Fast proton spectroscopic imaging of human brain using multiple spin-echoes

Acquisition time reduction in magnetic resonance spectroscopic imaging using discrete wavelet encoding

This paper describes a new magnetic resonance spectroscopic imaging (MRSI) technique based upon the discrete wavelet transform to reduce acquisition time and cross voxel contamination. Prototype functions called wavelets are used in wavelet encoding to localize defined regions in localized space by dilations and translations. Wavelet encoding in MRSI is achieved by matching the slice selective RF pulse profiles to a set of dilated and translated wavelets. Single and dual band slice selective excitation and refocusing pulses, with profiles resembling Haar wavelets, are used in a spin-echo sequence to acquire 2D-MRSI wavelet encoding data. The 2D space region is spanned up to the desired resolution by a proportional number of dilations (increases in the localization gradients) and translations (frequency shift) of the Haar wavelets (RF pulses). Acquisition time is reduced by acquiring successive MR signals from regions of space with variable size and different locations with no requirement for a TR waiting time between acquisitions. An inverse wavelet transform is performed on the data to produce the correct spatial MR signal distribution.

Fast spectroscopic imaging strategies for potential applications in fMRI

Technical aspects of two general fast spectroscopic imaging (SI) strategies, one based on gradient echo trains and the other on spin echo trains, are reviewed within the context of potential applications in the field of functional magnetic resonance imaging (fMRI). Fast spectroscopic imaging of water may prove useful for identifying mechanisms underlying the blood oxygenation level dependence (BOLD) of the water signal during brain activation studies. Reasonably rapid mapping of changes in proton signals from brain metabolites, like lactate, creatine or even neurotransmitter associated metabolites like GABA, is substantially more challenging but technically feasible particularly as higher field strengths become available. Fast spectroscopic methods directed towards the 31P signals from phosphocreatine (PCr) and adenosine tri-phosphates (ATP) are also technically feasible and may prove useful for studying cerebral energetics within fMRI contexts.

Reduction of artifacts by optimization of the sensitivity map in sensitivity-encoded spectroscopic imaging

Sensitivity-encoded spectroscopic imaging (SENSE-SI) reduces scanning time by using multiple coils for parallel signal acquisition. Significant artifacts could be induced by SENSE-SI, mainly due to the low-resolution nature of spectroscopic imaging. The present study introduces a novel method to reduce the artifacts. High-resolution sensitivity maps are used in low-resolution SENSE reconstruction. An intermediate unaliased image is obtained after SENSE reconstruction. Based on the intermediate image, the sensitivity maps are optimized and then the SENSE reconstruction is performed again. The final unaliased image has significantly reduced artifacts.

Multiple spin-echo spectroscopic imaging for rapid quantitative assessment of N-acetylaspartate and lactate in acute stroke

Monitoring the signal levels of lactate (Lac) and N-acetylaspartate (NAA) by chemical shift imaging can provide additional knowledge about tissue damage in acute stroke. Despite the need for this metabolic information, spectroscopic imaging (SI) has not been used routinely for acute stroke patients, mainly due to the long acquisition time required. The presented data demonstrate that the application of a fast multiple spin-echo (MSE) SI sequence can reduce the measurement time to 6 min (four spin echoes per echo train, 32 x 32 matrix). Quantification of Lac and NAA in terms of absolute concentrations (i.e., mmol/l) can be achieved by means of the phantom replacement approach, with correction terms for the longitudinal and transversal relaxation adapted to the multiple spin-echo sequence. In this pilot study of 10 stroke patients (symptom onset < 24 hr), metabolite concentrations obtained from MSE-SI add important information regarding tissue viability that is not provided by other sequences (e.g., diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI)). Metabolic changes extended beyond the borders of the apparent diffusion coefficient (ADC) lesion in nine of the 10 patients, showing a rise in Lac concentrations up to 18 mmol/l, while NAA levels sometimes dropped below the detection level. Considerable differences among the patients in terms of the Lac concentrations and the size of the SI-ADC mismatch were observed.

Out-and-in spiral spectroscopic imaging in rat brain at 7 T

With standard spectroscopic imaging, high spatial resolution is achieved at the price of a large number of phase-encoding steps, leading to long acquisition times. Fast spatial encoding methods reduce the minimum total acquisition time. In this article, a k-space scanning scheme using a continuous series of growing and shrinking, or "out-and-in," spiral trajectories is implemented and the feasibility of spiral spectroscopic imaging for animal models at high B(0) field is demonstrated. This method was applied to rat brain at 7 T. With a voxel size of about 8.7 microl (as calculated from the point-spread function), a 30 x 30 matrix, and a spectral bandwidth of 11 kHz, the minimum scan time was 9 min 20 sec for a signal-to-noise ratio of 7.1 measured on the N-acetylaspartate peak.

Increased medial thalamic choline found in pediatric patients with obsessive-compulsive disorder versus major depression or healthy control subjects: a magnetic resonance spectroscopy study

BACKGROUND

Neurobiologic abnormalities in medial thalamus have been implicated in the pathogenesis of obsessive-compulsive disorder (OCD). We previously used multislice proton magnetic resonance spectroscopic imaging (1-H MRSI) to identify localized functional neurochemical marker alterations in choline (Cho) in medial but not lateral thalamus in treatment-naïve pediatric patients with OCD compared with matched control subjects. Altered brain Cho levels have also been implicated in the pathogenesis of mood disorders.

METHODS

We used 1-H MRSI to study absolute Cho concentrations in 18 psychotropic-naïve pediatric patients with major depressive disorder (MDD) not suffering from OCD, 9-17 years of age, 18 case-matched healthy control subjects, and 27 nondepressed, psychotropic-naïve pediatric patients with OCD, 7-16 years of age.

RESULTS

Significantly increased left and right medial thalamic Cho concentrations were observed in OCD patients compared with both healthy control subjects and patients with MDD. Medial thalamic Cho concentrations did not differ significantly between patients with MDD and control subjects.

