Temperature and pH Imaging using Chemical Exchange Saturation Transfer (CEST) MRI Contrast

Chemical exchange saturation transfer (CEST) is a novel mechanism used to generate contrast in magnetic resonance imaging (MRI). Recently, CEST contrast was proposed to noninvasively measure physiological parameters including temperature and pH. Tissue temperature and pH are known markers of pathological processes in many diseases including stroke and cancer. CEST contrast can be generated using endogenous proteins and peptides (endogenous CEST) or using exogenous paramagnetic lanthanide agents (PARACEST). The general problem of optimizing applications of endogenous CEST and PARACEST contrast to measure temperature and pH is addressed in this thesis. Highlights of the thesis include a novel application of PARACEST contrast to measure extracellular pH and temperature in-vivo and a novel ratiometric approach that uses endogenous CEST contrast to measure intracellular pH in-vivo. Using a Tm3+-based PARACEST agent (Tm3+-DOTAM-Gly-Lys), the PARACEST amide peak chemical shift and linewidth were shown to depend on pH and temperature in a deterministic manner. Quantitative temperature and pH maps were simultaneously measured in a normal mouse leg following agent injection using empirical relations derived in-vitro. A ratio of endogenous amide and amine proton CEST effects was developed to measure absolute tissue pH that is heavily weighted to the intracellular compartment. The technique called amine and amide concentration-independent detection (AACID) was developed using in-vitro phantoms and numerical simulations. Following in-vivo pH-calibration using 31P-magnetic resonance spectroscopy (MRS), tissue pH measurement was demonstrated in mice following focal cerebral ischemia. Local acidosis was measured in ischemic regions and found to correlate with regions of tissue damage. Finally, two endogenous CEST metrics including the AACID ratio were used to monitor cancer treatment using an anticancer drug called lonidamine. Lonidamine selectively acidifies cancer cells. In-vivo experiments demonstrate that endogenous CEST imaging is sensitive to intracellular acidification by lonidamine in a glioblastoma brain tumor mouse model. Overall, the results presented in this thesis demonstrate quantitative measurement of pH and temperature using CEST and/or PARACEST contrast in-vivo. Some of the novel techniques developed in this thesis were demonstrated in stroke and cancer mouse models. Future work should focus on 1) development of PARACEST agents with higher sensitivity in-vivo to improve accuracy of temperature and pH maps; 2) application of AACID for absolute pH measurement to differentiate high- and low-grade tumors in-vivo; and 3) application of endogenous CEST measurement to monitor tumor response to different clinically approved chemotherapy treatments