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1

Döpfert, Jörg, Moritz Zaiss, Christopher Witte, and Leif Schröder. "Ultrafast CEST imaging." Journal of Magnetic Resonance 243 (June 2014): 47–53. http://dx.doi.org/10.1016/j.jmr.2014.03.008.

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Xu, Xiang, Nirbhay N. Yadav, Xiaolei Song, Michael T. McMahon, Alexej Jerschow, Peter C. M. van Zijl, and Jiadi Xu. "Screening CEST contrast agents using ultrafast CEST imaging." Journal of Magnetic Resonance 265 (April 2016): 224–29. http://dx.doi.org/10.1016/j.jmr.2016.02.015.

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3

Saito, Shigeyoshi. "5. Advanced Imaging Technology—T1rho—CEST Imaging." Japanese Journal of Radiological Technology 78, no. 1 (January 20, 2022): 95–100. http://dx.doi.org/10.6009/jjrt.780111.

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4

Sun, Phillip Zhe. "Quasi–steady‐state CEST (QUASS CEST) solution improves the accuracy of CEST quantification: QUASS CEST MRI‐based omega plot analysis." Magnetic Resonance in Medicine 86, no. 2 (March 10, 2021): 765–76. http://dx.doi.org/10.1002/mrm.28744.

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5

Kejia Cai, Rongwen Tain, Xiaohong J. Zhou, and Charles E. Ray. "CEST MRI for Molecular Imaging of Brain Metabolites." Current Molecular Imaging 4, no. 2 (August 2015): 100–108. http://dx.doi.org/10.2174/2211555204666160210232349.

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As a sensitive MRI method, Chemical Exchange Saturation Transfer (CEST) MRI based on endogenous contrast has been increasingly utilized for molecular imaging of various metabolites. Among these applications, the authors have described CEST MRI for molecular imaging of brain metabolites in this review, including brain glutamate, the most abundant excitatory neurotransmitter; creatine, a key molecular of bioenergetics; and myo-inositol, a biomarker of glial cells. Those metabolites conventionally have been quantified with MR spectroscopy methods. Compared to MR spectroscopy, CEST methods typically provide a few hundred to a few thousand fold enhancement in sensitivity, enabling twodimensional imaging or mapping of metabolites at high resolution. In this review, the authors have also reviewed the preliminary applications of these molecular imaging methods. Finally, the challenges related to CEST MRI for molecular imaging in general are discussed.
6

Longo, Dario Livio, Fatima Zzahra Moustaghfir, Alexandre Zerbo, Lorena Consolino, Annasofia Anemone, Martina Bracesco, and Silvio Aime. "EXCI-CEST: Exploiting pharmaceutical excipients as MRI-CEST contrast agents for tumor imaging." International Journal of Pharmaceutics 525, no. 1 (June 2017): 275–81. http://dx.doi.org/10.1016/j.ijpharm.2017.04.040.

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Yu, Qin, Zian Yu, Lijiao Yang, and Yue Yuan. "Recent progress on diaCEST MRI for tumor imaging." JUSTC 53, no. 6 (2023): 0601. http://dx.doi.org/10.52396/justc-2023-0027.

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Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) is an advanced imaging method that probes the chemical exchange between bulk water protons and exchangeable solute protons. This chemical exchange decreases the MR signal of water and reveals the distribution and concentration of certain endogenous biomolecules or extrogenous contrast agents in organisms with high sensitivity and spatial resolution. The CEST signal depends not only on the concentration of the CEST contrast agent and external magnetic field but also on the surrounding environments of the contrast agent, such as pH and temperature, thus enabling CEST MRI to monitor pH, temperature, metabolic level, and enzyme activity in vivo. In this review, we discuss the principle of CEST MRI and mainly summarize the recent progress of diamagnetic CEST (diaCEST) contrast agents on tumor imaging, diagnosis, and therapy effect evaluation.
8

Sawaya, Reika, Sohei Kuribayashi, Junpei Ueda, and Shigeyoshi Saito. "Evaluating the Cisplatin Dose Dependence of Testicular Dysfunction using Creatine Chemical Exchange Saturation Transfer Imaging." Diagnostics 12, no. 5 (April 21, 2022): 1046. http://dx.doi.org/10.3390/diagnostics12051046.

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Chemical exchange saturation transfer (CEST) imaging is a non-invasive molecular imaging technique for indirectly measuring low-concentration endogenous metabolites. Conventional CEST has low specificity, owing to the effects of spillover, magnetization transfer (MT), and T1 relaxation, thus necessitating an inverse Z-spectrum analysis. We aimed to investigate the usefulness of inverse Z-spectrum analysis in creatine (Cr)-CEST in mice, by conducting preclinical 7T-magnetic resonance imaging (MRI) and comparing the conventional analysis metric magnetization transfer ratio (MTRconv) with the novel metric apparent exchange-dependent relaxation (AREX). We performed Cr-CEST imaging using 7T-MRI on mouse testes, using C57BL/6 mice as the control and a cisplatin-treated model. We prepared different doses of cisplatin to observe its dose dependence effect on testicular function. CEST imaging was obtained using an MT pulse with varying saturation frequencies, ranging from −4.8 ppm to +4.8 ppm. The application of control mouse testes improved the specificity of the CEST effect and image contrast between the testes and testicular epithelium. The cisplatin-treated model revealed impaired testicular function, and the Cr-CEST imaging displayed decreased Cr levels in the testes. There was a significant difference between the low- and high-dose models. The MTR values of Cr-CEST reflected the cisplatin dose dependence of testicular dysfunction.
9

Gao, Tianxin, Chuyue Zou, Yifan Li, Zhenqi Jiang, Xiaoying Tang, and Xiaolei Song. "A Brief History and Future Prospects of CEST MRI in Clinical Non-Brain Tumor Imaging." International Journal of Molecular Sciences 22, no. 21 (October 26, 2021): 11559. http://dx.doi.org/10.3390/ijms222111559.

