{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T15:12:45Z","timestamp":1778425965491,"version":"3.51.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>\n              Peripheral artery disease (PAD) results in exercise-induced ischemia in leg muscles.\n              <jats:sup>31<\/jats:sup>\n              Phosphorus (P) magnetic resonance spectroscopy demonstrates prolonged phosphocreatine recovery time constant after exercise in PAD but has low signal to noise, low spatial resolution, and requires multinuclear hardware. Chemical exchange saturation transfer (CEST) is a quantitative magnetic resonance imaging method for imaging substrate (CEST asymmetry [CEST\n              <jats:sub>asym<\/jats:sub>\n              ]) concentration by muscle group. We hypothesized that kinetics measured by CEST could distinguish between patients with PAD and controls.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              Patients with PAD and age-matched normal subjects were imaged at 3T with a transmit-receive coil around the calf. Four CEST mages were acquired over 24-second intervals. The subjects then performed plantar flexion exercise on a magnetic resonance imaging-compatible ergometer until calf exhaustion. Twenty-five CEST images were obtained at end exercise. Regions of interest were drawn around individual muscle groups, and (CEST\n              <jats:sub>asym<\/jats:sub>\n              ) decay times were fitted by exponential curve to CEST values. In 10 patients and 11 controls,\n              <jats:sup>31<\/jats:sup>\n              P spectra were obtained 20 minutes later after repeat exercise. Five patients and 5 controls returned at a mean of 1\u00b11 days later for repeat CEST studies.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Thirty-five patients with PAD (31 male, age 66\u00b18 years) and 29 controls (11 male, age 63\u00b18 years) were imaged with CEST. The CEST\n              <jats:sub>asym<\/jats:sub>\n              decay times for the whole calf (341\u00b1332 versus 153\u00b172 seconds;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.03) as well as for the gastrocnemius and posterior tibialis were longer in patients with PAD. Agreement between CEST\n              <jats:sub>asym<\/jats:sub>\n              decay and phosphocreatine recovery time constant was good.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              CEST is a magnetic resonance imaging method that can distinguish energetics in patients with PAD from age-matched normal subjects on a per muscle group basis. CEST agrees reasonably well with the gold standard\n              <jats:sup>31<\/jats:sup>\n              P magnetic resonance spectroscopy. Moreover, CEST has higher spatial resolution, creates an image, and does not require multinuclear hardware and thus may be more suitable for clinical studies in PAD.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.121.013869","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T18:00:28Z","timestamp":1658253628000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Chemical Exchange Saturation Transfer Magnetic Resonance Imaging Identifies Abnormal Calf Muscle\u2013Specific Energetics in Peripheral Artery Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7695-3594","authenticated-orcid":true,"given":"Helen L.","family":"Sporkin","sequence":"first","affiliation":[{"name":"Departments of Biomedical Engineering (H.L.S., C.H.M.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toral R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Medicine, Cardiovascular Division (T.R.P., Y.B., R.M., C.L.S., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaqub","family":"Betz","sequence":"additional","affiliation":[{"name":"Medicine, Cardiovascular Division (T.R.P., Y.B., R.M., C.L.S., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshin","family":"Mathew","sequence":"additional","affiliation":[{"name":"Medicine, Cardiovascular Division (T.R.P., Y.B., R.M., C.L.S., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Schumann","sequence":"additional","affiliation":[{"name":"Medicine, Cardiovascular Division (T.R.P., Y.B., R.M., C.L.S., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-3848","authenticated-orcid":true,"given":"Craig H.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Departments of Biomedical Engineering (H.L.S., C.H.M.), University of Virginia Health, Charlottesville."},{"name":"Radiology and Medical Imaging (C.H.M., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-7731","authenticated-orcid":true,"given":"Christopher M.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Medicine, Cardiovascular Division (T.R.P., Y.B., R.M., C.L.S., C.M.K.), University of Virginia Health, Charlottesville."},{"name":"Radiology and Medical Imaging (C.H.M., C.M.K.), University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000137913.26087.F0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.03.290"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.101.1.e16"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X17751259"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.12.069"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3436"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24412"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.24641"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-199711000-00001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.080"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.28463"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0214805"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.03.022"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-015-0128-y"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2020.09.033"},{"key":"e_1_3_3_18_2","unstructured":"Kumar D Armbruster R Wilson N Prakash R Nanga R Reddy R. Indirect Inference of acidification in exercised skeletal muscle using creatine CEST. Oral presentation at Annual Meeting and Exhibition of the International Society for Magnetic Resonance in Medicine. May 2021; virtual."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.80.5.1338"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.121.013869","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T13:07:12Z","timestamp":1749042432000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.121.013869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1161\/CIRCIMAGING.121.013869"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.121.013869","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2021-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}