This study aimed to implement a multimodal1H/HP-13C imaging protocol to augment the serial monitoring of patients with glioma, while simultaneously pursuing methods for improving the robustness of HP-13C metabolic data. A total of 1001H/HP [1-13C]-pyruvate MR examinations (104 HP-13C datasets) were acquired from 42 patients according to the comprehensive multimodal glioma imaging protocol. Serial data coverage, accuracy of frequency reference, and acquisition delay were evaluated using a mixed-effects model to account for multiple exams per patient. Serial atlas-based HP-13C MRI demonstrated consistency in volumetric coverage measured by inter-exam dice coefficients (0.977 ± 0.008, mean ± SD; four patients/11 exams). The atlas-derived prescription provided significantly improved data quality compared to manually prescribed acquisitions (n= 26/78;p= 0.04). The water-based method for referencing [1-13C]-pyruvate center frequency significantly reduced off-resonance excitation relative to the coil-embedded [13C]-urea phantom (4.1 ± 3.7 Hz vs. 9.9 ± 10.7 Hz;p= 0.0007). Significantly improved capture of tracer inflow was achieved with the 2-s versus 5-s HP-13C MRI acquisition delay (p= 0.007). This study demonstrated the implementation of a comprehensive multimodal1H/HP-13C MR protocol emphasizing the monitoring of steady-state/dynamic metabolism in patients with glioma.
本研究旨在实施一种多模态¹H/HP-¹³C成像方案，以增强对胶质瘤患者的连续监测，同时探索提高HP-¹³C代谢数据稳健性的方法。根据综合多模态胶质瘤成像方案，对42例患者共进行了100次¹H/HP [1-¹³C]-丙酮酸磁共振检查（获得104组HP-¹³C数据集）。采用混合效应模型评估序列数据覆盖范围、频率参考准确性及采集延迟，以校正同一患者的多次检查数据。基于序列图谱的HP-¹³C磁共振成像在体积覆盖范围上表现出良好一致性，检查间Dice系数为0.977 ± 0.008（均值±标准差；4例患者/11次检查）。相较于人工定位采集（n=26/78），图谱导引的扫描方案显著提升了数据质量（p=0.04）。基于水信号的[1-¹³C]-丙酮酸中心频率参考方法，相较于线圈嵌入式¹³C-尿素体模，显著降低了偏共振激发（4.1 ± 3.7 Hz vs. 9.9 ± 10.7 Hz；p=0.0007）。采用2秒（对比5秒）HP-¹³C磁共振成像采集延迟可显著提升示踪剂流入捕获效果（p=0.007）。本研究成功实施了综合多模态¹H/HP-¹³C磁共振成像方案，重点实现了胶质瘤患者稳态/动态代谢过程的监测。
肿瘤(癌症)患者之家