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Chemical exchange saturation transfer (CEST) MRI is a promising molecular imaging tool which allows the specific detection of metabolites that contain exchangeable amide, amine, and hydroxyl protons. Decades of development have progressed CEST imaging from an initial concept to a clinical imaging tool that is used to assess tumor metabolism. The first translation efforts involved brain imaging, but this has now progressed to imaging other body tissues. In this review, we summarize studies using CEST MRI to image a range of tumor types, including breast cancer, pelvic tumors, digestive tumors, and lung cancer. Approximately two thirds of the published studies involved breast or pelvic tumors which are sites that are less affected by body motion. Most studies conclude that CEST shows good potential for the differentiation of malignant from benign lesions with a number of reports now extending to compare different histological classifications along with the effects of anti-cancer treatments. Despite CEST being a unique ‘label-free’ approach with a higher sensitivity than MR spectroscopy, there are still some obstacles for implementing its clinical use. Future research is now focused on overcoming these challenges. Vigorous ongoing development and further clinical trials are expected to see CEST technology become more widely implemented as a mainstream imaging technology.
10

Lingl, Julia P., Arthur Wunderlich, Steffen Goerke, Daniel Paech, Mark E. Ladd, Patrick Liebig, Andrej Pala, et al. "The Value of APTw CEST MRI in Routine Clinical Assessment of Human Brain Tumor Patients at 3T." Diagnostics 12, no. 2 (February 14, 2022): 490. http://dx.doi.org/10.3390/diagnostics12020490.

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Background. With fast-growing evidence in literature for clinical applications of chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI), this prospective study aimed at applying amide proton transfer-weighted (APTw) CEST imaging in a clinical setting to assess its diagnostic potential in differentiation of intracranial tumors at 3 tesla (T). Methods. Using the asymmetry magnetization transfer ratio (MTRasym) analysis, CEST signals were quantitatively investigated in the tumor areas and in a similar sized region of the normal-appearing white matter (NAWM) on the contralateral hemisphere of 27 patients with intracranial tumors. Area under curve (AUC) analyses were used and results were compared to perfusion-weighted imaging (PWI). Results. Using APTw CEST, contrast-enhancing tumor areas showed significantly higher APTw CEST metrics than contralateral NAWM (AUC = 0.82; p < 0.01). In subgroup analyses of each tumor entity vs. NAWM, statistically significant effects were yielded for glioblastomas (AUC = 0.96; p < 0.01) and for meningiomas (AUC = 1.0; p < 0.01) but not for lymphomas as well as metastases (p > 0.05). PWI showed results comparable to APTw CEST in glioblastoma (p < 0.01). Conclusions. This prospective study confirmed the high diagnostic potential of APTw CEST imaging in a routine clinical setting to differentiate brain tumors.
11

Huang, Jianpan, Zilin Chen, Se-Weon Park, Joseph H. C. Lai, and Kannie W. Y. Chan. "Molecular Imaging of Brain Tumors and Drug Delivery Using CEST MRI: Promises and Challenges." Pharmaceutics 14, no. 2 (February 20, 2022): 451. http://dx.doi.org/10.3390/pharmaceutics14020451.

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Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) detects molecules in their natural forms in a sensitive and non-invasive manner. This makes it a robust approach to assess brain tumors and related molecular alterations using endogenous molecules, such as proteins/peptides, and drugs approved for clinical use. In this review, we will discuss the promises of CEST MRI in the identification of tumors, tumor grading, detecting molecular alterations related to isocitrate dehydrogenase (IDH) and O-6-methylguanine-DNA methyltransferase (MGMT), assessment of treatment effects, and using multiple contrasts of CEST to develop theranostic approaches for cancer treatments. Promising applications include (i) using the CEST contrast of amide protons of proteins/peptides to detect brain tumors, such as glioblastoma multiforme (GBM) and low-grade gliomas; (ii) using multiple CEST contrasts for tumor stratification, and (iii) evaluation of the efficacy of drug delivery without the need of metallic or radioactive labels. These promising applications have raised enthusiasm, however, the use of CEST MRI is not trivial. CEST contrast depends on the pulse sequences, saturation parameters, methods used to analyze the CEST spectrum (i.e., Z-spectrum), and, importantly, how to interpret changes in CEST contrast and related molecular alterations in the brain. Emerging pulse sequence designs and data analysis approaches, including those assisted with deep learning, have enhanced the capability of CEST MRI in detecting molecules in brain tumors. CEST has become a specific marker for tumor grading and has the potential for prognosis and theranostics in brain tumors. With increasing understanding of the technical aspects and associated molecular alterations detected by CEST MRI, this young field is expected to have wide clinical applications in the near future.
12

Wang, Chengguang, Guisen Lin, Zhiwei Shen, and Runrun Wang. "Angiopep-2 as an Exogenous Chemical Exchange Saturation Transfer Contrast Agent in Diagnosis of Alzheimer’s Disease." Journal of Healthcare Engineering 2022 (April 5, 2022): 1–7. http://dx.doi.org/10.1155/2022/7480519.

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Background. Chemical exchange saturation transfer (CEST) is a novel imaging modality in clinical practice and scientific research. Angiopep-2 is an artificial peptide that can penetrate blood-brain barrier. The aim of this study was to explore the feasibility of Angiopep-2 serving as an exogenous CEST contrast. Methods. Phantoms of Angiopep-2 with different concentrations were prepared and then scanned using the 7.0T small animal MRI scanner. Different parameters including saturation powers and saturation duration were used to achieve the optimal CEST effect, and the optimal parameters were finally selected based on Z-spectra, asymmetric spectra, and phantom CEST imaging. CEST scanning of dimethyl sulfoxide (DMSO), the substance helping Angiopep-2 to be dissolved in water, was performed to exclude its contribution for the CEST effect. Results. A broad dip was observed from 2.5 to 3.5 ppm in the Z-spectra of Angiopep-2 phantoms. The most robust CEST was generated at 3.2 ppm when using formula (M–3.2ppm − M+3.2ppm)/M–3.2ppm. The CEST effect of Angiopep-2 was concentration dependent; the effect increased as the concentration increased. In addition, the CEST effect was more obvious as the saturation power increased and peaked at 5.5 µT, and the CEST effect increased as the saturation duration increased. DMSO showed nearly 0% of the CEST effect at 3.2 ppm. Conclusions. Our results demonstrate that Angiopep-2 can act as an excellent exogenous CEST contrast. As it can penetrate blood-brain barrier and bind amyloid-β protein, amyloid-β targeting CEST, with Angiopep-2 as an exogenous contrast agent, can be potentially used as a novel imaging modality for early diagnosis of Alzheimer’s disease. Collectively, Angiopep-2 may play a critical role in early diagnosis of Alzheimer’s disease.
13

Koike, Hirofumi, Minoru Morikawa, Hideki Ishimaru, Reiko Ideguchi, Masataka Uetani, and Mitsuharu Miyoshi. "Amide Proton Transfer–Chemical Exchange Saturation Transfer Imaging of Intracranial Brain Tumors and Tumor-Like Lesions: Our Experience and a Review." Diagnostics 13, no. 5 (February 28, 2023): 914. http://dx.doi.org/10.3390/diagnostics13050914.

