Abstract

BackgroundSodium MRI (23Na‐MRI)‐derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy.PurposeTo evaluate the repeatability and reproducibility of TSC measurements in the brains of healthy volunteers, providing evidence for the technical validation of 23Na‐MRI‐derived biomarkers.Study TypeProspective multicenter study.SubjectsEleven volunteers (32 ± 6 years; eight males, three females) were scanned twice at each of two sites.Field Strength/SequenceComparable 3D‐cones 23Na‐MRI ultrashort echo time acquisitions at 3T.AssessmentTSC values, quantified from calibration phantoms placed in the field of view, were obtained from white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), based on automated segmentation of coregistered 1H T1‐weighted images and hand‐drawn regions of interest by two readers.Statistical TestsCoefficients of variation (CoVs) from mean TSC values were used to assess intrasite repeatability and intersite reproducibility.ResultsMean GM TSC concentrations (52.1 ± 7.1 mM) were ∼20% higher than for WM (41.8 ± 6.7 mM). Measurements were highly repeatable at both sites with mean scan–rescan CoVs between volunteers and regions of 2% and 4%, respectively. Mean intersite reproducibility CoVs were 3%, 3%, and 6% for WM, GM, and CSF, respectively.Data ConclusionThese results demonstrate technical validation of sodium MRI‐derived biomarkers in healthy volunteers. We also show that comparable 23Na imaging of the brain can be implemented across different sites and scanners with excellent repeatability and reproducibility. Level of Evidence: 1 Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2019;50:1278–1284.

Highlights

  • Sodium magnetic resonance imaging (MRI) (23Na-MRI)-derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy

  • TSC values in segmented regions were consistent across sites, with mean gray matter (GM) concentrations slightly higher than white matter (WM), and cerebrospinal fluid (CSF) values generally higher than WM and GM

  • The total sodium concentration measurements acquired in this study from automated segmentation of white and gray matter analysis are consistent with previous studies,[19,21,26] eg, 41.8 Æ 6.9 vs. 45.9 Æ 3.1 mM, respectively, for WM and 52.1 Æ 7.1 vs. 52.7 Æ 3.6 mM for GM.[26]

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Summary

Introduction

Sodium MRI (23Na-MRI)-derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy. Purpose: To evaluate the repeatability and reproducibility of TSC measurements in the brains of healthy volunteers, providing evidence for the technical validation of 23Na-MRI-derived biomarkers. Statistical Tests: Coefficients of variation (CoVs) from mean TSC values were used to assess intrasite repeatability and intersite reproducibility. Measurements were highly repeatable at both sites with mean scan–rescan CoVs between volunteers and regions of 2% and 4%, respectively. Mean intersite reproducibility CoVs were 3%, 3%, and 6% for WM, GM, and CSF, respectively. Data Conclusion: These results demonstrate technical validation of sodium MRI-derived biomarkers in healthy volunteers. We show that comparable 23Na imaging of the brain can be implemented across different sites and scanners with excellent repeatability and reproducibility.

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