CONCLUSIONS

These results suggest that localized functional neurochemical marker alterations in medial thalamic Cho differentiate patients with OCD from healthy control subjects and patients with MDD. Although these results must be considered preliminary, further study of the diagnostic specificity of Cho as a relevant biomarker in OCD is clearly warranted.

Fast proton spectroscopic imaging using steady-state free precession methods

Various pulse sequences for fast proton spectroscopic imaging (SI) using the steady-state free precession (SSFP) condition are proposed. The sequences use either only the FID-like signal S(1), only the echo-like signal S(2), or both signals in separate but adjacent acquisition windows. As in SSFP imaging, S(1) and S(2) are separated by spoiler gradients. RF excitation is performed by slice-selective or chemical shift-selective pulses. The signals are detected in absence of a B(0) gradient. Spatial localization is achieved by phase-encoding gradients which are applied prior to and rewound after each signal acquisition. Measurements with 2D or 3D spatial resolution were performed at 4.7 T on phantoms and healthy rat brain in vivo allowing the detection of uncoupled and J-coupled spins. The main advantages of SSFP based SI are the short minimum total measurement time (T(min)) and the high signal-to-noise ratio per unit measurement time (SNR(t)). The methods are of particular interest at higher magnetic field strength B(0), as TR can be reduced with increasing B(0) leading to a reduced T(min) and an increased SNR(t). Drawbacks consist of the limited spectral resolution, particularly at lower B(0), and the dependence of the signal intensities on T(1) and T(2). Further improvements are discussed including optimized data processing and signal detection under oscillating B(0) gradients leading to a further reduction in T(min).

Parallel spectroscopic imaging with spin-echo trains

A reduction in scan time in spectroscopic imaging (SI) can be achieved by both fast and reduced k-space sampling. This work presents an ultrafast SI technique that combines the two approaches. The synergy of multiple spin-echo (MSE) acquisition and sensitivity encoding (SENSE) enables high-resolution SI to be performed within a clinically acceptable scan time. MSE-SENSE-SI with echo train lengths ranging from one to four echoes is evaluated with respect to SNR and spatial response function by means of in vitro experiments. It is shown that acquiring two spin-echoes (SEs) per acquisition yields a good practical trade-off among scan time, SNR, and spatial response. The clinical feasibility of the technique is demonstrated in a patient with an astrocytoma, and SI data are obtained with an image matrix of 24 x 24 in just over 2 min.

[Fast 1H-NR spectroscopic imaging of the human brain]

Techniques allowing the reduction of the measurement time of MR spectroscopic imaging of protons (1H SI) were studied in a 1.5-T whole-body MR tomograph. The purpose was to facilitate the inclusion of the modality into an MRT routine protocol for examination of the human brain. The techniques were evaluated in a study with 6 healthy volunteers. Shortening of the measurement times can be achieved by reducing the number of phase-encoding steps with spherical k-space sampling, or by using delay times during TR periods for excitation and detection of several slices or echos. Since the tomograph enables echo-planar imaging, multi-gradiennt-echo techniques were implemented, thus sparing one phase-encoding gradient and shortening the measurement time by a factor of N. Due to signal loss, however, this technique is applicable only when the concentration of the metabolites of interest is sufficiently high to obtain a signal-to-noise ratio of at least 2 with a single acquisition.

A multi-center 1H MRS study of the AIDS dementia complex: validation and preliminary analysis

PURPOSE

To demonstrate the technical feasibility and reliability of a multi-center study characterizing regional levels of the brain metabolite ratios choline (Cho)/creatine (Cr) and myoinositol (MI)/Cr, markers of glial cell activity, and N-acetyl aspartate (NAA)/Cr, a marker of mature neurons, in subjects with AIDS dementia complex (ADC).

MATERIALS AND METHODS

Using an automated protocol (GE PROBE-P), short echo time spectra (TE = 35 msec) were obtained at eight sites from uniformly prepared phantoms and from three brain regions (frontal white matter, basal ganglia, and parietal cortex) of normal volunteers and ADC and HIV-negative subjects.

RESULTS

A random-effects model of the phantom and volunteer data showed no significant inter-site differences. Feasibility of a multi-center study was further validated by detection of significant differences between the metabolite ratios of ADC subjects and HIV-negative controls. ADC subjects exhibited significantly higher Cho/Cr and MI/Cr in the basal ganglia and significantly reduced NAA/Cr and significantly higher MI/Cr in the frontal white matter. These results are consistent with the predominantly subcortical distribution of the pathologic abnormalities associated with ADC.

CONCLUSION

This is the first study to ascertain and validate the reliability and reproducibility of a short echo time (1)H-MRS acquisition sequence from multiple brain regions in a multi-center setting. It should now be possible to examine the regional effects of HIV infection in the brain in a large number of subjects and to study the metabolic effects of new therapies for the treatment of ADC in a clinical trial setting.

Characterization of untreated gliomas by magnetic resonance spectroscopic imaging

Although there are trends in the morphologic, metabolic, hemodynamic, and structural properties of untreated gliomas that are reflected in MR measurements, there is considerable heterogeneity both within and between lesions of the same histologic grade. The spatial extent of the abnormality in ADC and RA images is similar to the T2 lesion, but there is no obvious difference in intensity between grades. The rCBV is significantly increased in the enhancing volume of grade 4 lesions but is similar or reduced in intensity for most grade 3 lesions. There are clear differences between the enhancing volumes and the regions with increased Cho that may be highly significant for planning focal therapy. The location and intensity of the Lac/Lip peaks are consistent with those representing regions of necrosis for grade 4 lesions. The fact that small Lac/Lip peaks can also be seen in grade 2 and grade 3 lesions suggests that their presence may be indicative of regions that are likely to progress to a higher grade. If this were the case, it would be valuable for directing biopsies. The correlations between rCBV, Cho, and ADC suggest that cellularity, membrane turnover, and vascularity are linked in grade 4 lesions. It is not clear whether there is any relationship between these parameters regions in grade 2 or grade 3 gliomas. While further work is required to optimize the methodology associated with these MR parameters, it seems likely that combining the information from such measurements may be valuable for predicting outcome and tailoring therapy to individual patients.