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Chemical exchange saturation transfer (CEST) is a molecular magnetic resonance imaging (MRI) method that can generate image contrast based on the proton exchange between labeled protons in solutes and free, bulk water protons. Amide proton transfer (APT) imaging is the most frequently reported amide-proton-based CEST technique. It generates image contrast by reflecting the associations of mobile proteins and peptides resonating at 3.5 ppm downfield from water. Although the origin of the APT signal intensity in tumors is unclear, previous studies have suggested that the APT signal intensity is increased in brain tumors due to the increased mobile protein concentrations in malignant cells in association with an increased cellularity. High-grade tumors, which demonstrate a higher proliferation than low-grade tumors, have higher densities and numbers of cells (and higher concentrations of intracellular proteins and peptides) than low-grade tumors. APT-CEST imaging studies suggest that the APT-CEST signal intensity can be used to help differentiate between benign and malignant tumors and high-grade gliomas and low-grade gliomas as well as estimate the nature of lesions. In this review, we summarize the current applications and findings of the APT-CEST imaging of various brain tumors and tumor-like lesions. We report that APT-CEST imaging can provide additional information on intracranial brain tumors and tumor-like lesions compared to the information provided by conventional MRI methods, and that it can help indicate the nature of lesions, differentiate between benign and malignant lesions, and determine therapeutic effects. Future research could initiate or improve the lesion-specific clinical applicability of APT-CEST imaging for meningioma embolization, lipoma, leukoencephalopathy, tuberous sclerosis complex, progressive multifocal leukoencephalopathy, and hippocampal sclerosis.
14

Kikuchi, Kazufumi, Keisuke Ishimatsu, Shanrong Zhang, Ivan E. Dimitrov, Hiroshi Honda, A. Dean Sherry, and Masaya Takahashi. "Presaturation Power Adjusted Pulsed CEST: A Method to Increase Independence of Target CEST Signals." Contrast Media & Molecular Imaging 2018 (2018): 1–11. http://dx.doi.org/10.1155/2018/3141789.

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Chemical exchange saturation transfer (CEST) imaging has been demonstrated to discuss the concentration changes of amide proton, glutamate, creatine, or glucose measured at 3.5, 3.0, 2.0, and 1.0–1.2 ppm. However, these peaks in z-spectra are quite broad and overlap with each other, and thus, the independence of a CEST signal on any specific metabolite is still open to question. Here, we described whether there was interference among the CEST signals and how these CEST signals behave when the power of the presaturation pulse was changed. Based on these results, further experiments were designed to investigate a method to increase the independence of the CEST signal in both phantoms and animals. The result illustrates a clear interference among CEST signals. A presaturation power adjusted pulsed- (PPAP-) CEST method which was designed based on the exchange rates of the metabolites can be used to remove contributions from other exchanging species in the same sample. Further, the method was shown to improve the independence of the glutamate signal in vivo in the renal medulla in mice. The PPAP-CEST method has the potential to increase the independence of any target CEST signals in vivo by choosing the appropriate combination of pulse amplitudes and durations.
15

Shen, Zhi-wei, Lv-hao Wang, Zhuo-zhi Dai, Gang Xiao, Yin Wu, and Ren-hua Wu. "Chemical Exchange Saturation Transfer (CEST) Imaging of pH." Neuroscience and Biomedical Engineering 1, no. 2 (February 2014): 111–15. http://dx.doi.org/10.2174/2213385202666140207001055.

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16

Longo, D. "SP-0555 MRI-CEST Imaging of tumor acidosis." Radiotherapy and Oncology 133 (April 2019): S291—S292. http://dx.doi.org/10.1016/s0167-8140(19)30975-2.

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17

Peng, Qiaoli, Yaping Yuan, Huaibin Zhang, Shaowei Bo, Yu Li, Shizhen Chen, Zhigang Yang, Xin Zhou, and Zhong-Xing Jiang. "19F CEST imaging probes for metal ion detection." Organic & Biomolecular Chemistry 15, no. 30 (2017): 6441–46. http://dx.doi.org/10.1039/c7ob01068k.

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Yuan, Yifan, Yang Yu, Yu Guo, Yinghua Chu, Jun Chang, Yicheng Hsu, Patrick Alexander Liebig, et al. "Noninvasive Delineation of Glioma Infiltration with Combined 7T Chemical Exchange Saturation Transfer Imaging and MR Spectroscopy: A Diagnostic Accuracy Study." Metabolites 12, no. 10 (September 24, 2022): 901. http://dx.doi.org/10.3390/metabo12100901.

