Neural Regeneration Research ›› 2026, Vol. 21 ›› Issue (2): 553-568.doi: 10.4103/NRR.NRR-D-24-01246

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Chemical exchange saturation transfer MRI for neurodegenerative diseases: An update on clinical and preclinical studies

Ahelijiang Saiyisan1, #, Shihao Zeng1, #, Huabin Zhang1, 2, Ziyan Wang1 , Jiawen Wang1 , Pei Cai1 , Jianpan Huang1, 3, *   

  1. 1 Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China;  2 Department of Electronic Engineering and Information Science, University of Science and Technology of China, Hefei, Anhui Province, China;  3 Tam Wing Fan Neuroimaging Research Laboratory, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
  • Online:2026-02-15 Published:2025-05-22
  • Contact: Jianpan Huang, PhD, jphuang@hku.hk.
  • Supported by:
    This work was supported by The University of Hong Kong, China (109000487, 109001694, 204610401, and 204610519) and National Natural Science Foundation of China (82402225) (to JH).

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Abstract: Chemical exchange saturation transfer magnetic resonance imaging is an advanced imaging technique that enables the detection of compounds at low concentrations with high sensitivity and spatial resolution and has been extensively studied for diagnosing malignancy and stroke. In recent years, the emerging exploration of chemical exchange saturation transfer magnetic resonance imaging for detecting pathological changes in neurodegenerative diseases has opened up new possibilities for early detection and repetitive scans without ionizing radiation. This review serves as an overview of chemical exchange saturation transfer magnetic resonance imaging with detailed information on contrast mechanisms and processing methods and summarizes recent developments in both clinical and preclinical studies of chemical exchange saturation transfer magnetic resonance imaging for Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and Huntington’s disease. A comprehensive literature search was conducted using databases such as PubMed and Google Scholar, focusing on peer-reviewed articles from the past 15 years relevant to clinical and preclinical applications. The findings suggest that chemical exchange saturation transfer magnetic resonance imaging has the potential to detect molecular changes and altered metabolism, which may aid in early diagnosis and assessment of the severity of neurodegenerative diseases. Although promising results have been observed in selected clinical and preclinical trials, further validations are needed to evaluate their clinical value. When combined with other imaging modalities and advanced analytical methods, chemical exchange saturation transfer magnetic resonance imaging shows potential as an in vivo biomarker, enhancing the understanding of neuropathological mechanisms in neurodegenerative diseases.

Key words: Alzheimer’s disease, chemical exchange saturation transfer, Huntington’s disease, magnetic resonance imaging, molecular imaging, multiple sclerosis, neurodegenerative disease, Parkinson’s disease