Time-domain combination of MR spectroscopy data acquired using phased-array coils

Investigation of cortical glutamate-glutamine and γ-aminobutyric acid in obsessive-compulsive disorder by proton magnetic resonance spectroscopy

Glutamatergic abnormalities in corticostriatal brain circuits are thought to underlie obsessive-compulsive disorder (OCD). Whether these abnormalities exist in adults with OCD is not clear. We used proton magnetic resonance spectroscopy (¹H MRS) to test our hypothesis that unmedicated adults with OCD have reduced glutamate plus glutamine (Glx) levels in the medial prefrontal cortex (MPFC) compared with healthy controls. Levels of γ-aminobutyric acid (GABA) were also explored. Twenty-four unmedicated adults with OCD and 22 matched healthy control subjects underwent ¹H MRS scans at 3.0 T. Resonances of both Glx and GABA were obtained using the standard J-editing technique and assessed as ratios relative to voxel tissue water (W) in the MPFC (the region of interest) and the dorsolateral prefrontal cortex (DLPFC) to explore the regional specificity of any finding. In the MPFC, Glx/W did not differ by diagnostic group (p=0.98) or sex (p=0.57). However, GABA/W was decreased in OCD (2.16±0.46 × 10⁻³) compared with healthy controls (2.43±0.45 × 10⁻³, p=0.045); moreover, age of OCD onset was inversely correlated with MPFC GABA/W (r=-0.50, p=0.015). MPFC GABA/W was higher in females than in males. In the DLPFC, there were no main effects of diagnosis or gender on Glx/W or GABA/W. These data indicate that unmedicated adults with OCD do not have Glx abnormalities in a MPFC voxel that includes the pregenual anterior cingulate cortex. However, they may have decreased MPFC GABA levels. How GABA abnormalities might contribute to corticostriatal dysfunction in OCD deserves further study.

Quantitative mapping of total choline in healthy human breast using proton echo planar spectroscopic imaging (PEPSI) at 3 Tesla

PURPOSE

To quantitatively measure tCho levels in healthy breasts using Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI).

MATERIALS AND METHODS

The two-dimensional mapping of tCho at 3 Tesla across an entire breast slice using PEPSI and a hybrid spectral quantification method based on LCModel fitting and integration of tCho using the fitted spectrum were developed. This method was validated in 19 healthy females and compared with single voxel spectroscopy (SVS) and with PRESS prelocalized conventional Magnetic Resonance Spectroscopic Imaging (MRSI) using identical voxel size (8 cc) and similar scan times (∼7 min).

RESULTS

A tCho peak with a signal to noise ratio larger than 2 was detected in 10 subjects using both PEPSI and SVS. The average tCho concentration in these subjects was 0.45 ± 0.2 mmol/kg using PEPSI and 0.48 ± 0.3 mmol/kg using SVS. Comparable results were obtained in two subjects using conventional MRSI. High lipid content in the spectra of nine tCho negative subjects was associated with spectral line broadening of more than 26 Hz, which made tCho detection impossible. Conventional MRSI with PRESS prelocalization in glandular tissue in two of these subjects yielded tCho concentrations comparable to PEPSI.

CONCLUSION

The detection sensitivity of PEPSI is comparable to SVS and conventional PRESS-MRSI. PEPSI can be potentially used in the evaluation of tCho in breast cancer. A tCho threshold concentration value of ∼0.7 mmol/kg might be used to differentiate between cancerous and healthy (or benign) breast tissues based on this work and previous studies.

