Recent technical developments and clinical research applications of sodium (23Na) MRI

Gast, Lena V.; Platt, Tanja; Nagel, Armin M.; Gerhalter, Teresa

doi:10.1016/j.pnmrs.2023.04.002

Cited by 5 publications

(8 citation statements)

References 288 publications

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“…To explore potential sources for deviations in both low and high aTSC ranges, correlations were examined between relaxation-corrected aTSC, calibrated with agarose phantoms, and water T2 along with PDFF measured by 1 H MRI (Fig. 5).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the technical aspects of sodium quantification in skeletal muscle tissue, the short relaxation times of 23 Na in skeletal muscle tissue significantly impacts the Na MRI are frequently used in more methodical studies that included healthy subjects (see Table S4), in the majority of clinical studies, Cartesian GRE sequences have been used (see Additional file 1: Supplemental Table S5) [1]. However, the phase encoding gradients of the Cartesian GRE limit the achievable echo times, so that these sequences encounter significant T2 * weighting.…”

Section: Discussionmentioning

confidence: 99%

“…Sodium ( 23 Na) magnetic resonance imaging (MRI) has gained increasing use as a method to evaluate sodium homeostasis within skeletal muscle tissue [1]. Its successful application spans various pathologies, detecting changes in muscular sodium content, from (neuro-)muscular diseases [2,3] to renal impairment [4][5][6] and cardiovascular diseases [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…In biological tissues such as the muscle, 23 Na nuclei exhibit a biexponential signal decay with a short component, T2 s * , and a long component, T2 l * : Within skeletal muscle tissue, T2 s * ranges from 0.6 to 3.6 ms, while T2 l * has been measured in the range of 11-26 ms [1]. Given that the short component constitutes 60% of the total 23 Na signal, specific pulse sequences are necessary to capture the rapidly decaying 23 Na signal and achieve a spin-density weighted image contrast.…”

Section: Introductionmentioning

confidence: 99%

“…However, a separation of the long and short T1 components is challenging due to the 20/80% ratio for the short and long components of T1 as well as due to the smaller difference between them, compared to the larger difference between the T2 components [13]. Typical monoexponential 23 Na T1 values are in the range of 25-33 ms for skeletal muscle tissue and around 60 ms for saline solutions [1]. These T1 values are crucial for quantitative 23 Na imaging, where reference compartments with known sodium concentrations are required for calibration of the 23 Na MR signal.…”

Section: Introductionmentioning

confidence: 99%

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Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques

Gerhalter,

Schilling,

Zeitouni

et al. 2024

Eur Radiol Exp

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Background Clinical magnetic resonance imaging (MRI) studies often use Cartesian gradient-echo (GRE) sequences with ~2-ms echo times (TEs) to monitor apparent total sodium concentration (aTSC). We compared Cartesian GRE and ultra-short echo time three-dimensional (3D) radial-readout sequences for measuring skeletal muscle aTSC. Methods We retrospectively evaluated 211 datasets from 112 volunteers aged 62.3 ± 12.1 years (mean ± standard deviation), acquired at 3 T from the lower leg. For 23Na MRI acquisitions, we used a two-dimensional Cartesian GRE sequence and a density-adapted 3D radial readout sequence with cuboid field-of-view (DA-3D-RAD-C). We calibrated the 23Na MR signal using reference tubes either with or without agarose and subsequently performed a relaxation correction. Additionally, we employed a six-echo 1H GRE sequence and a multi-echo spin-echo sequence to calculate proton density fat fraction (PDFF) and water T2. Paired Wilcoxon signed-rank test, Cohen dz for paired samples, and Spearman correlation were used. Results Relaxation correction effectively reduced the differences in muscle aTSC between the two acquisition and calibration methods (DA-3D-RAD-C using NaCl/agarose references: 20.05 versus 19.14 mM; dz = 0.395; Cartesian GRE using NaCl/agarose references: 19.50 versus 18.82 mM; dz = 0.427). Both aTSC of the DA-3D-RAD-C and Cartesian GRE acquisitions showed a small but significant correlation with PDFF as well as with water T2. Conclusions Different 23Na MRI acquisition and calibration approaches affect aTSC values. Applying relaxation correction is advised to minimize the impact of sequence parameters on quantification, and considering additional fat correction is advisable for patients with increased fat fractions. Relevance statement This study highlights relaxation correction’s role in improving sodium MRI accuracy, paving the way for better disease assessment and comparability of measured sodium signal in patients. Key points • Differences in MRI acquisition methods hamper the comparability of sodium MRI measurements. • Measured sodium values depend on used MRI sequences and calibration method. • Relaxation correction during postprocessing mitigates these discrepancies. • Thus, relaxation correction enhances accuracy of sodium MRI, aiding its clinical use. Graphical Abstract

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques

Gerhalter,

Schilling,

Zeitouni

et al. 2024

Eur Radiol Exp

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Tissue Sodium Magnetic Resonance Imaging: Agreement and Repeatability of Manual Region of Interest Segmentation Methods

Martin,

Nguyen,

Tiong

et al. 2024

Magnetic Resonance Imaging

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Quantitative 23Na magnetic resonance imaging in the abdomen at 3 T

Birchall,

Horvat-Menih,

Kaggie

et al. 2024

Magn Reson Mater Phy

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Objectives To assess the feasibility of sodium-23 MRI for performing quantitative and non-invasive measurements of total sodium concentration (TSC) and relaxation in a variety of abdominal organs. Materials and methods Proton and sodium imaging of the abdomen was performed in 19 healthy volunteers using a 3D cones sequence and a sodium-tuned 4-rung transmit/receive body coil on a clinical 3 T system. The effects of B1 non-uniformity on TSC measurements were corrected using the double-angle method. The long-component of 23Na T2* relaxation time was measured using a series of variable echo-times. Results The mean and standard deviation of TSC and long-component 23Na T2* values were calculated across the healthy volunteer group in the kidneys, cerebrospinal fluid (CSF), liver, gallbladder, spleen, aorta, and inferior vena cava. Discussion Mean TSC values in the kidneys, liver, and spleen were similar to those reported using 23Na-MRI previously in the literature. Measurements in the CSF and gallbladder were lower, potentially due to the reduced spatial resolution achievable in a clinically acceptable scan time. Mean long-component 23Na T2* values were consistent with previous reports from the kidneys and CSF. Intra-population standard error was larger in smaller, fluid-filled structures due to fluid motion and partial volume effects.

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Recent technical developments and clinical research applications of sodium (23Na) MRI

Cited by 5 publications

References 288 publications

Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques

Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques

Tissue Sodium Magnetic Resonance Imaging: Agreement and Repeatability of Manual Region of Interest Segmentation Methods

Quantitative 23Na magnetic resonance imaging in the abdomen at 3 T

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