Chemical Exchange Saturation Transfer Imaging in Neuroinflammation: Methods, Challenges, and Recommendations

Area of Science:

• Neuroimaging
• Molecular MRI
• Neuroinflammation Research

Background:

• Chemical Exchange Saturation Transfer (CEST) imaging offers non-invasive insights into brain's metabolic and molecular changes.
• Neuroinflammation is implicated in various neurological disorders, necessitating advanced diagnostic tools.

Purpose of the Study:

• To provide a comprehensive review of CEST imaging principles, methodological advancements, and applications in neuroinflammation.
• To examine the role of artificial intelligence (AI) and high-field MRI in enhancing CEST imaging.
• To identify challenges and provide recommendations for clinical adoption.

Main Methods:

• Review of fundamental CEST mechanisms, pulse sequences, and contrast strategies.
• Discussion of advancements in fast CEST imaging, AI-driven reconstruction, and quantification.
• Analysis of preclinical and clinical studies demonstrating CEST's utility in neuroinflammation.

Main Results:

• CEST imaging shows potential as a non-invasive biomarker for detecting neuroinflammation across neurological diseases.
• AI and high-field MRI can improve CEST sensitivity, specificity, and image quality.
• Despite progress, challenges like field inhomogeneity and lack of standardization persist.

Conclusions:

• CEST imaging holds significant promise for understanding molecular mechanisms in neurological diseases.
• Addressing technical and translational challenges is crucial for widespread clinical implementation of CEST.
• Integrating AI-based approaches can lead to robust molecular characterization of neuroinflammation.