ArticleNMR in biomedicine2014
Assessment of ischemic penumbra in patients with hyperacute stroke using amide proton transfer (APT) chemical exchange saturation transfer (CEST) MRI.
Article in NMR in biomedicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers.
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110 citing papers in PubMed, 168 citations in OpenAlex.
- Assessment of lymphatic impairment and interstitial protein accumulation in patients with breast cancer treatment-related lymphedema using CEST MRI.Magnetic resonance in medicine · 2016Trial
- Article
- FlexCENT: A frequency-flexible CEST imaging network combining frequency offset encoding and three-dimensional U-Net.Magnetic resonance letters · 2026Article
- A rapid and accurate guanidine CEST imaging in ischemic stroke using a machine learning approach.Physics in medicine and biology · 2026Article
- Melatonin Alleviates Cerebral Ischemia/Reperfusion Injury by Mitigating AIM2-Mediated PANoptosis in Ischemic Penumbra.Molecular neurobiology · 2026Article
- Accelerating CEST MRI through complementary undersampling and multi-offset transformer reconstruction.Communications engineering · 2026Article
- Field strength-dependent sensitivity of chemical exchange saturation transfer: a methodological comparison of 3 Tesla and 7 Tesla in a clinical cohort.Brain communications · 2026Article
- pH-sensitive probes for ischemic stroke: advancing early detection and accurate grading.Frontiers in molecular biosciences · 2026Review
- Evaluation of skeletal muscle microcirculation via magnetic resonance intravoxel incoherent motion perfusion imaging in an acute ischemia rabbit model.Quantitative imaging in medicine and surgery · 2025Article
- Double-Step R1rho-Based Lorentzian Fitting (DROF): A New CEST Analysis Approach and Its Comparison With Existing Methods.NMR in biomedicine · 2025Article
- Machine learning-based multi-pool Voigt fitting of CEST, rNOE, and MTC in Z-spectra.Magnetic resonance in medicine · 2025Article
- Validation of qMT and CEST MRI as Biomarkers of Response to Treatment After Lumbar Spinal Cord Injury in Rats.NMR in biomedicine · 2025Article
- Multiparametric Chemical Exchange Saturation Transfer MRI Detects Metabolic Changes in Mild Cognitive Impairment Cases at 3.0 Tesla.Neurochemical research · 2024Article
- Assessment of myelination development in neonatal rats using chemical exchange saturation transfer (CEST) 7-T MRI.Experimental brain research · 2024Article
- Amide proton transfer MRI at 9.4 T for differentiating tissue acidosis in a rodent model of ischemic stroke.Magnetic resonance in medicine · 2024Article
- Quantitative separation of CEST effect by RScientific reports · 2024Article
- Multimodal imaging evaluation of early neurological deterioration following acute ischemic stroke.Quantitative imaging in medicine and surgery · 2024Article
- Specific and rapid guanidinium CEST imaging using double saturation power and QUASS analysis in a rodent model of global ischemia.Magnetic resonance in medicine · 2024Article
- Spatiotemporal Dynamics of Neuroinflammation Relate to Behavioral Recovery in Rats with Spinal Cord Injury.Molecular imaging and biology · 2024Article
- Dual contrast CEST MRI for pH-weighted imaging in stroke.Magnetic resonance in medicine · 2024Article
50 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Chemical exchange saturation transfer (CEST)-derived, pH-weighted, amide proton transfer (APT) MRI has shown promise in animal studies for the prediction of infarction risk in ischemic tissue. Here, APT MRI was translated to patients with acute stroke (1-24 h post-symptom onset), and assessments of APT contrast, perfusion, diffusion, disability and final infarct volume (23-92 days post-stroke) are reported. Healthy volunteers (n = 5) and patients (n = 10) with acute onset of symptoms (0-4 h, n = 7; uncertain onset <24 h, n = 3) were scanned with diffusion- and perfusion-weighted MRI, fluid-attenuated inversion recovery (FLAIR) and CEST. Traditional asymmetry and a Lorentzian-based APT index were calculated in the infarct core, at-risk tissue (time-to-peak, TTP; lengthening) and final infarct volume. On average (mean ± standard deviation), control white matter APT values (asymmetry, 0.019 ± 0.005; Lorentzian, 0.045 ± 0.006) were not significantly different (p > 0.05) from APT values in normal-appearing white matter (NAWM) of patients (asymmetry, 0.022 ± 0.003; Lorentzian, 0.048 ± 0.003); however, ischemic regions in patients showed reduced (p = 0.03) APT effects compared with NAWM. Representative cases are presented, whereby the APT contrast is compared quantitatively with contrast from other imaging modalities. The findings vary between patients; in some patients, a trend for a reduction in the APT signal in the final infarct region compared with at-risk tissue was observed, consistent with tissue acidosis. However, in other patients, no relationship was observed in the infarct core and final infarct volume. Larger clinical studies, in combination with focused efforts on sequence development at clinically available field strengths (e.g. 3.0 T), are necessary to fully understand the potential of APT imaging for guiding the hyperacute management of patients.
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