Metabolic dysfunction plays a major role in the pathogenesis of many neurological diseases, including brain tumors, epilepsy, traumatic brain injury and multiple sclerosis. As a result, clinicians may wish to image the metabolism of a subject in-vivo to diagnose or monitor progression of a disease.
One approach to in-vivo metabolic imaging is based on positron emission tomography (PET) which detects glucose uptake by imaging radioactively-labeled substances introduced into the body. Another approach is to use magnetic resonance imaging (MRI) to detect nutrients or substrates that are labeled with 13C.
According to some aspects, a magnetic resonance imaging system is provided comprising at least one processor configured to instruct a magnetic resonance imager to acquire a deuterium-labeled three-dimensional (3D) data set of at least part of a subject, determine a spectrum for each of a plurality of voxels of the 3D data set, at least a portion of the determined spectra comprising at least one peak corresponding to a deuterium-labeled molecule, and generate at least one metabolic image based at least in part on the spectra determined for the voxels in the 3D dataset.
According to some embodiments, the at least one processor is configured to acquire the deuterium-labeled 3D data set by instructing the magnetic resonance imager to apply one or more magnetic pulses to the at least part of the subject.
According to some embodiments, the spectra determined for the voxels in the 3D dataset are determined based on deuterium-labeled 3D data acquired from a single magnetic pulse.
According to some embodiments, the at least one peak corresponding to a deuterium-labeled molecule comprises a peak corresponding to 2H-labeled glucose, 2H-labeled lactate, 2H-labeled glutamine, or 2H-labeled glutamate.
According to some embodiments, the at least one processor is configured to quantify intensities of a plurality of peaks within the determined spectrum.
According to some embodiments, the plurality of peaks include a peak that corresponds to 2H-labeled glucose and a peak that corresponds to 2H-labeled lactate.
According to some embodiments, generating the at least one metabolic image comprises generating at least one color-coded image that reflects an amount of metabolic activity for one or more deuterium-labeled molecules at different voxel locations in a 3D volume.
According to some embodiments, the at least one processor is further configured to produce a plurality of metabolic images based on respective deuterium-labeled 3D data sets acquired at different times.
According to some embodiments, the at least one processor is further configured to determine a glucose uptake rate and/or an acetate uptake rate.
According to some embodiments, the at least one metabolic image has a spatial resolution of less than 10 mL.
According to some embodiments, the magnetic resonance imaging system further comprises at least one computer readable medium comprising instructions, and wherein the at least one processor is configured to perform said acts of instructing, determining and generating by executing the instructions.
According to some embodiments, the plurality of voxels of the 3D data set are arranged in a single layer of voxels, thereby representing a two-dimensional slice.
According to some aspects, a computer-implemented method of metabolic imaging is provided, the method comprising acquiring a deuterium-labeled three-dimensional (3D) data set of at least part of a subject, determining, using at least one processor, a spectrum for each of a plurality of voxels of the 3D data set, at least a portion of the determined spectra comprising at least one peak corresponding to a deuterium-labeled molecule, and generating, using the at least one processor, at least one metabolic image based at least in part on the spectra determined for the voxels in the 3D dataset.
According to some embodiments, acquiring the deuterium-labeled 3D data set comprises instructing a magnetic resonance imager to apply one or more magnetic pulses to the at least part of the subject.
According to some embodiments, the at least one peak corresponding to a deuterium-labeled molecule comprises a peak corresponding to 2H-labeled glucose, 2H-labeled lactate, 2H-labeled glutamine, or 2H-labeled glutamate.
According to some embodiments, the method further comprises quantifying, using the at least one processor, intensities of a plurality of peaks within the determined spectrum.
According to some embodiments, the plurality of peaks include a peak that corresponds to 2H-labeled glucose and a peak that corresponds to 2H-labeled lactate.
According to some embodiments, generating the at least one metabolic image comprises generating at least one color-coded image that reflects an amount of metabolic activity for one or more deuterium-labeled molecules at different voxel locations in a 3D volume.
According to some embodiments, the method further comprises determining, using the at least one processor, a glucose uptake rate and/or an acetate uptake rate.
According to some aspects, at least one computer readable medium is provided comprising instructions that, when executed by at least one processor, perform a method of metabolic imaging, the method comprising acquiring a deuterium-labeled three-dimensional (3D) data set of at least part of a subject, determining, using at least one processor, a spectrum for each of a plurality of voxels of the 3D data set, at least a portion of the determined spectra comprising at least one peak corresponding to a deuterium-labeled molecule, and generating, using the at least one processor, at least one metabolic image based at least in part on the spectra determined for the voxels in the 3D dataset.
