Refining CREST MRI to Track Creatine in Heart Patients

A new magnetic resonance imaging (MRI) approach to map creatine at higher resolutions in the heart may help clinicians and scientists find abnormalities and disorders earlier than traditional diagnostic methods.

Investigators from the Perelman School of Medicine at the University of Pennsylvania (Penn Medicine; Philadelphia, PA, USA) reported in a new study published online January 13, 2014, in the journal Nature Medicine that their preclinical findings show an advantage over less sensitive tests and point to a safer and more cost-effective strategy than those with radioactive or contrasting agents.


Creatine is a naturally occurring metabolite that helps supply energy to all cells through creatine kinase reaction, including those involved in contraction of the heart. Even in the very early stages, when heart tissue becomes injured from a loss of blood supply, creatine levels decrease. Researchers utilized this process in a large animal model with a technique called chemical exchange saturation transfer (CEST), which measures specific molecules in the body, to track the creatine on a regional basis.

The team, led by Ravinder Reddy, PhD, professor of radiology and director of the Center for Magnetic Resonance and Optical Imaging at Penn Medicine, discovered that imaging creatine through CEST MRI provides higher resolution compared to standard magnetic resonance spectroscopy (MRS), a typically used technique for measuring creatine. Its inferior resolution, however, makes it difficult to determine precisely which areas of the heart have been compromised.

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Perelman School of Medicine at the University of Pennsylvania