An evaluation of motion compensation strategies and repeatability for abdominal (1)H MR spectroscopy measurements in volunteer studies and clinical trials

Increased expression of choline kinase has frequently been shown in tumours and is thought to be associated with disease progression. Studies using magnetic resonance spectroscopy have shown an increase in total choline-containing metabolites (tCho) in tumour compared with healthy tissue. Subsequent reductions in tCho following successful treatment support the use of tCho as a biomarker of disease and response. However, accurate measurement of tCho using MRS in abdominal tumours is complicated by respiratory motion, blurring the acquisition volume and degrading the lineshape and signal-to-noise ratio (SNR) of metabolites. Motion compensation using prospectively gated acquisitions or offline correction of phase and frequency distortions can help restore the SNR and linewidth of metabolites. Prospectively gated acquisitions have the advantage of confining the volume of acquisition to the prescribed volume but are constrained by the repetition time (TR) of the respiratory motion. In contrast, data acquired for offline correction may use a shorter repetition time and therefore yield an increased SNR per unit time. In this study abdominal spectra acquired from single-voxel 'free-breathing' measurements in liver of healthy volunteers and in abdominal tumours of cancer patients were compared with those of prospective gating and with an implementation of offline correction. The two motion compensation methodologies were assessed in terms of SNR, linewidth and repeatability. Our experiments show that prospective gating and offline correction result in a 12-22% reduction in median tCho linewidth, while offline correction also provides a significant increase in SNR. The repeatability coefficient (the expected interval for 95% of repeat measurements) for tCho/water ratio was reduced by 37% (prospective gating) and 41% (offline correction). Both methods of motion compensation substantially improved the reproducibility of the tCho/water measurement and the tCho linewidth. While offline correction also leads to a significant improvement in SNR, it may suffer more from out-of-voxel contamination.

Metabolite Mapping with Extended Brain Coverage Using a Fast Multisection MRSI Pulse Sequence and a Multichannel Coil

Multisection magnetic resonance spectroscopic imaging is a widely used pulse sequence that has distinct advantages over other spectroscopic imaging sequences, such as dynamic shimming, large region-of-interest coverage within slices, and rapid data acquisition. It has limitations, however, in the number of slices that can be acquired in realistic scan times and information loss from spacing between slices. In this paper, we synergize the multi-section spectroscopic imaging pulse sequence with multichannel coil technology to overcome these limitations. These combined techniques now permit elimination of the gaps between slices and acquisition of a larger number of slices to realize the whole brain metabolite mapping without incurring the penalties of longer repetition times (and therefore longer acquisition times) or lower signal-to-noise ratios.

Implementation of multi-echo-based correlated spectroscopic imaging and pilot findings in human brain and calf muscle

PURPOSE

To implement a spatially encoded correlated spectroscopic imaging (COSI) sequence on 3 Tesla (T) MRI/MR spectroscopy scanners incorporating four echoes to collect four phase-encoded acquisitions per repetition time (TR), and to evaluate the performance and reliability of this four-dimensional (4D) multi-echo COSI (ME-COSI) sequence in brain and calf muscle.

MATERIALS AND METHODS

Typical scan parameters for the 4D datasets were as follows: repetition time = 1500 ms, 2000 Hz bandwidth, 8 × 8 spatial encoding, one average, 64 Δt(1) increments and the scan duration was 25 min. The performance and test-retest reliability of ME-COSI were evaluated with phantoms and in the occipitoparietal brain tissues and calf of six healthy volunteers (mean age = 32 years old).

RESULTS

Regional differences in concentrations of lipids, creatine (Cr), choline (Ch), and carnosine (Car) were observed between spectra from voxels located in tibial marrow, tibialis anterior, and soleus muscle. Diagonal and cross-peak resonances were identified from several brain metabolites including N-acetyl aspartate (NAA), Ch, Cr, lactate (Lac), aspartate (Asp), glutathione (GSH), and glutamine\glutamate (Glx). Coefficients of variation (CV) in metabolite ratios across repeated measurements were <15% for diagonal and <25% for cross-peaks observed in vivo.

CONCLUSION

The ME-COSI sequence reliably acquired spatially resolved 2D Correlated Spectroscopy (COSY) spectra demonstrating the feasibility of differentiating spatial variation of metabolites in different tissues. Multi-echo acquisition shortens scan duration to clinically feasible times.