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For precise delineation of glioma extent, amino acid PET is superior to conventional MR imaging. Since metabolic MR sequences such as chemical exchange saturation transfer (CEST) imaging and MR spectroscopy (MRS) were developed, we aimed to evaluate the diagnostic accuracy of combined CEST and MRS to predict glioma infiltration. Eighteen glioma patients of different tumor grades were enrolled in this study; 18F-fluoroethyltyrosine (FET)-PET, amide proton transfer CEST at 7 Tesla(T), MRS and conventional MR at 3T were conducted preoperatively. Multi modalities and their association were evaluated using Pearson correlation analysis patient-wise and voxel-wise. Both CEST (R = 0.736, p < 0.001) and MRS (R = 0.495, p = 0.037) correlated with FET-PET, while the correlation between CEST and MRS was weaker. In subgroup analysis, APT values were significantly higher in high grade glioma (3.923 ± 1.239) and IDH wildtype group (3.932 ± 1.264) than low grade glioma (3.317 ± 0.868, p < 0.001) or IDH mutant group (3.358 ± 0.847, p < 0.001). Using high FET uptake as the standard, the CEST/MRS combination (AUC, 95% CI: 0.910, 0.907–0.913) predicted tumor infiltration better than CEST (0.812, 0.808–0.815) or MRS (0.888, 0.885–0.891) alone, consistent with contrast-enhancing and T2-hyperintense areas. Probability maps of tumor presence constructed from the CEST/MRS combination were preliminarily verified by multi-region biopsies. The combination of 7T CEST/MRS might serve as a promising non-radioactive alternative to delineate glioma infiltration, thus reshaping the guidance for tumor resection and irradiation.
19

Li, Yuguo, Hanwei Chen, Jiadi Xu, Nirbhay N. Yadav, Kannie W. Y. Chan, Liangping Luo, Michael T. McMahon, et al. "CEST theranostics: label-free MR imaging of anticancer drugs." Oncotarget 7, no. 6 (February 2, 2016): 6369–78. http://dx.doi.org/10.18632/oncotarget.7141.

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Dai, Zhuozhi, Jim Ji, Gang Xiao, Gen Yan, Shengkai Li, Guishan Zhang, Yan Lin, Zhiwei Shen, and Renhua Wu. "Magnetization Transfer Prepared Gradient Echo MRI for CEST Imaging." PLoS ONE 9, no. 11 (November 10, 2014): e112219. http://dx.doi.org/10.1371/journal.pone.0112219.

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21

Cobb, Jared Guthrie, Ke Li, Jingping Xie, Daniel F. Gochberg, and John C. Gore. "Exchange-mediated contrast in CEST and spin-lock imaging." Magnetic Resonance Imaging 32, no. 1 (January 2014): 28–40. http://dx.doi.org/10.1016/j.mri.2013.08.002.

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22

Zhang, Shanrong, Robert Trokowski, and A. Dean Sherry. "A Paramagnetic CEST Agent for Imaging Glucose by MRI." Journal of the American Chemical Society 125, no. 50 (December 2003): 15288–89. http://dx.doi.org/10.1021/ja038345f.

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23

Shin, Soo Hyun, Michael F. Wendland, Brandon Zhang, An Tran, Albert Tang, and Moriel H. Vandsburger. "Noninvasive imaging of renal urea handling by CEST‐MRI." Magnetic Resonance in Medicine 83, no. 3 (September 4, 2019): 1034–44. http://dx.doi.org/10.1002/mrm.27968.

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Pavuluri, KowsalyaDevi, and Michael T. McMahon. "pH Imaging Using Chemical Exchange Saturation Transfer (CEST) MRI." Israel Journal of Chemistry 57, no. 9 (August 17, 2017): 862–79. http://dx.doi.org/10.1002/ijch.201700075.

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Dixon, W. Thomas, Ileana Hancu, S. James Ratnakar, A. Dean Sherry, Robert E. Lenkinski, and David C. Alsop. "A multislice gradient echo pulse sequence for CEST imaging." Magnetic Resonance in Medicine 63, no. 1 (November 13, 2009): 253–56. http://dx.doi.org/10.1002/mrm.22193.

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Farrar, Christian T., Jason S. Buhrman, Guanshu Liu, Anne Kleijn, Martine L. M. Lamfers, Michael T. McMahon, Assaf A. Gilad, and Giulia Fulci. "Establishing the Lysine-rich Protein CEST Reporter Gene as a CEST MR Imaging Detector for Oncolytic Virotherapy." Radiology 275, no. 3 (June 2015): 746–54. http://dx.doi.org/10.1148/radiol.14140251.

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Wu, Yulun, Tobias C. Wood, Fatemeh Arzanforoosh, Juan A. Hernandez-Tamames, Gareth J. Barker, Marion Smits, and Esther A. H. Warnert. "3D APT and NOE CEST-MRI of healthy volunteers and patients with non-enhancing glioma at 3 T." Magnetic Resonance Materials in Physics, Biology and Medicine 35, no. 1 (January 7, 2022): 63–73. http://dx.doi.org/10.1007/s10334-021-00996-z.

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Abstract Objective Clinical application of chemical exchange saturation transfer (CEST) can be performed with investigation of amide proton transfer (APT) and nuclear Overhauser enhancement (NOE) effects. Here, we investigated APT- and NOE-weighted imaging based on advanced CEST metrics to map tumor heterogeneity of non-enhancing glioma at 3 T. Materials and methods APT- and NOE-weighted maps based on Lorentzian difference (LD) and inverse magnetization transfer ratio (MTRREX) were acquired with a 3D snapshot CEST acquisition at 3 T. Saturation power was investigated first by varying B1 (0.5–2 µT) in 5 healthy volunteers then by applying B1 of 0.5 and 1.5 µT in 10 patients with non-enhancing glioma. Tissue contrast (TC) and contrast-to-noise ratios (CNR) were calculated between glioma and normal appearing white matter (NAWM) and grey matter, in APT- and NOE-weighted images. Volume percentages of the tumor showing hypo/hyperintensity (VPhypo/hyper,CEST) in APT/NOE-weighted images were calculated for each patient. Results LD APT resulting from using a B1 of 1.5 µT was found to provide significant positive TCtumor,NAWM and MTRREX NOE (B1 of 1.5 µT) provided significant negative TCtumor,NAWM in tissue differentiation. MTRREX-based NOE imaging under 1.5 µT provided significantly larger VPhypo,CEST than MTRREX APT under 1.5 µT. Conclusion This work showed that with a rapid CEST acquisition using a B1 saturation power of 1.5 µT and covering the whole tumor, analysis of both LD APT and MTRREX NOE allows for observing tumor heterogeneity, which will be beneficial in future studies using CEST-MRI to improve imaging diagnostics for non-enhancing glioma.
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Chen, Yu-Wen, Hong-Qing Liu, Qi-Xuan Wu, Yu-Han Huang, Yu-Ying Tung, Ming-Huang Lin, Chia-Huei Lin, Tsai-Chen Chen, Eugene C. Lin, and Dennis W. Hwang. "pH Mapping of Skeletal Muscle by Chemical Exchange Saturation Transfer (CEST) Imaging." Cells 9, no. 12 (December 4, 2020): 2610. http://dx.doi.org/10.3390/cells9122610.

