Development of a Clinical Chemical Exchange Saturation Transfer MR fingerprinting (CEST-MRF) Pulse Sequence and Reconstruction for Brain Tumor Quantification

Purpose: To develop a clinical chemical exchange saturation transfer magnetic resonance fingerprinting (CEST-MRF) pulse sequence and reconstruction method. Methods: The CEST-MRF pulse sequence was modified to conform to hardware limits on clinical scanners while keeping scan time $\leqslant$ 2 minutes. The measured data was reconstructed using a deep reconstruction network (DRONE) to yield the water relaxation and chemical exchange parameters. The feasibility of the 6 parameter DRONE reconstruction was tested in simulations in a digital brain phantom. A healthy subject was scanned with the CEST-MRF sequence and a conventional MRF sequence for comparison. The reproducibility was assessed via test-retest experiments and the concordance correlation coefficient (CCC) calculated for white matter (WM) and grey matter (GM). The clinical utility of CEST-MRF was demonstrated in a brain metastasis patient in comparison to standard clinical imaging sequences. The tumor was segmented into edema, solid core and necrotic core regions and the CEST-MRF values compared to the contra-lateral side. Results: The 6 parameter DRONE reconstruction of the digital phantom yielded a mean absolute error of $\leqslant$ 6% for all parameters. The CEST-MRF parameters were in good agreement with those from a conventional MRF sequence and previous studies in the literature. The mean CCC for all 6 parameters was 0.79$\pm$0.02 in WM and 0.63$\pm$0.03 in GM. The CEST-MRF values in nearly all tumor regions were significantly different (p=0.001) from each other and the contra-lateral side. Conclusion: The clinical CEST-MRF sequence provides a method for fast simultaneous quantification of multiple tissue parameters in pathologies.