In this study, we evaluated AREX(apparent exchange-dependent relaxation rate) in the human spinal cord in patients with MS. Current clinical MRI is insensitive to biochemical changes which may precede inflammatory lesions in the spinal cord. Development of an MRI biomarker capable of detecting tissue changes prior to lesion formation would improve our diagnostic and prognostic capabilities. APT CEST is an MRI contrast approach sensitive to protein and peptide concentration and AREX removes magnetization transfer, T1-relaxation, and RF-spillover effects. Our results suggest that AREX is an improvement over alternative methods and may increase sensitivity to pathological changes in the spinal cord.
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