Proton magnetic resonance spectroscopic imaging in pediatric major depression

BACKGROUND

Neurobiologic abnormalities in dorsolateral prefrontal cortex (DLPFC) are believed to be involved in the pathophysiology of major depressive disorder (MDD). Although MDD commonly emerges during childhood and adolescence, to our knowledge, no prior study has examined the DLPFC in pediatric patients with MDD.

METHODS

In this study, choline compounds (Cho), N-acetylaspartate (NAA), and creatine/phosphocreatine (Cr) were measured in left and right DLPFC using a multislice proton magnetic resonance spectroscopic imaging sequence with validated phantom replacement methodology in 11 treatment-naïve MDD patients, 10-16 years of age, and 11 case-matched healthy control subjects.

RESULTS

A significant increase in Cho was observed in left but not right DLPFC in MDD patients versus control subjects (32.5% higher). No significant differences in NAA or Cr were observed between case-control pairs.

CONCLUSIONS

These results provide new evidence of localized functional neurochemical marker alterations in left DLPFC in pediatric MDD. Our results must be considered preliminary, however, given the small sample size.

Scan time reduction in proton magnetic resonance spectroscopic imaging of the human brain

A simple technique is described for scan time reductions in proton magnetic resonance spectroscopic imaging (MRSI) of the human brain. Scan time is reduced by approximately 35% while preserving spatial resolution by reducing the field of view (FOV) and number of phase-encoding steps in the transverse direction of the brain. A multislice MRSI of the brain is demonstrated which takes approximately 20 min with a square FOV, and 13 min with a reduced FOV. The signal-to-noise ratio (SNR) in the reduced FOV scan was measured to be 15% lower than that of the full FOV scan, which is close to the expected theoretical value of 19% based on the square root of the scan time. The method can be applied with any sequence, and requires minimal software and no hardware modifications. Scan time in MRSI is minimized in this method by using FOVs no larger than the dimensions of the object to be imaged. The method may also be combined with other fast MRSI techniques to provide further scan time reductions.

Chemical-shift imaging utilizing the positional shifts along the readout gradient direction

In this work, we describe a method that uses the linear phase acquired during the readout period due to chemical shift to generate individual magnetic resonance (MR) images of chemically shifted species. The method utilizes sets of Fourier (or k-space) data acquired with different directions of the readout gradient and a postprocessing algorithm to generate chemical shift images. The methodology is developed for both Cartesian data acquisition and for radial data acquisition. The method is presented here for two chemically shifted species but it can be extended to more species. In this work, we present the theory, show the results in phantoms and in human images, and discuss the artifacts and signal-to-noise ratio of the images obtained with the technique.

Sensitivity-encoded spectroscopic imaging

Sensitivity encoding (SENSE) offers a new, highly effective approach to reducing the acquisition time in spectroscopic imaging (SI). In contrast to conventional fast SI techniques, which accelerate k-space sampling, this method permits reducing the number of phase encoding steps in each phase encoding dimension of conventional SI. Using a coil array for data acquisition, the missing encoding information is recovered exploiting knowledge of the distinct spatial sensitivities of the individual coil elements. In this work, SENSE is applied to 2D spectroscopic imaging. Fourfold reduction of scan time is achieved at preserved spectral and spatial resolution, maintaining a reasonable SNR. The basic properties of the proposed method are demonstrated by phantom experiments. The in vivo feasibility of SENSE-SI is verified by metabolic imaging of N-acetylaspartate, creatine, and choline in the human brain. These results are compared to conventional SI, with special attention to the spatial response and the SNR.

Increased medial thalamic choline in pediatric obsessive-compulsive disorder as detected by quantitative in vivo spectroscopic imaging

The thalamus has been implicated in the pathophysiology of obsessive-compulsive disorder. Using a multislice spectroscopic imaging sequence, we reported reductions in right and left medial thalamic N-acetylaspartate/cytosolic choline + creatine/phosphocreatine and N-acetylaspartate/cytosolic choline levels in 11 pediatric patients with obsessive-compulsive disorder, 8 to 15 years, versus 11 case-matched healthy controls. These changes may reflect a change in N-acetylaspartate, cytosolic choline, or creatine concentrations. Therefore, using a validated phantom replacement methodology, we obtained absolute measures (mmol/L) of N-acetylaspartate, a putative marker of neuronal viability, cytosolic choline, and creatine in these subjects. A significant increase in cytosolic choline was observed in right and left medial but not lateral thalami in patients with obsessive-compulsive disorder versus controls. N-acetylaspartate and creatine did not differ significantly between case-control pairs in the medial or lateral thalamus. These findings provide new evidence of cytosolic choline abnormalities in the thalamus in pediatric obsessive-compulsive disorder.

An efficient chemical shift imaging scheme for magnetic resonance-guided neurosurgery

An efficient magnetic resonance spectroscopic imaging (MRSI) or chemical shift imaging (CSI) technique based on multiple spin echoes (MSE) has been implemented, validated, and used in both phantom and in vivo MR-guided neurosurgical applications. The key concept of the method is to employ MSE to significantly speed up the data collection rate for mapping hydrogen-containing metabolites. Using an echo train length (ETL) of three per excitation to simultaneously fill three consecutive k-space areas, the total scan time for a spectroscopic image matrix size of 32 x 32 has been shortened to approximately 11 minutes. An interecho spacing time of 273 msec was used to null the phase anomalies of lactate double peaks due to the J-coupling. This allowed a sufficient long data sampling time to achieve 4 Hz spectral resolution. Performing CSI intraopertively during an MR-guided neurosurgical procedure was shown to be feasible at 1.5 T. More importantly, it was shown that more relevant information can be obtained regarding neurochemistry about a targeted lesion, in addition to conventional MR morphological imaging noninvasively. In 25 MR-guided neurosurgical cases, the alleviated choline signal has been found to be consistent with the existence of rapid tumor cell proliferation in the corresponding area. The actual neurobiopsy guided by the spectroscopic imaging method demonstrated that it could provide valuable information in specifying the optimal site in a biopsy procedure, especially in the case involving a nonenhancing tumor. The multiecho scheme has made the CSI technique efficient enough to be routinely used in MR-guided surgical procedures at 1.5 T and also allows the possibility of taking full advantage of MRI capability.