Anterior cingulate cortex γ-aminobutyric acid in depressed adolescents: relationship to anhedonia

CONTEXT

Anhedonia, a core symptom of major depressive disorder (MDD) and highly variable among adolescents with MDD, may involve alterations in the major inhibitory amino acid neurotransmitter system of γ-aminobutyric acid (GABA).

OBJECTIVE

To test whether anterior cingulate cortex (ACC) GABA levels, measured by proton magnetic resonance spectroscopy, are decreased in adolescents with MDD. The associations of GABA alterations with the presence and severity of anhedonia were explored.

DESIGN

Case-control, cross-sectional study using single-voxel proton magnetic resonance spectroscopy at 3 T.

SETTING

Two clinical research divisions at 2 teaching hospitals.

PARTICIPANTS

Twenty psychotropic medication-free adolescents with MDD (10 anhedonic, 12 female, aged 12-19 years) with episode duration of 8 weeks or more and 21 control subjects group matched for sex and age.

MAIN OUTCOME MEASURES

Anterior cingulate cortex GABA levels expressed as ratios relative to unsuppressed voxel tissue water (w) and anhedonia scores expressed as a continuous variable.

RESULTS

Compared with control subjects, adolescents with MDD had significantly decreased ACC GABA/w (t = 3.2; P < .003). When subjects with MDD were categorized based on the presence of anhedonia, only anhedonic patients had decreased GABA/w levels compared with control subjects (t = 4.08; P < .001; P(Tukey) < .001). Anterior cingulate cortex GABA/w levels were negatively correlated with anhedonia scores for the whole MDD group (r = -0.50; P = .02), as well as for the entire participant sample including the control subjects (r = -0.54; P < .001). Anterior cingulate cortex white matter was also significantly decreased in adolescents with MDD compared with controls (P = .04).

CONCLUSIONS

These findings suggest that GABA, the major inhibitory neurotransmitter in the brain, may be implicated in adolescent MDD and, more specifically, in those with anhedonia. In addition, use of a continuous rather than categorical scale of anhedonia, as in the present study, may permit greater specificity in evaluating this important clinical feature.

Signal-to-noise ratio enhancement of intermolecular double-quantum coherence MR spectroscopy in inhomogeneous fields with phased array coils on a 3 Tesla whole-body scanner

PURPOSE

To improve signal-to-noise ratio (SNR) of intermolecular double-quantum coherence (iDQC) MRS on a 3 Tesla (T) whole-body scanner.

MATERIALS AND METHODS

A 32-channel phased array coil was used to acquire iDQC signal of a MRS phantom in the presence of large field inhomogeneity. The obtained individual spectra from the array elements were combined together in the time domain using a multichannel nonparametric singular value decomposition algorithm. The results were compared quantitatively with those acquired with a circularly polarized (CP) head coil.

RESULTS

The achieved gain in SNR ranges from 1.63 to 2.10 relative to the CP coil, mainly depending on the relative position between the surface of the phased array coil and the voxel of acquisition.

CONCLUSION

SNR enhancement of iDQC MRS in inhomogeneous fields on a 3T whole-body scanner is feasible with phased array coils. This can facilitate iDQC applications of high-resolution in vivo spectroscopy in the presence of field inhomogeneity for potential disease diagnosis in humans.

Reconstructing very short TE phase rotation spectral data collected with multichannel phased-array coils at 3 T

Phased-array volume coils were used in conjunction with the phase rotation STEAM (PR-STEAM) spectroscopy technique to acquire very short TE data from the anterior cingulate gyrus at 3 T. A method for combining PR-STEAM data from multiple subcoils is presented. The data were acquired from seven healthy participants using PR-STEAM (repetition time/mixing time/echo time=3500/10/6.5 ms, 6 cm(3), NEX=128, spectral width=2000 Hz, 2048 complex points, Δφ(1)=135°, Δφ(2)=22.5°, Δφ(3)=112.5° and Δφ(ADC)=0°). In addition to the primary metabolites, LCModel fit results suggest that glutathione and glutamate can also be identified with Cramér-Rao lower bounds of 10% or less.

