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Schüre, Jan‐Rüdiger; Shrestha, Manoj; Breuer, Stella; Deichmann, Ralf; Hattingen, Elke; Wagner, Marlies; Pilatus, Ulrich
NMR in biomedicine, November 2019, Letnik: 32, Številka: 11Journal Article
The pH value is a potential physiological marker for clinical diagnosis as it is altered in pathologies such as tumors. While intracellular pH can be measured noninvasively via phosphorus spectroscopy (31P MRSI), Amide Proton Transfer‐Chemical Exchange Saturation Transfer (APT‐CEST) MRI has been suggested as an alternative method for pH quantification. To assess the suitability of APT‐CEST contrast for pH quantification, two approaches (magnetization transfer ratio asymmetry MTRasym and Lorentzian difference analysis LDA) for analyzing the Z‐spectrum have been correlated with pH values obtained by 31P MRSI. Fourteen patients with glioblastoma and 12 healthy controls were included. In contrast to MTRasym, the LDA is modeling the direct water saturation and the semi‐solid magnetization transfer, allowing a separate evaluation of the aliphatic nuclear Overhauser effect and the APT‐CEST. The results of our study show that the pH values obtained by 31P MRSI correspond well with both methods describing the APT‐CEST contrast. Two‐sample t‐test showed significant differences in MTRasym, LDA and pH obtained by 31P MRSI for regions of interest in glioblastoma, contralateral control areas and normal appearing white matter (P < 0.001). A slightly improved correlation between the amide signal and pH was found after performing LDA (r = 0.78) compared with MTRasym (r = 0.70). While both methods can be used to monitor pH changes, the LDA approach appears to be better suited. In this in vivo study we compare pH obtained by 31P‐MRSI with the pH sensitivity of Amide Proton Transfer‐Chemical Exchange Saturation Transfer (APT‐CEST) contrast, analyzed by either the asymmetric magnetization transfer rate (MTRasym) or by Lorentzian Difference Analysis (LDA). While both approaches show a good correlation with 31P spectroscopic data, LDA appears to be more suitable for the detection of pH changes.
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