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Magnetic resonance imaging (MRI) is extensively used in clinical and basic biomedical research. However, MRI detection of pH changes still poses a technical challenge. Chemical exchange saturation transfer (CEST) imaging is a possible solution to this problem. Using saturation transfer, alterations in the exchange rates between the solute and water protons because of small pH changes can be detected with greater sensitivity. In this study, we examined a fatigued skeletal muscle model in electrically stimulated mice. The measured CEST signal ratio was between 1.96 ppm and 2.6 ppm in the z-spectrum, and this was associated with pH values based on the ratio between the creatine (Cr) and the phosphocreatine (PCr). The CEST results demonstrated a significant contrast change at the electrical stimulation site. Moreover, the pH value was observed to decrease from 7.23 to 7.15 within 20 h after electrical stimulation. This pH decrease was verified by 31P magnetic resonance spectroscopy and behavioral tests, which showed a consistent variation over time.
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Sawaya, Reika, Junpei Ueda, and Shigeyoshi Saito. "Quantitative Susceptibility Mapping and Amide Proton Transfer-Chemical Exchange Saturation Transfer for the Evaluation of Intracerebral Hemorrhage Model." International Journal of Molecular Sciences 24, no. 7 (April 1, 2023): 6627. http://dx.doi.org/10.3390/ijms24076627.

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This study aimed to evaluate an intracerebral hemorrhage (ICH) model using quantitative susceptibility mapping (QSM) and chemical exchange saturation transfer (CEST) with preclinical 7T-magnetic resonance imaging (MRI) and determine the potential of amide proton transfer-CEST (APT-CEST) for use as a biomarker for the early detection of ICH. Six Wistar male rats underwent MRI, and another six underwent histopathological examinations on postoperative days 0, 3, and 7. The ICH model was created by injecting bacterial collagenase into the right hemisphere of the brain. QSM and APT-CEST MRI were performed using horizontal 7T-MRI. Histological studies were performed to observe ICH and detect iron deposition at the ICH site. T2-weighted images (T2WI) revealed signal changes associated with hemoglobin degeneration in red blood cells, indicating acute-phase hemorrhage on day 0, late-subacute-phase hemorrhage on day 3, and chronic-phase hemorrhage on day 7. The susceptibility alterations in each phase were detected using QSM. QSM and Berlin blue staining revealed hemosiderin deposition in the chronic phase. APT-CEST revealed high magnetization transfer ratios in the acute phase. Abundant mobile proteins and peptides were observed in early ICH, which were subsequently diluted. APT-CEST imaging may be a reliable noninvasive biomarker for the early diagnosis of ICH.
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Liu, Jing, Chengyan Chu, Jia Zhang, Chongxue Bie, Lin Chen, Safiya Aafreen, Jiadi Xu, et al. "Label-Free Assessment of Mannitol Accumulation Following Osmotic Blood–Brain Barrier Opening Using Chemical Exchange Saturation Transfer Magnetic Resonance Imaging." Pharmaceutics 14, no. 11 (November 20, 2022): 2529. http://dx.doi.org/10.3390/pharmaceutics14112529.

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Purpose: Mannitol is a hyperosmolar agent for reducing intracranial pressure and inducing osmotic blood–brain barrier opening (OBBBO). There is a great clinical need for a non-invasive method to optimize the safety of mannitol dosing. The aim of this study was to develop a label-free Chemical Exchange Saturation Transfer (CEST)-based MRI approach for detecting intracranial accumulation of mannitol following OBBBO. Methods: In vitro MRI was conducted to measure the CEST properties of D-mannitol of different concentrations and pH. In vivo MRI and MRS measurements were conducted on Sprague-Dawley rats using a Biospec 11.7T horizontal MRI scanner. Rats were catheterized at the internal carotid artery (ICA) and randomly grouped to receive either 1 mL or 3 mL D-mannitol. CEST MR images were acquired before and at 20 min after the infusion. Results: In vitro MRI showed that mannitol has a strong, broad CEST contrast at around 0.8 ppm with a mM CEST MRI detectability. In vivo studies showed that CEST MRI could effectively detect mannitol in the brain. The low dose mannitol treatment led to OBBBO but no significant mannitol accumulation, whereas the high dose regimen resulted in both OBBBO and mannitol accumulation. The CEST MRI findings were consistent with 1H-MRS and Gd-enhanced MRI assessments. Conclusion: We demonstrated that CEST MRI can be used for non-invasive, label-free detection of mannitol accumulation in the brain following BBBO treatment. This method may be useful as a rapid imaging tool to optimize the dosing of mannitol-based OBBBO and improve its safety and efficacy.
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Nasrallah, Fatima A., Guilhem Pagès, Philip W. Kuchel, Xavier Golay, and Kai-Hsiang Chuang. "Imaging Brain Deoxyglucose Uptake and Metabolism by Glucocest MRI." Journal of Cerebral Blood Flow & Metabolism 33, no. 8 (May 15, 2013): 1270–78. http://dx.doi.org/10.1038/jcbfm.2013.79.

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2-Deoxy-D-glucose (2DG) is a known surrogate molecule that is useful for inferring glucose uptake and metabolism. Although 13C-labeled 2DG can be detected by nuclear magnetic resonance (NMR), its low sensitivity for detection prohibits imaging to be performed. Using chemical exchange saturation transfer (CEST) as a signal-amplification mechanism, 2DG and the phosphorylated 2DG-6-phosphate (2DG6P) can be indirectly detected in 1H magnetic resonance imaging (MRI). We showed that the CEST signal changed with 2DG concentration, and was reduced by suppressing cerebral metabolism with increased general anesthetic. The signal changes were not affected by cerebral or plasma pH, and were not correlated with altered cerebral blood flow as demonstrated by hypercapnia; neither were they related to the extracellular glucose amounts as compared with injection of D- and L-glucose. In vivo31P NMR revealed similar changes in 2DG6P concentration, suggesting that the CEST signal reflected the rate of glucose assimilation. This method provides a new way to use widely available MRI techniques to image deoxyglucose/glucose uptake and metabolism in vivo without the need for isotopic labeling of the molecules.
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Kunth, Martin, Christopher Witte, and Leif Schröder. "Mapping of Absolute Host Concentration and Exchange Kinetics of Xenon Hyper-CEST MRI Agents." Pharmaceuticals 14, no. 2 (January 21, 2021): 79. http://dx.doi.org/10.3390/ph14020079.