In vivo 31P echo-planar spectroscopic imaging of human calf muscle

Localized phosphorus-31 NMR spectra of human calf muscle in vivo were obtained by means of echo-planar spectroscopic imaging (EPSI) with a 1.5-T whole-body scanner. The technique permits the measurement of two-dimensional 31P SI data at a minimum acquisition time of 2.4 s (8x8 voxels, TR=300 ms). With 9.4 min measurement time (TR=1100 ms, 64 averages) and 25x25x40 mm spatial resolution in vivo the 31P NMR signal-to-noise ratio (S/N) of the phosphocreatine (PCr) resonance was about 45; the multiplets of nucleoside 5'-triphosphates were resolved. Spectral quality permits quantitative assessment of the PCr signal in a measurement time that is shorter by a factor of 2 or more than the minimum measurement time feasible with chemical-shift imaging. In a functional EPSI study with a time resolution of 20.5 s on the calf muscle of volunteers, spectra showed a 40% decrease of the PCr signal intensity (at rest: S/N congruent with12) upon exertion of the muscle.

Menstrual cycle-related brain metabolite changes using 1H magnetic resonance spectroscopy in premenopausal women: a pilot study

Proton magnetic resonance spectroscopy (1H-MRS) was used to assess neurochemical brain changes across the menstrual cycle in five women with premenstrual dysphoric disorder (PMDD) and six control subjects. Women with PMDD and control subjects were scanned on days 8 and 26 within one menstrual cycle (i.e. at times of complete absence and height of PMDD symptoms, respectively). The point resolved spectroscopic sequence (PRESS) was used to localize a voxel of 8 ml in the medial frontal gray matter and in the occipito-parietal white matter. The ratio of N-acetyl-aspartate to creatine in the region of the medial prefrontal cortex and the cingulate gyrus declined significantly from the follicular to the luteal phase in both groups of subjects. The menstrual phase-dependent significant increase in the ratio of choline to creatine was observed in the parietal white matter. The myo-inositol/creatine ratio exhibited a trend toward higher levels in the PMDD patients in the luteal phase of the menstrual cycle. Differences between PMDD and control subjects were not statistically significant. Menstrual cycle phase-dependent changes in ovarian hormonal concentrations may influence the neurochemistry of brain activity in premenopausal women.

Improving diagnostic yield in brain biopsy: coupling spectroscopic targeting with real-time needle placement

The purpose of this study was to determine the utility of intraoperative magnetic resonance spectroscopy (MRS) for targeting during brain biopsy using a skull-mounted trajectory guide. From January 1999 to January 2001, 17 patients had intraoperative MRS-guided brain biopsy using a trajectory guide. Ten had turbo spectroscopic imaging (TSI), and seven had both SVS (single-voxel spectroscopy) and TSI. Prospective stereotaxy was used to align the device in a short-bore 1.5-T MR scanner. Areas of elevated choline relative to creatine on SVS and TSI were targeted during the biopsy. Intraoperative imaging confirmed appropriate positioning of the biopsy needle at the time of tissue sampling in all cases. All 17 biopsies (100%) yielded diagnostic tissue. Six patients (34%) had glioblastomas multiforme, three (18%) had anaplastic astrocytomas, three (18%) had anaplastic oligodendrogliomas, two (12%) had radiation necrosis, and one each (6%) had germinoma, ganglioglioma, and astrocytoma. Postoperative imaging confirmed the absence of clinically and radiographically relevant hemorrhage. The findings on SVS correlated with the pathology in all seven cases (100%). In 13 of 17 patients (76%) who had TSI, the spectra correlated well with the permanent pathologic examination. The SVS and TSI spectra were similar in six of seven (86%) cases. Intraoperative MRS-guided brain biopsy using a trajectory guide is a simple, safe, and accurate technique for accessing areas of the brain of diagnostic interest. J. Magn. Reson. Imaging 2001;13:12-15.

The accuracy of whole brain N-acetylaspartate quantification

A non-localizing pulse sequence to quantify the total amount of N-acetylaspartate (NAA) in the whole brain (WBNAA) was introduced recently [Magn. Reson. Med. 40, 684-689 (1998)]. However, it is known that regional magnetic field inhomogeneities, deltaB0s, arising from susceptibility differences at tissue interfaces, shift and broaden local resonances to outside the integration window, leading to an underestimation of the true amount of NAA in the entire brain. To quantify the upper limit of this loss, the whole-head proton MR spectrum (1H-MRS) of the water was integrated over the same frequency width as the NAA. The ratio of this area/total-water-line was 75 +/- 5% in 5 volunteers. The procedure was repeated with the brain-only water peak, obtained by summing signals only from voxels within that organ from a three-dimensional chemical-shift-imaging (3D CSI) set. It indicated that <10% of the water signal loss occurred in the brain. Therefore, by analogy, WBNAA accounts for >90% of that metabolite.