According to some embodiments, the at least one peak corresponding to a deuterium-labeled molecule comprises a peak corresponding to 2H-labeled glucose, 2H-labeled lactate, 2H-labeled glutamine, or 2H-labeled glutamate.
According to some embodiments, generating the at least one metabolic image comprises generating at least one color-coded image that reflects an amount of metabolic activity for one or more deuterium-labeled molecules at different voxel locations in a 3D volume.
The foregoing apparatus and method embodiments may be implemented with any suitable combination of aspects, features, and acts described above or in further detail below. These and other aspects, embodiments, and features of the present teachings can be more fully understood from the following description in conjunction with the accompanying drawings.
Various aspects and embodiments will be described with reference to the following figures. It should be appreciated that the figures are not necessarily drawn to scale. In the drawings, each identical or nearly identical component that is illustrated in various figures is represented by a like numeral. For purposes of clarity, not every component may be labeled in every drawing.
A wide range of neurodegenerative diseases may be characterized by metabolic components that play a role at various stages of pathogenesis. For instance, deficient glucose metabolism (“hypometabolism”) due to mitochondrial dysfunction is considered a common factor in the development of Alzheimer's and Parkinson's diseases in addition to acquired epilepsy. As another example, secondary brain injury acquired after sudden head trauma has been described to disturb homeostasis of essential neural metabolites and neurochemicals.
Some conventional nuclear magnetic resonance (NMR) methods that detect metabolism rely on the use of nutrients or substrates that are labeled with the stable isotope 13C. However, such data can be acquired only from relatively large volumes because of the poor sensitivity of 13C detection. Because of the large volumes required for 13C MR techniques, it is impractical to generate images using such techniques.
Other challenges associated with conventional metabolic imaging techniques based on 13C magnetic resonance spectroscopy (MRS) include the requirement to perform lipid suppression and broadband decoupling. Hyperpolarized 13C MRS requires expensive equipment for hyperpolarization, has a short time window for signal detection, and is currently limited to a single clinically-approved substrate, pyruvate. These requirements have largely prevented 13C MRS from maturing into a clinically-viable method of metabolic imaging.
Other in-vivo metabolic imaging techniques include the use of positron emission tomography (PET) to detect glucose uptake by imaging radioactively-labeled substances introduced into the body. Although the spatial resolution and sensitivity of PET is acceptable, such techniques may have a low clinical adoption rate to assess metabolic processes due to the requirement to use radioactively-labeled substances and the limited metabolic information that can be obtained using such techniques. For example, typically only the uptake of a glucose analog (e.g., 18F-deoxyglucose or 18FDG) can be interrogated using PET, which does not provide information about downstream glucose metabolism.
The inventors have recognized a need for non-invasive metabolic imaging techniques that do not require the administration of radioactively-labeled substances to a patient (e.g., as required for PET) and provide an alternative to conventional 13C NMR imaging, which has intrinsically low sensitivity.
The inventors have recognized and appreciated metabolic imaging techniques in which deuterium (i.e., 2H)-labeled molecules are detected to assess metabolic processes. These techniques may have an improved spatial resolution compared to 13C MR techniques, providing the ability to determine metabolic information on a voxel-by-voxel basis to form a metabolic image of an imaged volume. The metabolic imaging techniques in accordance with some embodiments are referred to herein as “deuterium metabolic imaging” (DMI), representing the fact that peaks of deuterium-labeled molecules in individual voxels are determined based on 2H nuclear magnetic resonance (NMR).
In some embodiments, deuterium metabolic imaging techniques may perform NMR imaging (also referred to herein as Magnetic Resonance Imaging, or MRI) of a deuterium-labeled substrate introduced into a subject. In some cases, such substrates may require minimal pharmaceutical preparation for intravenous infusion in human subjects. For instance, 2H-labeled nutrients such as glucose, acetate and ketone bodies may not be subject to drug approval and may be purchased pre-tested for sterility, and at low cost.
In some embodiments, deuterium metabolic imaging techniques may perform MRI of a substance produced within a subject as a result of metabolic processes that act upon a deuterium-labeled substrate introduced into the subject. Such substances may include metabolites and/or intermediates in metabolic pathways. For instance, deuterium-labeled glucose introduced into a subject may produce pyruvate and lactate as a result of the deuterium-labeled glucose being converted in the glycolytic pathway. As a result of such a process, the resultant pyruvate and/or lactate may be deuterium-labeled and may be imaged through the deuterium metabolic imaging techniques described herein.
