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 13 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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To the Editor: Sodium-23 magnetic resonance imaging ( 23 Na MRI) has been used to noninvasively quantify tissue sodium (Na + ) in various conditions including hypertension, inflammation, and cardiovascular and metabolic disease. 1 While the reliability and agreement in serial 23 Na MR images 2,3 has been established, there is a paucity of studies focused on the agreement and reliability of the various manual region of interest (ROI) segmentation methods and the agreement between different methods. This study assesses this deficiency in published literature. Concise MethodsComplete methods are included in the Data S1. 23 Na MRI scans were completed with a 23 Na/ 1 H radiofrequency knee-coil (Rapid Biomedical, Rimpar, Germany) on a 3 T MAGNETOM Prisma Fit (Siemens Healthcare, Erlangen, Germany, software version VE11C). Affine registration was performed between 23 Na MR and 1 H proton images. Three raters used Insight Toolkit (ITK-SNAP) software (version 3.8.0) for ROI segmentation on a T1 image coregistered to 23 Na image (method definitions and visual examples in Fig. 1

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Sodium MRI of the Lumbar Intervertebral Discs of the Human Spine: An Ex Vivo Study

Kamp,

Radke,

Knet

et al. 2024

Magnetic Resonance Imaging

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BackgroundLower back pain affects 75%–85% of people at some point in their lives. The detection of biochemical changes with sodium (23Na) MRI has potential to enable an earlier and more accurate diagnosis.PurposeTo measure 23Na relaxation times and apparent tissue sodium concentration (aTSC) in ex‐vivo intervertebral discs (IVDs), and to investigate the relationship between aTSC and histological Thompson grade.Study TypeEx‐vivo.SpecimenThirty IVDs from the lumbar spines of 11 human body donors (4 female, 7 male, mean age 86 ± 8 years).Field Strength/Sequence3 T; density‐adapted 3D radial sequence (DA‐3D‐RAD).AssessmentIVD 23Na longitudinal (T1), short and long transverse (T2s* and T2l*) relaxation times and the proportion of the short transverse relaxation (ps) were calculated for one IVD per spine sample (11 IVDs). Furthermore, aTSCs were calculated for all IVDs. The degradation of the IVDs was assessed via histological Thompson grading.Statistical TestsA Kendall Tau correlation (τ) test was performed between the aTSCs and the Thompson grades. The significance level was set to P < 0.05.ResultsMean 23Na relaxation parameters of a subset of 11 IVDs were T1 = 9.8 ± 1.3 msec, T2s* = 0.7 ± 0.1 msec, T2l* = 7.3 ± 1.1 msec, and ps = 32.7 ± 4.0%. A total of 30 IVDs were examined, of which 3 had Thompson grade 1, 4 had grade 2, 5 had grade 3, 5 had grade 4, and 13 had grade 5. The aTSC decreased with increasing degradation, being 274.6 ± 18.9 mM for Thompson grade 1 and 190.5 ± 29.5 mM for Thompson grade 5. The correlation between whole IVD aTSC and Thompson grade was significant and strongly negative (τ = −0.56).Data ConclusionThis study showed a significant correlation between aTSC and degenerative IVD changes. Consequently, aTSC has potential to be useful as an indicator of degenerative spinal changes.Evidence Level2Technical EfficacyStage 1

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

Cited by 13 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

Sodium MRI of the Lumbar Intervertebral Discs of the Human Spine: An Ex Vivo Study

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