MR-guided and MR-monitored neurosurgical procedures at 1.5 T

A combined MR suite and operating room (MR-OR) has been developed and extensively assessed for its use in a wide spectrum of therapeutic applications. Equipped with a 1.5 T short bore clinical MR scanner and standard neurosurgical OR equipment, in this MR surgical suite, surgeons can obtain intraoperative planar and volumetric MR images with superior soft tissue contrast and spatial resolution for surgical planning, guidance, and monitoring. Besides MR morphologic imaging capability, blood oxygen level-dependent functional MRI and proton MR spectroscopic imaging have been demonstrated intraoperatively in the same MR-OR to aid in surgical planning and guide tumor resections. A perspective surgical navigation device and remotely operated instrument have been developed and successfully used to assist surgeons in aligning and introducing biopsy needles under fluoroscopic MRI in brain biopsy procedures. Furthermore, surgical complications can be assessed immediately before the closure. There are numerous advantages offered by this unprecedented MR-guided surgical approach, most of which are demonstrated and presented herein. Since 1997, >270 neurosurgical cases (42% brain biopsies, 25% tumor resections, 11% functional neurosurgeries, 10% cyst drainages and shunt placements, and 12% others) have been performed in the MR-OR with a <1% overall complication rate. The tumor recurrence rate for the MR-guided surgical approach is significantly less than that of the conventional one. Exemplary neurosurgical cases that have been performed in the MR-OR suite within the last 24 months are included. Overall, this high magnetic field approach to the MR-guided minimally invasive surgical procedures has been shown to be practical and acceptable to neurosurgeons as well as to neuroradiologists for a wide range of neurosurgical and neuroradiologic applications.

Proton spectroscopic imaging of the thalamus in treatment-naive pediatric obsessive-compulsive disorder

BACKGROUND

Neurobiological abnormalities in the thalamus, particularly the dorsomedial nucleus of the thalamus, are believed to be involved in the pathophysiology of obsessive-compulsive disorder. Although obsessive-compulsive disorder commonly arises in childhood and adolescence, no prior study has examined the thalamus in pediatric obsessive-compulsive disorder patients.

METHODS

In this study, N-acetyl-aspartate, a putative marker of neuronal viability, creatine/phosphocreatine, and choline levels were measured in the lateral and medical subregions of the left and right thalami using a multislice proton magnetic resonance spectroscopic imaging sequence in 11 treatment-naive, nondepressed obsessive-compulsive disorder outpatients, 8-15 years old, and 11 case-matched control subjects.

RESULTS

A significant reduction in N-acetyl-aspartate/choline and N-acetyl-aspartate/(creatine/phosphocreatine + choline) was observed in both the right and left medial thalami in obsessive-compulsive disorder patients compared with control subjects. The N-acetyl-aspartate/choline and N-acetyl-aspartate/(creatine/phosphocreatine + choline) levels did not differ significantly between case-control pairs in either the left or the right lateral thalamus. Reduction in N-acetyl-aspartate levels in the left medial thalamus was inversely correlated with increased obsessive-compulsive disorder symptom severity.

CONCLUSIONS

These findings provide new evidence of localized functional neurochemical marker abnormalities in the thalamus in pediatric obsessive-compulsive disorder. Our results must be considered preliminary, however, given the small sample size.

Imaging of acute cerebral ischemia

Until recently, there was no efficacious treatment for acute cerebral ischemia. As a result, the role of neuroimaging and the radiologist was peripheral in the diagnosis and management of this disease. The demonstration of efficacy using thrombolysis has redefined this role, with the success of intervention becoming increasingly dependent on timely imaging and accurate interpretation. The potential benefits of intervention have only begun to be realized. In this State-of-the-Art review of imaging of acute stroke, the role of imaging in the current and future management of stroke is presented. The role of computed tomography is emphasized in that it is currently the most utilized technique, and its value has been demonstrated in prospective clinical trials. Magnetic resonance techniques are equally emphasized in that they have the potential to provide a single modality evaluation of tissue viability and vessel patency in an increasingly rapid evaluation.

Performance of 2D 1H spectroscopic imaging of the brain: some practical considerations regarding the measurement procedure

This paper deals with some of the practical considerations in the planning and performance of chemical shift imaging (MRSI or CSI) of the brain. It contains some aspects of 1) the imaging procedure (MRI), i.e., suggestions of an imaging protocol useful for the spectroscopic planning, 2) the planning of the spectroscopic volume, i.e., size and position, 3) evaluation and judgment of the preparation results, and 4) evaluation of the MRSI images. The paper also contains suggestions of developmental work and quality assessment to be done before patient studies are begun. Examples are given for MRSI studies of temporal lobe epilepsy. Several of the aspects described are obvious for the experienced spectroscopist but may be useful in the initiation of MRSI. The goal of this paper was to share our experiences of how to achieve high quality MRSI, experiences that we would had been grateful for in our prelude of MRSI experiments.

Serial evaluation of patients with brain tumors using volume MRI and 3D 1H MRSI

Patients with brain tumors are routinely monitored for tumor progression and response to therapy using magnetic resonance imaging (MRI). Although serial changes in gadolinium enhancing lesions provide valuable information for making treatment decisions, they do not address the fate of non-enhancing lesions and are unable to distinguish treatment induced necrosis from residual or recurrent tumor. The introduction of a non-invasive methodology, which could identify an active tumor more reliably, would have a major impact upon patient care and evaluation of new therapies. There is now compelling evidence that magnetic resonance spectroscopic imaging (MRSI) can provide such information as an add-on to a conventional MRI examination. We discuss data acquisition and analysis procedures which are required to perform such serial MRI-MRSI examinations and compare their results with data from histology, contrast enhanced MRI, MR cerebral blood volume imaging and FDG-PET. Applications to the serial assessment of response to therapy are illustrated by considering populations of patients being treated with brachytherapy and gamma knife radiosurgery.

Echoplanar chemical shift imaging

A novel method of chemical shift imaging utilizing echoplanar imaging (EPI) has been developed for the purpose of improving the spatial resolution of metabolite images for the specific goal of high spatial resolution mapping of neuronal content. An EPI sequence was modified to allow temporal offsets of the 180 degree refocusing pulse that encode the chemical shift information into the phase of the signal. Implementation of this method on 1.5 and 3 T human imagers has resulted in images of N-acetyl aspartate in humans with spatial resolution of 360 microl and signal-to-noise ratio approximately 7:1 in less than 13 min.