In some embodiments, deuterium metabolic imaging techniques may produce an MRI spectrum for each of a plurality of voxels within a three-dimensional (3D) volume. Imaging of a deuterium-labeled substrate introduced into a subject within each of a plurality of voxels may allow generation of a 3D map of a metabolite within the subject. In cases where the substrate produces additional deuterium-labeled substances as a result of metabolic processes, 3D maps of those substances may be generated as well.
In some embodiments, by combining multiple 3D maps of deuterium-labeled substances, an understanding of the metabolic processes occurring within the 3D volume may be obtained. For example, as discussed above, deficient glucose metabolism is considered a factor in the development of Alzheimer's and Parkinson's diseases. Imaging of deuterium-labeled glucose (and/or other deuterium-labeled substances) within a subject may thereby allow identification of such diseases and/or allow the progression of such diseases to be tracked.
Following below are more detailed descriptions of various concepts related to, and embodiments of, techniques of deuterium metabolic imaging. It should be appreciated that various aspects described herein may be implemented in any of numerous ways. Examples of specific implementations are provided herein for illustrative purposes only. In addition, the various aspects described in the embodiments below may be used alone or in any combination, and are not limited to the combinations explicitly described herein.
In act 102, the MRI system or device performing method 100 acquires NMR data of deuterium-labeled molecules. Act 102 may comprise performing one or more NMR scans of any suitable subject, including a human subject, and may comprise one or more NMR scans of particular regions of the subject's body. In some cases, the regions of the body may be selected based on particular organs of interest. For example, the subject's head may be scanned to produce NMR data of the subject's brain. Other suitable organs that may be scanned in act 102 include the liver and the heart. References to a “scan” or “scanning” via NMR herein refer simply to the performance of any suitable number of NMR sequences in which oscillating magnetic pulses are applied to a target area.
In the example of
In some embodiments, a subject scanned in act 102 may have previously been administered one or more deuterium-labeled substrates. Such substrates may be administered to the subject in any suitable manner, including oral administration and/or via infusion (which may include intravenous administration in addition to other non-oral routes such as intramuscular injections or epidural routes). Act 102 may be performed a suitable time after administration of such substrates (e.g., between 50 and 115 minutes following administration in the case of oral administration of [6, 6′-2H2]-glucose), immediately after administration of one or more substrates, or during administration of one or more substrates.
According to some embodiments, one or more deuterium-labeled substrates administered to a subject scanned in act 102 may comprise deuterium-labeled organic molecules. For instance, the one or more deuterium-labeled substrates may include one or more deuterium-labeled sugars (e.g., glucose), deuterium-labeled amino acids (e.g., glycine), deuterium-labeled ketones, deuterium-labeled salts (e.g., acetate), deuterium-labeled glutamate, or combinations thereof.
In some embodiments, the MRI system or device performing method 100 comprises one or more RF coils tuned for NMR measurement of deuterium. In some embodiments, the MRI system or device may also comprise RF coils tuned for NMR measurement of protons. In some cases, the MRI system or device performing method 100 may be configured to acquire NMR data of a number of different deuterium-labeled molecules with a single pulse.
Deuterium is a quadrupolar nucleus with spin 1 and a small gyromagnetic ratio. Deuterated molecules (i.e., molecules containing one or more deuterium atoms) generally have a much shorter NMR T1 relaxation time than equivalent molecules labeled with 13C. It has been found by the inventors, however, that T2 values of deuterium labeled metabolites are relatively long, which results in well resolved 2H spectra of substances such as deuterated glucose, glutamate and lactate in vivo, which allows for the quantitation of multiple such substances with a single RF pulse. Further, producing a deuterium MRI spectrum requires comparatively low RF power. This, coupled with the molecules low Larmor frequency allows for rapid pulsing (e.g., <500 ms) for extended signal averaging.
According to some embodiments, in act 102 the MRI system or device performing method 100 may acquire NMR data for a plurality of volume elements (“voxels”) within a selected volume. For instance, NMR data may be acquired for a plurality of voxels at different locations within a human brain. Voxels may be of any suitable size, such as between 50 mm3 and 1 cm3. Voxel positions for acquired data may be determined via any suitable method, for instance via detecting differences in frequency, phase and/or signal timing within the acquired data. In some embodiments, the MRI system or device performing method 100 may, in act 102, apply a magnetic field configured to allow subsequent position detection of signals received from different voxels. For example, a magnetic field gradient may be applied in act 102 to alter the primary magnetic field in a spatially specific pattern (e.g., via the use of gradient coils), thereby allowing position detection through detecting spatial variation in the Larmor frequency.