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Xenon magnetic resonance imaging (MRI) provides excellent sensitivity through the combination of spin hyperpolarization and chemical exchange saturation transfer (CEST). To this end, molecular hosts such as cryptophane-A or cucurbit[n]urils provide unique opportunities to design switchable MRI reporters. The concentration determination of such xenon binding sites in samples of unknown dilution remains, however, challenging. Contrary to 1H CEST agents, an internal reference of a certain host (in this case, cryptophane-A) at micromolar concentration is already sufficient to resolve the entire exchange kinetics information, including an unknown host concentration and the xenon spin exchange rate. Fast echo planar imaging (EPI)-based Hyper-CEST MRI in combination with Bloch–McConnell analysis thus allows quantitative insights to compare the performance of different emerging ultra-sensitive MRI reporters.
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Villano, Daisy, Feriel Romdhane, Pietro Irrera, Lorena Consolino, Annasofia Anemone, Moritz Zaiss, Walter Dastrù, and Dario Livio Longo. "A fast multislice sequence for 3D MRI‐CEST pH imaging." Magnetic Resonance in Medicine 85, no. 3 (October 8, 2020): 1335–49. http://dx.doi.org/10.1002/mrm.28516.

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Albatany, Mohammed, Susan Meakin, and Robert Bartha. "Brain pH Measurement Using AACID CEST MRI Incorporating the 2 ppm Amine Resonance." Tomography 8, no. 2 (March 9, 2022): 730–39. http://dx.doi.org/10.3390/tomography8020060.

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Many pathological conditions lead to altered intracellular pH (pHi) disrupting normal cellular functions. The chemical exchange saturation transfer (CEST) method, known as Amine and Amide Concentration Independent Detection (AACID), can produce image contrast that is predominantly dependent on tissue intracellular pHi. The AACID value is linearly related to the ratio of the 3.5 ppm amide CEST effect and the 2.75 ppm amine CEST effect in the physiological range. However, the amine CEST effect at 2 ppm is often more clearly defined in vivo, and may provide greater sensitivity to pH changes. The purpose of the current study was to compare AACID measurement precision utilizing the 2.0 and 2.75 ppm amine CEST effects. We hypothesized that the 2.0 ppm amine CEST resonance would produce measurements with greater sensitivity to pH changes. In the current study, we compare the range of the AACID values obtained in 24 mice with brain tumors and in normal tissue using the 2 ppm and 2.75 ppm amine resonances. All CEST data were acquired on a 9.4T MRI scanner. The AACID measurement range increased by 39% when using the 2 ppm amine resonance compared to the 2.75 ppm resonance, with decreased measurement variability across the brain. These data indicate that in vivo pH measurements made using AACID CEST can be enhanced by incorporating the 2 ppm amine resonance. This approach should be considered for pH measurements made over short intervals when no changes are expected in the concentration of metabolites that contribute to the 2 ppm amine resonance.
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Carniato, Fabio, Giuseppe Ferrauto, Mónica Muñoz-Úbeda, and Lorenzo Tei. "Water Diffusion Modulates the CEST Effect on Tb(III)-Mesoporous Silica Probes." Magnetochemistry 6, no. 3 (September 1, 2020): 38. http://dx.doi.org/10.3390/magnetochemistry6030038.

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The anchoring of lanthanide(III) chelates on the surface of mesoporous silica nanoparticles (MSNs) allowed their investigation as magnetic resonance imaging (MRI) and chemical exchange saturation transfer (CEST) contrast agents. Since their efficiency is strongly related to the interaction occurring between Ln-chelates and “bulk” water, an estimation of the water diffusion inside MSNs channels is very relevant. Herein, a method based on the exploitation of the CEST properties of TbDO3A-MSNs was applied to evaluate the effect of water diffusion inside MSN channels. Two MSNs, namely MCM-41 and SBA-15, with different pores size distributions were functionalized with TbDO3A-like chelates and polyethylene glycol (PEG) molecules and characterized by HR-TEM microscopy, IR spectroscopy, N2 physisorption, and thermogravimetric analysis (TGA). The different distribution of Tb-complexes in the two systems, mainly on the external surface in case of MCM-41 or inside the internal pores for SBA-15, resulted in variable CEST efficiency. Since water molecules diffuse slowly inside silica channels, the CEST effect of the LnDO3A-SBA-15 system was found to be one order of magnitude lower than in the case of TbDO3A-MCM-41. The latter system reaches an excellent sensitivity of ca. 55 ± 5 μM, which is useful for future theranostic or imaging applications.
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Shahid, Syed Salman, Mario Dzemidzic, Elizabeth R. Butch, Erin E. Jarvis, Scott E. Snyder, and Yu-Chien Wu. "Estimating the synaptic density deficit in Alzheimer’s disease using multi-contrast CEST imaging." PLOS ONE 19, no. 3 (March 14, 2024): e0299961. http://dx.doi.org/10.1371/journal.pone.0299961.