Feasibility study of lactate imaging of head and neck tumors

A proton spectroscopic imaging sequence was used to investigate the feasibility of lactate imaging in head and neck tumors. The sequence employs a two-shot lactate editing method with inversion recovery for additional lipid suppression, and a restricted field of view to suppress motion artifacts. Variations in acquisition parameters and two different receive coils were investigated on twelve patients. Elevated lactate was detected in three patients, no lactate was observed in seven patients, and two studies were inconclusive because of severe motion or inhomogeneity artifacts. Best results were obtained with an anterior/posterior neck coil at a 288 ms echo time (TE).

Strategy for lipid suppression in lactate imaging using STIR-DQCT: a study of hypoxic-ischemic brain injury

In vivo lactate detection using gradient enhanced double quantum coherence transfer (DQCT) was significantly improved by addition of short-time-inversion-recovery (STIR). Phantom studies demonstrated lipid suppression down to the background noise level with 33% loss of lactate signal. In vivo studies using a rabbit model of hypoxic and unilateral-ischemic brain injury showed reduction down to 29 +/- 11% in lipids with inversion times between 140 and 170 ms. Lactate signals on the ischemic side were 51 +/- 53% higher than the nonischemic side at the peak of hypoxia. STIR-DQCT can be a useful robust method of obtaining metabolic maps of lactate in vivo.

Fast 1H spectroscopic imaging using a multi-element head-coil array

Fast proton magnetic resonance spectroscopic imaging (MRSI) using a multi-element head-coil array is examined with respect to three aspects: the coil design, the use of an appropriate signal combination method, and the design of the MRSI pulse sequence itself. An eight-element head-coil array has been developed to increase the signal-to-noise ratio (SNR) of MRSI in the human brain. The flexible wraparound design optimally fits different head sizes and thus provides high sensitivity. The signal combination of the individual coil elements is based on the approach proposed by Roemer et al. (Magn. Reson. Med. 16, 192 (1990)). An additional short prescan is performed to provide a good estimate of the complex coil sensitivity profiles, which are used in the signal combination procedure to correct the spectroscopic imaging data for the spatially varying intensity. The use of coil arrays in MRSI has some effect on the requirements for both water and lipid suppression. These techniques and a MRSI pulse sequence that provides a high spectroscopic resolution are described and discussed. Experimental results at 1.5 T show that metabolite maps of N-acetylaspartate (NAA), choline (Cho), phosphocreatine (PCr)/creatine (Cr) can be obtained within a 5-min acquisition time.

Fast spectroscopic imaging of water and fat resonances to improve the quality of MR images

RATIONALE AND OBJECTIVES

The authors evaluated whether fast spectroscopic imaging of water and fat resonances can produce high-quality anatomic magnetic resonance (MR) images of rodent tumors and human breast.

MATERIALS AND METHODS

Fast MR spectroscopic images of eight rats with mammary tumors were acquired by using a 4.7-T MR unit equipped with self-shielded gradient coils. MR spectroscopic images of four human breasts were acquired with a 1.5-T MR unit.

RESULTS

Artifacts due to eddy currents were minimal. Images synthesized from MR spectroscopic data, in which intensity was proportional to water signal peak height, were similar to T2-weighted MR images. Boundaries of rodent mammary tumors are similar but not identical on peak height-weighted and T2-weighted images. MR spectroscopic images of human breast showed improved detail compared to gradient-echo MR images.

CONCLUSION

Preliminary results suggest that incorporation of fast MR spectroscopic imaging methods into many standard clinical MR imaging procedures may substantially improve image quality.

Multiple-echo proton spectroscopic imaging using time domain parametric spectral analysis

A multiple-echo MR spectroscopic imaging (MRSI) method is presented that enables improved metabolite imaging in the presence of local field inhomogeneities and measurement of transverse relaxation parameters. Short echo spacing is used to maximize signal energy from inhomogeneously line-broadened resonances, and time domain parametric spectral analysis of the entire echo train is used to obtain sufficient spectral resolution from the shortened sampling periods. Optimal sequence parameters for 1H MRSI are determined by computer simulation, and performance is compared with conventional single-echo acquisition using phantom studies at a field strength of 4.7 T. A preliminary example for use at 1.5 T is also presented using phantom and human brain MRSI studies. This technique is shown to offer improved performance relative to single-echo MRSI for imaging of metabolites with shortened T2* values due to the presence of local field inhomogeneities. Additional advantages are the intrinsic measurement of metabolite T2 values and determination of metabolite integrals without T2 weighting, thereby facilitating quantitative metabolite imaging.

3D multivoxel proton spectroscopy of human brain using a hybrid of 8th-order Hadamard encoding with 2D chemical shift imaging

Multivoxel 3D localized proton spectroscopy using a hybrid of 1D 8th-order transverse Hadamard spectroscopic imaging (HSI) with 2D chemical shift imaging (CSI) is demonstrated in human brain. The spatially selective HSI pulse incorporates naturally into the PRESS sequence (TE = 135 ms), which then both excites an 8 x 8 x 6 cm parallelepiped volume of interest (VOI) and subdivides it into eight slices. The planes of these slices are further partitioned into 16 x 16 voxel arrays using 2D CSI to yield 8 x 8 x 8 voxels within the VOI. Simultaneous 3D coverage yields good voxel signal-to-noise (8, 12, and 22 for choline, creatine, and N-acetylaspartate, respectively) from these 0.75-ml voxels, in approximately 45 min. The high spatial isolation allows localization to within less than 1 cm from the skull without fat contamination.

