The current state-of-the-art of spinal cord imaging: methods.

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research

Investigation of brain tumour metabolism using naturally occurring chemical exchange saturation transfer agents with magnetic resonance imaging

This thesis presents a thorough study on the newly developed glucoCEST magnetic resonance imaging (MRI) technique and its application for the assessment of malignant brain tumours. The key asset of glucoCEST is that it allows the detection of small concentration of glucose with standard MRI scanners and has the potential to provide a novel imaging tool to investigate diseases in which glucose metabolism is affected, in particular cancer. The physical principles and the rationale behind the glucoCEST technique are described in detail and factors influencing the measurements (both physiological and hardware related) are analysed using computer simulations and evaluated with in vitro experiments. Special attention is given to the analysis of the first four sugars along the glycolytic pathway i.e. glucose, glucose 6-phosphate, fructose 6-phosphate and fructose 1,6-biphosphate as contributors to the overall observed signal. The results of this analysis give grounds for the argument of the intracellular origin of the glucoCEST signal, which opens the possibility of characterising tumours based on their metabolism with MRI. A preclinical glucoCEST study on mice bearing human xenograft glioblastoma is also presented in which cancers with diverse phenotype are scanned longitudinally throughout the different stages of tumour development. While not conclusive, the results suggest that the glucoCEST technique is able to identify the presence of cancer at an earlier stage than standard MRI methods