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In vivo noninvasive imaging of neurometabolites is crucial to improve our understanding of the underlying pathophysiological mechanism in neurodegenerative diseases. Abnormal changes in synaptic organization leading to synaptic degradation and neuronal loss is considered as one of the primary factors driving Alzheimer’s disease pathology. Magnetic resonance based molecular imaging techniques such as chemical exchange saturation transfer (CEST) and magnetic resonance spectroscopy (MRS) can provide neurometabolite specific information which may relate to underlying pathological and compensatory mechanisms. In this study, CEST and short echo time single voxel MRS was performed to evaluate the sensitivity of cerebral metabolites to beta-amyloid (Aβ) induced synaptic deficit in the hippocampus of a mouse model of Alzheimer’s disease. The CEST based spectra (Z-spectra) were acquired on a 9.4 Tesla small animal MR imaging system with two radiofrequency (RF) saturation amplitudes (1.47 μT and 5.9 μT) to obtain creatine-weighted and glutamate-weighted CEST contrasts, respectively. Multi-pool Lorentzian fitting and quantitative T1 longitudinal relaxation maps were used to obtain metabolic specific apparent exchange-dependent relaxation (AREX) maps. Short echo time (TE = 12 ms) single voxel MRS was acquired to quantify multiple neurometabolites from the right hippocampus region. AREX contrasts and MRS based metabolite concentration levels were examined in the ARTE10 animal model for Alzheimer’s disease and their wild type (WT) littermate counterparts (age = 10 months). Using MRS voxel as a region of interest, group-wise analysis showed significant reduction in Glu-AREX and Cr-AREX in ARTE10, compared to WT animals. The MRS based results in the ARTE10 mice showed significant decrease in glutamate (Glu) and glutamate-total creatine (Glu/tCr) ratio, compared to WT animals. The MRS results also showed significant increase in total creatine (tCr), phosphocreatine (PCr) and glutathione (GSH) concentration levels in ARTE10, compared to WT animals. In the same ROI, Glu-AREX and Cr-AREX demonstrated positive associations with Glu/tCr ratio. These results indicate the involvement of neurotransmitter metabolites and energy metabolism in Aβ-mediated synaptic degradation in the hippocampus region. The study also highlights the feasibility of CEST and MRS to identify and track multiple competing and compensatory mechanisms involved in heterogeneous pathophysiology of Alzheimer’s disease in vivo.
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Abecassis Schmitz, B., E. Ercan, J. de Bresser, L. Dirven, M. J. B. Taphoorn, M. J. P. van Osch, and J. A. F. Koekkoek. "P15.12.A Amine CEST contrast in gliomas to measure metabolic treatment effect at 7T." Neuro-Oncology 24, Supplement_2 (September 1, 2022): ii86. http://dx.doi.org/10.1093/neuonc/noac174.302.

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Abstract Background Chemical exchange saturation transfer (CEST) is an imaging technique that generates contrast based on proton exchange between water and a solute pool of interest. CEST is sensitive to molecules containing amine groups such as glutamate and creatine. Since creatine is a crucial metabolite in cellular metabolism and deregulation in cellular bioenergetics is a hallmark of cancer, CEST could be relevant for glioma imaging, specifically when evaluating treatment response. No clear consensus has been established on its use, therefore we wanted to preliminarily investigate the presence of amine CEST contrast in the contrast enhanced (CE) and non-enhanced (NE) lesions of gliomas, and to assess whether treated tumors would display different CEST contrast compared to treatment naïve tumors. Material and Methods We prospectively scanned 12 glioma patients on a whole-body 7 Tesla Philips Achieva MRI scanner (7 treated glioblastomas; 4 treatment naïve glioblastomas; 1 treatment naïve low-grade astrocytoma). Treatment included surgical resection, chemotherapy and radiotherapy. All patients gave informed consent. CEST images were post-processed, including corrections for B0 and B1 inhomogeneities. The CEST Z-spectra and magnetization transfer ratio (MTR) asymmetry were calculated per voxel. To retrieve the CEST values within the tumor lesions and contralateral white matter for normalization, segmentations were manually delineated on the clinical T2-FLAIR or post contrast 3D-T1. Results Overall we observed a relative increase of amine CEST contrast in the CE (MTRasym: Mean (x̄)=1.32; Standard deviation (σ)= 0.28) compared to a relative decrease (MTRasym: x̄=1.20; σ= 0.35) in the NE lesion. When evaluating the results from the CE and NE lesions for treated and treatment naïve groups individually, we observed a slightly different trend. In the treatment group, the CE lesions showed a higher amine CEST contrast (MTRasym: x̄=1.38; σ= 0.30) than the NE (MTRasym: x̄ = 1.11; σ = 0.302). In contrast, in the treatment naïve group, the CE lesion showed a slightly lower CEST contrast (MTRasym: x̄ = 1.23; σ=0.21) than in the NE group (MTRasym: x̄ = 1.29; σ= 0.38). Conclusion Our results show different amine CEST contrast trends between treated and treatment naïve groups when comparing CE and NE lesions. This suggests that treatment may have an effect on tumor tissue bioenergetics affecting the concentration of creatine. Nevertheless, future work is necessary to verify our results in a larger group of patients.
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Chen, Zelong, Zheng Han, and Guanshu Liu. "Repurposing Clinical Agents for Chemical Exchange Saturation Transfer Magnetic Resonance Imaging: Current Status and Future Perspectives." Pharmaceuticals 14, no. 1 (December 24, 2020): 11. http://dx.doi.org/10.3390/ph14010011.

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Molecular imaging is becoming an indispensable tool to pursue precision medicine. However, quickly translating newly developed magnetic resonance imaging (MRI) agents into clinical use remains a formidable challenge. Recently, Chemical Exchange Saturation Transfer (CEST) MRI is emerging as an attractive approach with the capability of directly using low concentration, exchangeable protons-containing agents for generating quantitative MRI contrast. The ability to utilize diamagnetic compounds has been extensively exploited to detect many clinical compounds, such as FDA approved drugs, X-ray/CT contrast agents, nutrients, supplements, and biopolymers. The ability to directly off-label use clinical compounds permits CEST MRI to be rapidly translated to clinical settings. In this review, the current status of CEST MRI based on clinically available compounds will be briefly introduced. The advancements and limitations of these studies are reviewed in the context of their pre-clinical or clinical applications. Finally, future directions will be briefly discussed.
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Meissner, Jan-Eric, Steffen Goerke, Eugenia Rerich, Karel D. Klika, Alexander Radbruch, Mark E. Ladd, Peter Bachert, and Moritz Zaiss. "Quantitative pulsed CEST-MRI usingΩ-plots." NMR in Biomedicine 28, no. 10 (August 17, 2015): 1196–208. http://dx.doi.org/10.1002/nbm.3362.