Biological and clinical MRS at ultra-high field

The advantages of performing spectroscopic studies at higher field strengths include increased SNR, improved spectral resolution for J-coupled resonances, and improvements in the selectivity of spectral editing schemes. By using pulse sequences that minimize the required echo time, refocus J-evolution, employ low peak B1 requiring pulses and take advantage of spectroscopic imaging methods, these advantages can also be utilized in clinical applications of spectroscopy at high field. In addition to the static measurements measurements of N-acetyl aspartate (NAA), creatine (CR) and choline (CH) which can be performed at 1.5 T, high resolution measurements of glutamate, glutamine, GABA and the incorporation of 13C labeled glucose into glutamate are possible with improved spatial and spectral resolution. These methods have been utilized in patients with seizure disorders and multiple sclerosis to identify, characterize and map the metabolic changes associated with these diseases and their treatment.

Temperature monitoring of ultrasonically heated muscle with RARE chemical shift imaging

The ability to monitor tissue temperature in ultrasonically heated rabbit muscle is demonstrated using a chemical shift imaging approach based on the rapid acquisition with relaxation enhancement (RARE) fast imaging method [Hennig et al., Magn. Reson. Med. 3, 823-833 (1986)] applied in a line scan format. A three echo sequence with a 16 Hz spectral resolution with 64 ms echo readouts and 78 ms echo spacings is shown capable of measuring relevantly small water frequency shifts in phantoms. Applied to the in vivo model of ultrasonically heated rabbit muscle, water resonance frequencies at the ultrasonic focal point were found to be linearly related to temperature with a slope of -0.007 +/- 0.001 ppm/degree C (N = 6 studies). Measurements of the frequency shift in unheated tissue located away from the ultrasonically heated tissue varied by approximately 0.011 ppm over the course of the experiments, leading to an estimated temperature accuracy of +/- 1.6 degrees C in vivo.

High spatial resolution and speed in MRSI

The in vivo applications of magnetic resonance spectroscopic imaging (MRSI) have expanded significantly over the past 10 years and have reached the point where clinical trials are underway for a number of different diseases. One of the limiting factors in the widespread use of this technology has been the lack of widely available tools for obtaining data which are localized to sufficiently small tissue volumes to make an impact upon diagnosis and treatment planning. This is especially difficult within the timeframe of a clinical MR examination, which requires that both anatomic and metabolic data are acquired and processed. Recent advances in the hardware and software associated with clinical scanners have provided the potential for improvements in the spatial and time resolution of imaging and spectral data. The two areas which hold the most promise in terms of MRSI data are the use of phased array coils and the implementation of echo planar k-space sampling techniques. These could have immediate impact for 1H MRSI and may prove valuable for future applications of 31P MRSI.

Theoretical evaluation and comparison of fast chemical shift imaging methods

Magnetic resonance chemical shift imaging (CSI) is becoming the method of choice for localized NMR spectroscopic examinations, allowing simultaneous detection of NMR spectra from a large number of voxels. The main limitation of these methods is their long experimental duration. A number of fast CSI experiments have been presented, promising to reduce that duration. In this contribution the criteria for evaluating and optimizing the sensitivity of fast CSI experiments are elaborated. For a typical experiment in the human brain, the performance of various methods is compared. While conventional CSI provides optimal sensitivity per unit time, it is shown in which circumstances fast sequences allow a shorter experimental duration. Using these results, the best method for any experimental requirements can be selected.

In vivo bone marrow lipid characterization with line scan Carr-Purcell-Meiboom-Gill proton spectroscopic imaging

Line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging sequences have been used to extract lipid chemical composition indices in healthy adult bone marrow in the knee at 1.5 T. Since several spectroscopic echo readouts follow each excitation, the information acquired reflects a balance between spectral T2 decay processes and spectral resolution. To examine this balance in detail, data sets with two different echo spacings and spectral resolutions have been acquired to compare the information available from each in studies of bone marrow. Oils for which high field (7 T) proton spectra were recorded were used to evaluate the accuracy of lipid chemical composition indices extracted from the line scan Carr-Purcell-Meiboom-Gill spectroscopic imaging methods at 1.5 T. The extension of the method to fast spectroscopic imaging of bone marrow with multiple echoes is demonstrated.

Multiecho approaches to spectroscopic imaging of the brain

Spectroscopic imaging (SI) with nuclear magnetic resonance (NMR) is one of the most powerful tools available for studying brain chemistry in vivo. Both proton (1H) and phosphorus (31P) NMR offer valuable biochemical information that can in principle be mapped throughout the entire brain, thereby enhancing our understanding of brain function. With the exception of protons from tissue water and the triglycerides of adipose tissue, however, nuclei contributing to the NMR signals of living tissue are in relatively small (millimolar) concentrations. The low concentration of metabolite nuclei reduces the overall sensitivity of conventional SI techniques, making high-quality metabolite mapping a lengthy procedure. This problem has led to the development and testing of nonconventional methods for reducing SI scan times, including techniques based on the collection of multiple spin-echoes. The extent to which multiecho methods can be used to decrease SI scan times and maintain high-quality metabolite mapping depends on several factors. These include the spectral transverse relaxation times, the spectral resolution required, and J-coupling interactions. We have discussed these various technical aspects of multiecho SI methods as applied to 1H and 31P spectroscopic imaging of the living brain.

3D localized in vivo 1H spectroscopy of human brain by using a hybrid of 1D-Hadamard with 2D-chemical shift imaging

We report acquisition of 3D image-guided localized proton spectroscopy (1H-MRS) in the human brain on a standard clinical imager. 3D coverage is achieved with a hybrid of chemical shift imaging (CSI) and transverse Hadamard spectroscopic imaging (HSI). 16 x 16 x 4 arrays of 3.5 and 1 ml voxels were obtained in 27 min. The spatially selective HSI 90 degrees pulses incorporate naturally into a PRESS double spin-echo sequence to subdivide the VOI into four partitions along its short axis. 2D CSI (16 x 16) is performed along the other long axes. Because the hybrid excites the spins in the entire VOI, a square-root-N signal-to-noise-ratio (SNR) gain per given examination time is realized compared with sequentially interleaving N 2D slices. A two-fold gain in sensitivity is demonstrated in the brain for N = 4.

