In ischemic stroke, anaerobic glycolysis leads to a local increase in lactate concentration. Such elevated levels of lactate can be detected via CEST/NOE. In vivo, several broad tissue contributions as well as metabolites lead to a complex intermingled baseline in Z-spectra. With PROBE, such effects are compensated based on healthy tissue, and a flat baseline is achieved. Stroke affected areas can hence be identified in direct contrast to healthy tissue. Lactate contributions to the Z-spectrum became distinctively observable. The feasibility was demonstrated in-vivo for thalamic stroke in a clinical setting at 3T.
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