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40

Dhakan, Chetan, Annasofia Anemone, Vittoria Ventura, Antonella Carella, Alessia Corrado, Elisa Pirotta, Daisy Villano, et al. "Assessing the Therapeutic Efficacy of Proton Transport Inhibitors in a Triple-Negative Breast Cancer Murine Model with Magnetic Resonance Imaging—Chemical Exchange Saturation Transfer Tumor pH Imaging." Metabolites 13, no. 11 (November 18, 2023): 1161. http://dx.doi.org/10.3390/metabo13111161.

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Proton transporters play a key role in maintaining the acidic tumor microenvironment; hence, their inhibition has been proposed as a new therapeutic treatment, although few methods can accurately assess their effect in vivo. In this study, we investigated whether MRI-CEST (Magnetic Resonance Imaging—Chemical Exchange Saturation Transfer) tumor pH imaging can be a useful tool to evaluate in vivo the therapeutic efficacy of several Proton Pump Inhibitors (PPIs) in breast cancer. Cell viability and extracellular pH assays were carried out in breast cancer cells cultured at physiological pH (7.4) or acid-adapted (pH of 6.5 and 6.8) following the exposure to inhibitors of V-ATPase (Lansoprazole, Esomeprazole) or NHE1 (Amiloride, Cariporide) at several concentrations. Next, triple-negative breast cancer 4T1 tumor-bearing mice were treated with Lansoprazole or Amiloride and MRI-CEST tumor pH imaging was utilized to assess the in vivo efficacy. Only Lansoprazole induced, in addition to breast cancer cell toxicity, a significant inhibition of proton extrusion. A significant reduction in tumor volume, prolonged survival, and increase in extracellular tumor pH after 1 and 2 weeks were observed after Lansoprazole treatment, whereas no significant changes were detected upon Amiloride treatment. Our results suggested that MRI-CEST tumor pH imaging can monitor the therapeutic efficacy of PPIs in breast cancer murine models.
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Bar-Shir, Amnon, Yajie Liang, Kannie W. Y. Chan, Assaf A. Gilad, and Jeff W. M. Bulte. "Supercharged green fluorescent proteins as bimodal reporter genes for CEST MRI and optical imaging." Chemical Communications 51, no. 23 (2015): 4869–71. http://dx.doi.org/10.1039/c4cc10195b.

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42

Wu, Yin, Zhou Liu, Qian Yang, Liyan Zou, Fan Zhang, Long Qian, Xin Liu, Hairong Zheng, Dehong Luo, and Phillip Zhe Sun. "Fast and equilibrium CEST imaging of brain tumor patients at 3T." NeuroImage: Clinical 33 (2022): 102890. http://dx.doi.org/10.1016/j.nicl.2021.102890.

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43

Arena, Francesca, Pietro Irrera, Lorena Consolino, Sonia Colombo Serra, Moritz Zaiss, and Dario Livio Longo. "Flip-angle based ratiometric approach for pulsed CEST-MRI pH imaging." Journal of Magnetic Resonance 287 (February 2018): 1–9. http://dx.doi.org/10.1016/j.jmr.2017.12.007.

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44

Msayib, Y., G. W. J. Harston, Y. K. Tee, F. Sheerin, N. P. Blockley, T. W. Okell, P. Jezzard, J. Kennedy, and M. A. Chappell. "Quantitative CEST imaging of amide proton transfer in acute ischaemic stroke." NeuroImage: Clinical 23 (2019): 101833. http://dx.doi.org/10.1016/j.nicl.2019.101833.

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45

Akbey, Suzan, Philipp Ehses, Rüdiger Stirnberg, Moritz Zaiss, and Tony Stöcker. "Whole‐brain snapshot CEST imaging at 7 T using 3D‐EPI." Magnetic Resonance in Medicine 82, no. 5 (June 14, 2019): 1741–52. http://dx.doi.org/10.1002/mrm.27866.

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Msayib, Y., G. W. J. Harston, F. Sheerin, N. P. Blockley, T. W. Okell, P. Jezzard, J. Kennedy, and M. A. Chappell. "Partial volume correction for quantitative CEST imaging of acute ischemic stroke." Magnetic Resonance in Medicine 82, no. 5 (June 14, 2019): 1920–28. http://dx.doi.org/10.1002/mrm.27872.

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47

Windschuh, Johannes, Moritz Zaiss, Jan-Eric Meissner, Daniel Paech, Alexander Radbruch, Mark E. Ladd, and Peter Bachert. "Correction ofB1-inhomogeneities for relaxation-compensated CEST imaging at 7 T." NMR in Biomedicine 28, no. 5 (March 18, 2015): 529–37. http://dx.doi.org/10.1002/nbm.3283.

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48

Schmitt, Benjamin, Moritz Zaiß, Jinyuan Zhou, and Peter Bachert. "Optimization of pulse train presaturation for CEST imaging in clinical scanners." Magnetic Resonance in Medicine 65, no. 6 (February 17, 2011): 1620–29. http://dx.doi.org/10.1002/mrm.22750.

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49

Chen, Bixue, Xianfu Meng, Wanlu Wu, Yuwen Zhang, Lin Ma, Kaidong Chen, and Xiangming Fang. "A novel CEST-contrast nanoagent for differentiating the malignant degree in breast cancer." RSC Advances 13, no. 21 (2023): 14131–38. http://dx.doi.org/10.1039/d3ra01006f.

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A new nano-contrast agent had been designed to respond to the pH of the microenvironment of breast cancer, enabling CEST MRI imaging to identify the aggressiveness of different subtypes of breast cancer.
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Herz, Kai, Sebastian Mueller, Or Perlman, Maxim Zaitsev, Linda Knutsson, Phillip Zhe Sun, Jinyuan Zhou, et al. "Pulseq‐CEST: Towards multi‐site multi‐vendor compatibility and reproducibility of CEST experiments using an open‐source sequence standard." Magnetic Resonance in Medicine 86, no. 4 (May 7, 2021): 1845–58. http://dx.doi.org/10.1002/mrm.28825.

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