Multi-echo 31P spectroscopic imaging of ATP: a scan time reduction strategy

Spectroscopic imaging of 31P metabolites and adenosine triphosphate (ATP) in particular with multiple spin echoes may prove useful for reducing data acquisition times. The usual T2 decay processes that degrade multi-echo spectroscopic imaging methods, however, are further compounded by J-coupling modulations in the case of ATP. We determine how these modulations affect multi-echo spectroscopic imaging k-space data and produce systematic spatial misregistrations of the ATP resonances. The specific J-coupling modulations of ATP are determined to identify echo-spacing effects in multi-echo spectroscopic imaging of ATP and to determine appropriate post-processing correction schemes to address the spatial misregistration problem. An in vivo demonstration of the technique that offers a threefold reduction in scan time compared to conventional SI methods is provided and compared with the conventional SI approach.

2D locally focused MRI: applications to dynamic and spectroscopic imaging

Conventional magnetic resonance images have uniform spatial resolution across the entire field of view. A method of creating MR images with user-specified spatial resolution along one dimension of the field of view was described recently by the authors. This paper presents the 2D generalization of this technique, which allows the user to specify arbitrary spatial resolution in arbitrary 2D regions. These images are reconstructed from signals that sparsely sample the k-space representation of the image. Therefore, locally focused images can be acquired in less time than that required by Fourier imaging with uniformaly high resolution. In this paper the authors show how to increase the temporal resolution of dynamic imaging (e.g., interventional imaging) by using high resolution in areas of expected change and lower resolution elsewhere. Alternatively, by matching the local spatial resolution to the expected edge content of the image, it is possible to avoid the localized truncation artifacts that mark Fourier images reconstructed from the same number of signals. For example, the authors show how proton spectroscopic images of the head may be improved by using high resolution in the neighborhood of scalp lipids that might otherwise cause truncation artifacts.

Dynamic shim updating: a new approach towards optimized whole brain shimming

The static magnetic field within two widely spaced axial slices of the human brain was mapped in five subjects following global shimming. This revealed a first order field shift in the anterior-posterior direction between the cerebellum and cerebrum, which has implications for functional and spectroscopic magnetic resonance imaging. A new method is described called dynamic shim updating (DSU) to compensate for these field differences whereby the shim correction fields are updated in real time during multislice data acquisition to match the current imaging or spectroscopy slice. A hardware unit is presented to demonstrate the method using the first order shim corrections, which can be updated virtually instantaneously between slice acquisitions to give optimal shimming of each slice. The efficiency of the approach is demonstrated using field mapping and high speed MR imaging (echo-planar imaging), which are sensitive to field inhomogeneity.

Expansion of the spectral bandwidth by spatial and chemical shift selective saturation in high-speed magnetic resonance spectroscopic imaging

A new spectral bandwidth expansion technique for high-speed magnetic resonance spectroscopic imaging (MRSI) based on an echo-planar technique is presented. This expansion can be achieved by spatial and chemical shift selective saturation without increasing the total measurement time. In addition, displacement along the slice-select direction due to chemical-shift differences between the measured compounds is also suppressed. Experimental results are shown using a phantom consisting of benzene and acetone. High spatial resolution (1 x 1 mm2) and wide spectral bandwidth (1.5-1.8 kHz; the effective spectral bandwidth has been doubled) are obtained without the displacement along the slice-select direction.

Fast proton spectroscopic imaging employing k-space weighting achieved by variable repetition times

A k-space weighted spectroscopic imaging (SI) method is presented that allows a reduction in the total data acquisition time by up to 55% compared with standard SI. The k-space weighting is achieved by varying the repetition time, thus realizing an inherent apodization that corresponds to a circularly symmetric generalized Hamming filter. The flip angle is varied with the repetition time to enhance the signal-to-noise ratio. These techniques were employed using a short echo time of 10 ms. In vivo measurements on healthy rat brain at 4.7 T were conducted, obtaining two-dimensional spectroscopic imaging data from a 25 x 25 circularly reduced k-space area in as little as 5 min. The signal-to-noise ratio is sufficiently high to detect J-coupled resonances such as myo-inositol or glutamate/glutamine, demonstrating the ability to combine short acquisition times with comprehensive metabolic information. The T1 dependency of the apodization and the corresponding point spread function was evaluated by computer simulations. The achievable signal-to-noise ratio per unit time was compared with standard SI giving a parameter-dependent advantage of approximately 20% of the standard SI method.

Line scan imaging of brain metabolites with CPMG sequences at 1.5 tesla

A line scan Carr-Purcell-Meiboom-Gill (CPMG) spectroscopic imaging sequence has been implemented on a standard 1.5 T clinical scanner to map metabolite signals at multiple echo times from voxels along selected tissue columns through the brain. The CPMG multiecho spectroscopic image data sets are used to estimate brain metabolite T2 decay parameters in a group of healthy volunteers and in one tumor patient. Inherent trade-offs between T2 decay, spectral resolution, and echo spacing prove to be important limiting factors. In particular, separate quantitation of choline and creatine resonances at 1.5 T was not achieved in the present implementation. However, the ability to collect data sets suitable for T2 decay analyses of combined choline and creatine resonances and N-acetyl aspartate resonances in under 10 minutes may prove of clinical utility in the study of brain pathology.

Echo-time-encoded burst imaging (EBI): a novel technique for spectroscopic imaging

A new technique for rapid spectroscopic imaging is presented. The proposed experiment enables a complete mapping of the two-dimensional reciprocal space kx, k sigma, and thus the acquisition of a 1D spectroscopic image in a single scan. The properties of the pulse sequence, based on the use of a burst of low flip angle pulses, are analyzed in the framework of linear response theory, and it is shown that chemical shift information may be introduced into the spatially encoded echoes. First experimental results are presented demonstrating that 32 x 32 proton spectroscopic images may be acquired within less than 1 min with a conventional imaging system.