Recovery kinetics of creatine in mild plantar flexion exercise using 3D creatine CEST imaging at 7 Tesla

Dushyant Kumar, Ravi Prakash Reddy Nanga, Deepa Thakuri, Neil Wilson, Abigail Cember, Melissa Lynne Martin, Dan Zhu, Russell T. Shinohara, Qin Qin, Hari Hariharan, Ravinder Reddy

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: Two-dimensional creatine CEST (2D-CrCEST), with a slice thickness of 10-20 mm and temporal resolution (τRes) of about 30 seconds, has previously been shown to capture the creatine-recovery kinetics in healthy controls and in patients with abnormal creatine-kinase kinetics following the mild plantar flexion exercise. Since the distribution of disease burden may vary across the muscle length for many musculoskeletal disorders, there is a need to increase coverage in the slice-encoding direction. Here, we demonstrate the feasibility of 3D-CrCEST with τRes of about 30 seconds, and propose an improved voxel-wise (Formula presented.) -calibration approach for CrCEST. Methods: The current 7T study with enrollment of 5 volunteers involved collecting the baseline CrCEST imaging for the first 2 minutes, followed by 2 minutes of plantar flexion exercise and then 8 minutes of postexercise CrCEST imaging, to detect the temporal evolution of creatine concentration following exercise. Results: Very good repeatability of 3D-CrCEST findings for activated muscle groups on an intraday and interday basis was established, with coefficient of variance of creatine recovery constants (τCr) being 7%-15.7%, 7.5%, and 5.8% for lateral gastrocnemius, medial gastrocnemius, and peroneus longus, respectively. We also established a good intraday and interday scan repeatability for 3D-CrCEST and also showed good correspondence between τCr measurements using 2D-CrCEST and 3D-CrCEST acquisitions. Conclusion: In this study, we demonstrated for the first time the feasibility and the repeatability of the 3D-CrCEST method in calf muscle with improved (Formula presented.) correction to measure creatine-recovery kinetics within a large 3D volume of calf muscle.

Original languageEnglish (US)
Pages (from-to)802-817
Number of pages16
JournalMagnetic resonance in medicine
Issue number2
StatePublished - Feb 1 2021


  • creatine
  • creatine CEST
  • creatine kinase
  • creatine recovery kinetics
  • phosphocreatine
  • plantar flexion exercise

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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