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Visualization of the Energy Metabolism: Oxygen-17 (17O) MR Imaging

Dynamic ¹⁷O MRI utilizes the stable and MR-detectable oxygen isotope (¹⁷O) to quantify the functional parameter of the cerebral metabolic rate of oxygen consumption (CMRO₂), reflecting the energy metabolism in the human brain. The CMRO₂ parameter is an indicator of cell viability. In many diseases such as Parkinson’s or in Alzheimer’s disease or cancer (‘Warburg Effect’) CMRO₂ is reduced and might therefore be an important diagnostic parameter. The method, which includes inhalation of ¹⁷O₂ gas, was first validated in a volunteer study, where we could verify our results and show reproducibility (Niesporek et al. Magn Reson Med 2018). Measuring various glioma patients demonstrated the capability of dynamic ¹⁷O MRI for direct metabolic imaging generating a functional contrast between healthy and malignant tissue (Paech et al. Radiology 2020). Moreover, this complex method was applied in a first patient with early subacute stroke (Ebersberger et al. Frontiers in Neuroscience 2023).

Example structural 1H and metabolic 17O MRI in a patient (WHO grade IV glioblastoma), Clinical anatomical 1H images with delineated tumor volume without (A) and after contrast media administration with typical tumor ring enhancement and (B). Color-coded map of relative 17O signal change with/ without fusion of 1H MRI data (C, D). Regions of tumor tissue show a clearly reduced metabolic activity measured with information of dynamic 17O MRI demonstrating the metabolic contrast in tumor tissue. Tumor metabolism is shifted to a more anaerobic pathway, consuming less oxygen than healthy tissue (‘Warburg-Effect’). Data acquired at the German Cancer Research Center (DKFZ), Heidelberg.

References

Ebersberger L, Kratzer FJ, Potreck A, Niesporek SC, Keymling M, Nagel AM, ... Paech D & Platt T. First application of dynamic oxygen-17 (17O) magnetic resonance imaging at 7 Tesla in a patient with early subacute stroke. Frontiers in Neuroscience 2023.
Paech D, Nagel AM, Schultheiss MN, Umathum R, Regnery S, Scherer M, ... & Niesporek SC. Quantitative dynamic oxygen 17 MRI at 7.0 T for the cerebral oxygen metabolism in glioma. Radiology 2020; 295(1): 181-189.
Niesporek SC, Umathum R, Lommen JM, Behl NGR, Paech D, Bachert P, Ladd ME, Nagel AM. Reproducibility of CMRO2 determination using dynamic ⁽¹⁷⁾ O MRI. Magn Reson Med 2018; 79(6):2923-2934.
Niesporek SC, Umathum R, Fiedler TM, Bachert P, Ladd ME, Nagel AM. Improved T2* determination in ²³Na, ³⁵Cl, and ¹⁷O MRI using iterative partial volume correction based on 1H MRI segmentation. Magnetic Resonance Materials in Physics, Biology and Medicine 2017:1-18.
Niesporek SC, Hoffmann SH, Berger MC, Benkhedah N, Kujawa A, Bachert P, Nagel AM. Partial volume correction for in vivo ⁽²³⁾Na-MRI data of the human brain. Neuroimage 2015; 112:353-363.
Hoffmann SH, Radbruch A, Bock M, Semmler W, Nagel AM. Direct ⁽¹⁷⁾O MRI with partial volume correction: first experiences in a glioblastoma patient. MAGMA 2014; 27(6):579-587.
Hoffmann SH, Begovatz P, Nagel AM, Umathum R, Schommer K, Bachert P, Bock M. A measurement setup for direct ¹⁷O MRI at 7 T. Magn Reson Med 2011;66(4):1109-1115.
Nagel AM, Laun FB, Weber MA, Matthies C, Semmler W, Schad LR. Sodium MRI using a density-adapted 3D radial acquisition technique. Magn Reson Med 2009; 62(6):1565-1573.

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