In act 104 of method 100, NMR spectra are determined for a plurality of voxels within a 3D volume based on at least some of the NMR data acquired in act 102. As discussed above, NMR data acquired in act 102 may be analyzed to determine signals produced by each of a plurality of different voxels. In act 104, such signals may be analyzed to produce corresponding NMR spectra for at least some of these voxels. As referred to herein, an NMR spectrum indicates relative signals strengths of acquired NMR data as a function of chemical shift, which is a more convenient way to represent the resonant frequency shift. The chemical shift is not dependent on the magnetic field strength of the device which produced the data and is typically expressed as a parts per million (ppm) deviation from the resonant frequency of a reference substance (e.g., tetramethylsilane). As such, in some embodiments, a result of act 104 may be a plurality of spectra each indicating relative signal strengths at a plurality of different chemical shifts.
In some embodiments, act 104 may comprise determining NMR spectra at a plurality of different times. In such cases, act 102 may also comprise acquiring NMR data at a plurality of different times, such as by applying a sequence of single pulses that each produce 2H NMR data corresponding to multiple different deuterated molecules. In some cases, observation of NMR spectra over time may provide insight into changes in a subject's metabolism over a time scale of seconds or minutes. In some embodiments, act 104 (and/or act 106) may comprise performing a spectral fit of one or more spectral lines at known resonant shifts (or chemical shifts) to the experimentally obtained spectral data to determine intensities of the one or more spectral lines.
In the example of
As
In the case of acetate substrate 202, acetate 208 within the cell and oxidation of the acetate to produce glutamate 205 and glutamine 206 (Glx) via oxidation may be quantified.
As a result of the above-described process, deuterated glucose and/or acetate in the blood can give rise to deuterated glucose, lactate, glutamine and glutamate in the cells. Via the DMI techniques described herein, NMR spectra of one or more of these deuterium-labeled substances may be detected and quantified, thereby providing insight into the metabolic processes of a subject.
For instance, in the example of
In the example of
In the example of
As can be seen in
In the example of
Images 421 and 431 represent conventional T2-weighted MRI images with each being an image of a different slice within the subject's brain. A glioblastoma is located at the upper left of each image, labeled “1” in image 421 and “3” in image 431. Locations 2 and 4 in images 421 and 431 are comparative locations.
According to some embodiments, DMI metabolic images 440 may have been produced via, for instance, the method 100 of
The Warburg effect may be seen in the example of
NMR spectra corresponding to the locations 1-4 of images 421 and 431 are shown in
It will be noted from
According to some embodiments, computing device 610 is configured to execute instructions that, when executed, perform aspects of DMI discussed herein. Such instructions may be implemented in any suitable way, including via software, hardware, or a combination of both.
In some embodiments, computing device 610 is located within a common housing with MRI device 620. For instance, a console of an MRI system that contains the MRI device 620 may provide controls for a user to operate the MRI device, and the computing device 610 may be part of such a console or otherwise coupled to it. In some cases, the computing device 610 may be located close to, but separate from, the MRI device 620 (e.g., in an adjacent room) and configured to communicate with the MRI device via the link 615, which may comprise any suitable wired and/or wireless connections.
In the example of
In some embodiments, the RF coils 623 may consist of, or may comprise, one or more transverse electromagnetic (TEM) coils. In some embodiments, the MRI device 620 may comprise a 4-coil phased array which may, in some cases, be operable as a single RF coil. In some embodiments, RF coils 623 may be configured to produce phase-encoding gradients (e.g., may be instructed to produce pulses according by computing device 610, or otherwise). In some embodiments, MRI device 620 may comprise one or more phased array receivers. The RF coils 623 may include any type of volume and/or surface coils, including a combination of volume and surface coils.
An illustrative implementation of a computer system 700 that may be used to perform any of the aspects of deuterium metabolic imaging is shown in
In connection with techniques described herein, code used to, for example, instruct an MRI device to produce pulses, to detect received magnetic signals from a subject, to decode a location of a voxel based on a signal, generate an NMR spectrum, perform a spectral fit, generate a metabolic image, etc. may be stored on one or more computer-readable storage media of computer system 700. Processor 710 may execute any such code to provide any techniques for deuterium metabolic imaging as described herein. Any other software, programs or instructions described herein may also be stored and executed by computer system 700. It will be appreciated that computer code may be applied to any aspects of methods and techniques described herein. For example, computer code may be applied to interact with an operating system of an MRI device to operate magnetic fields through conventional processes.
