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Chemical exchange saturation transfer (CEST) imaging is an emerging molecular MRI technique that can detect various metabolites and proteins <jats:italic>in vivo<\/jats:italic>. However, the role of CEST imaging for TSC\u2010associated epilepsy has not been assessed. Here, we aim to investigate the feasibility of applying CEST imaging to TSC\u2010associated epilepsy, optimize the CEST acquisition parameters, and provide an analysis method for exploring the dominant molecular contributors to the CEST signal measured. Nine TSC epilepsy patients were scanned on a 3\u2010T MRI system. The CEST saturation frequencies were swept from \u22126 to 6\u00a0ppm with 12 different combinations of saturation power (4, 3, 2 and 1 \u03bcT) and duration (1000, 700 and 400\u2009ms). Furthermore, a two\u2010stage simulation method based on the seven\u2010pool Bloch\u2010McConnell model was proposed to assess the contribution of each exchangeable pool to the CEST signal in normal\u2010appearing white matter and cortical tubers, which avoided the complexity and uncertainty of full Bloch\u2010McConnell fitting. The results showed that under the optimal saturation duration of 1000\u2009ms, the greatest contrast between tubers and normal tissues occurred around 3, 2.5, 1.75\u2009and 3.5\u00a0ppm for B<jats:sub>1<\/jats:sub> of 4, 3, 2 and 1 \u03bcT, respectively. At the optimal frequency offsets, the CEST values of tubers were significantly higher than those in the normal brain tissues (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Furthermore, the two\u2010stage analysis suggested that the amine pool played a dominant role in yielding the contrast between cortical tubers and normal tissues. These results indicate that CEST MRI may serve as a potentially useful tool for identifying tubers in TSC, and the two\u2010stage analysis method may provide a route for investigating the molecular contributions to the CEST contrast in biological tissues.<\/jats:p>","DOI":"10.1002\/nbm.4563","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T01:50:24Z","timestamp":1622166624000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Chemical exchange saturation transfer imaging for epilepsy secondary to tuberous sclerosis complex at 3\u00a0T: Optimization and analysis"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-9279","authenticated-orcid":false,"given":"Qingqing","family":"Wen","sequence":"first","affiliation":[{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering &amp; Instrument Science Zhejiang University  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Affiliated Hospital, College of Medicine Zhejiang University  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Cheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"MR Collaboration Siemens Healthcare Ltd.  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