Clinical applications of chemical exchange saturation transfer (CEST) MRI

Kyle M. Jones, Alyssa C. Pollard, Mark D. Pagel

Research output: Contribution to journalArticlepeer-review

137 Scopus citations


Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) has been developed and employed in multiple clinical imaging research centers worldwide. Selective radiofrequency (RF) saturation pulses with standard 2D and 3D MRI acquisition schemes are now routinely performed, and CEST MRI can produce semiquantitative results using magnetization transfer ratio asymmetry (MTRasym) analysis while accounting for B0 inhomogeneity. Faster clinical CEST MRI acquisition methods and more quantitative acquisition and analysis routines are under development. Endogenous biomolecules with amide, amine, and hydroxyl groups have been detected during clinical CEST MRI studies, and exogenous CEST agents have also been administered to patients. These CEST MRI tools show promise for contributing to assessments of cerebral ischemia, neurological disorders, lymphedema, osteoarthritis, muscle physiology, and solid tumors. This review summarizes the salient features of clinical CEST MRI protocols and critically evaluates the utility of CEST MRI for these clinical imaging applications. Level of Evidence: 5. Technical Efficacy: Stage 1. J. Magn. Reson. Imaging 2018;47:11–27.

Original languageEnglish (US)
Pages (from-to)11-27
Number of pages17
JournalJournal of Magnetic Resonance Imaging
Issue number1
StatePublished - Jan 2018


  • CEST
  • MRI
  • clinical imaging applications

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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