The various methods or processes outlined herein may be coded as software that is executable on one or more processors that employ any one of a variety of operating systems or platforms. Additionally, such software may be written using any of numerous suitable programming languages and/or programming or scripting tools, and also may be compiled as executable machine language code or intermediate code that is executed on a virtual machine or a suitable framework.
In this respect, various inventive concepts may be embodied as at least one non-transitory computer readable storage medium (e.g., a computer memory, one or more floppy discs, compact discs, optical discs, magnetic tapes, flash memories, circuit configurations in Field Programmable Gate Arrays or other semiconductor devices, etc.) encoded with one or more programs that, when executed on one or more computers or other processors, implement the various embodiments of the present invention. The non-transitory computer-readable medium or media may be transportable, such that the program or programs stored thereon may be loaded onto any computer resource to implement various aspects of the present invention as discussed above.
The terms “program,” “software,” and/or “application” are used herein in a generic sense to refer to any type of computer code or set of computer-executable instructions that can be employed to program a computer or other processor to implement various aspects of embodiments as discussed above. Additionally, it should be appreciated that according to one aspect, one or more computer programs that when executed perform methods of the present invention need not reside on a single computer or processor, but may be distributed in a modular fashion among different computers or processors to implement various aspects of the present invention.
Computer-executable instructions may be in many forms, such as program modules, executed by one or more computers or other devices. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types. Typically, the functionality of the program modules may be combined or distributed as desired in various embodiments.
Also, data structures may be stored in non-transitory computer-readable storage media in any suitable form. Data structures may have fields that are related through location in the data structure. Such relationships may likewise be achieved by assigning storage for the fields with locations in a non-transitory computer-readable medium that convey relationship between the fields. However, any suitable mechanism may be used to establish relationships among information in fields of a data structure, including through the use of pointers, tags or other mechanisms that establish relationships among data elements.
Various inventive concepts may be embodied as one or more methods, of which examples have been provided. The acts performed as part of a method may be ordered in any suitable way. Accordingly, embodiments may be constructed in which acts are performed in an order different than illustrated, which may include performing some acts simultaneously, even though shown as sequential acts in illustrative embodiments. It will be appreciated that the provided examples of methods are non-limiting and that other inventive methods may be envisioned based on the above disclosure.
For instance, it will be appreciated based on the above that diagnosis of various diseases may be performed through analysis of DMI-produced metabolic images. One example provided above is cancer in the brain, although the techniques described herein may also be applied to detect cancerous cells in other parts of the body, such as in the heart or liver. By detecting molecules that play a role in metabolism, diagnosis of other diseases may also be performed through DMI.
One illustrative method of diagnosis may comprise acts of administering a 2H-labeled substrate to a subject via any suitable method, subsequently performing deuterium metabolic imaging (e.g., method 100) upon one or more regions of the subject's body to produce one or more metabolic images, and diagnosing a disease (e.g., cancer) based on at least one of the one or more metabolic images.
Some actions may be described herein as being taken by a “user.” It should be appreciated that a “user” need not be a single individual, and that in some embodiments, actions attributable to a “user” may be performed by a team of individuals and/or an individual in combination with computer-assisted tools or other mechanisms.
Use of ordinal terms such as “first,” “second,” “third,” etc., in the claims to modify a claim element does not by itself connote any priority, precedence, or order of one claim element over another or the temporal order in which acts of a method are performed, but are used merely as labels to distinguish one claim element having a certain name from another element having a same name (but for use of the ordinal term) to distinguish the claim elements.
Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having,” “containing,” “involving,” and variations thereof herein, is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.
This application is a national stage filing under 35 U.S.C. § 371 of International Patent Application Serial No. PCT/US2018/067089, filed Dec. 21, 2018, which claims priority to U.S. Application Ser. No. 62/608,861, filed Dec. 21, 2017. The contents of these applications are incorporated herein by reference in their entirety.
This invention was made with government support under NS087568 awarded by the National Institutes of Health. The government has certain rights in the invention.
Filing Document | Filing Date | Country | Kind |
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PCT/US2018/067089 | 12/21/2018 | WO | 00 |
Number | Date | Country | |
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62608861 | Dec 2017 | US |