sclerosis (RRMS) patients.

Field Strength/Sequence

3.0T MRI with T₂-weighted imaging, postcontrast T₁-weighted imaging, and single-slice chemical exchange saturation transfer imaging.

Assessment

MS lesions in white matter were assessed for Gd enhancement and k_ex elevation compared to normal-appearing white matter (NAWM).

Statistical Tests

Student's t-test was used for analyzing the difference of k_ex values between lesions and NAWM, with statistical significance set at 0.05.

Results

Of all 153 MS lesions, 78 (51%) lesions were Gd-enhancing and 75 (49%) were Gd-negative. Without exception, all 78 Gd-enhancing lesions showed significantly elevated k_ex values compared to NAWM (924 ± 130 s^–1 vs. 735 ± 61 s^–1, P < 0.05). Of 75 Gd-negative lesions, 18 lesions (24%) showed no k_ex elevation (762 ± 29 s^–1 vs. 755 ± 28 s^–1, P = 0.47) and 57 (76%) showed significant k_ex elevation (950 ± 124 s^–1 vs. 759 ± 48 s^–1, P < 0.05) compared to NAWM. MS lesions with k_ex elevation appeared nodular (118, 87.4%), ring-like (15, 11.1%), or irregular-shaped (2, 1.5%).

Data Conclusion

For Gd-enhancing lesions, k_ex MRI is highly consistent with Gd-enhanced images by showing 100% of elevated k_ex. For all Gd-negative lesions, the discrepancy on k_ex MRI may further differentiate active slowly expanding lesions or chronic inactive lesions, supporting k_ex as an imaging biomarker for tissue oxidative stress and inflammation.

Level of Evidence 2

Technical Efficacy Stage 3

J. MAGN. RESON. IMAGING 2021;53:408–415.

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Citing Literature

Volume53, Issue2

February 2021

Pages 408-415

In Vivo Proton Exchange Rate (k_ex) MRI for the Characterization of Multiple Sclerosis Lesions in Patients

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Information

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In Vivo Proton Exchange Rate (kex) MRI for the Characterization of Multiple Sclerosis Lesions in Patients

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Related

Information

In Vivo Proton Exchange Rate (k_ex) MRI for the Characterization of Multiple Sclerosis Lesions in Patients