Use of in vivo two-dimensional MR spectroscopy to compare the biochemistry of the human brain to that of glioblastoma

PURPOSE

To develop an in vivo two-dimensional localized correlation spectroscopy technique with which to monitor the biochemistry of the human brain and the pathologic characteristics of diseases in a clinically applicable time, including ascertainment of appropriate postprocessing parameters with which to allow diagnostic and prognostic molecules to be measured, and to investigate how much of the chemical information, known to be available from malignant cultured cells, could be recorded in vivo from human brain.

MATERIALS AND METHODS

The study was approved by the institutional review board and was compliant with HIPAA. With use of a 3.0-T clinical magnetic resonance (MR) unit and a 32-channel head coil, localized correlation spectroscopy was performed in six healthy control subjects and six patients with glioblastoma multiforme (GBM) with an acquisition time of 11 minutes. Two-dimensional spectra were processed and analyzed and peak volume ratios were tabulated. The data used were proved to be normally distributed by passing the Shapiro-Wilk normality test. The first row of the spectra was extracted to examine diagnostic features. The pathologic characteristics and grade of each GBM were determined after biopsy or surgery. Statistically significant differences were assessed by using a t test.

RESULTS

The localized correlation spectroscopy method assigned biochemical species from the healthy human brain. The correlation spectra of GBM were of sufficiently high quality that many of the cross peaks, recorded previously from malignant cell models in vitro, were observed, demonstrating a statistically significant difference (P < .05) between the cross peak volumes measured for healthy subjects and those with GBM (which include lipid, alanine, N-acetylaspartate, γ-aminobutyric acid, glutamine and glutamate, glutathione, aspartate, lysine, threonine, total choline, glycerophosphorylcholine, myo-inositol, imidazole, uridine diphosphate glucose, isocitrate, lactate, and fucose). The first row of the spectra was found to contain diagnostic features.

CONCLUSION

Localized correlation spectroscopy of the human brain at 3.0 T with use of a 32-channel head coil was performed in 11 minutes and provided information about neurotransmitters, metabolites, lipids, and macromolecules. The method was able to help differentiate healthy brain from the biochemical signature of GBM in vivo. This method may, in the future, reduce the need for biopsy and is now applicable for the study of selected neurologic diseases.

Receive array magnetic resonance spectroscopy: Whitened singular value decomposition (WSVD) gives optimal Bayesian solution

Receive array coils play a pivotal role in modern MRI. MR spectroscopy can also benefit from the enhanced signal-to-noise ratio and field of view provided by a receive array. In any experiment using an n-element array, n different complex spectra will be recorded and each spectrum unavoidably contains an undesired noise contribution. Previous algorithms for combining spectra have ignored the fact that the noise detected by different array elements is correlated. We introduce here an algorithm for efficiently, robustly, and automatically combining these n spectra using noise whitening and the singular value decomposition to provide the single combined spectrum that has maximum likelihood in the presence of this correlated noise. Simulations are performed that demonstrate the superiority of this approach to previous methods. Experiments in phantoms and in vivo on the brain, heart, and liver of normal volunteers, at 1.5 T and 3 T, using array coils from eight to 32 elements and with (1)H and (31)P nuclei, validate our approach, which provides signal-to-noise ratio improvements of up to 60% in our tests. The whitening and the singular value decomposition algorithm become most advantageous for large arrays, when the noise is markedly correlated, and when the signal-to-noise ratio is low.

Metabolic Abnormalities in Abstinent Methamphetamine Dependent Subjects

INTRODUCTION: Chronic methamphetamine use results in persistent neuropsychological deficits in abstinent methamphetamine dependent (AMD) subjects. We examined the hypothesis that elevated concentration of cerebral glutamate (Glu), an excitatory neurotransmitter and neurotoxin, occurs in human AMD. MATERIALS AND METHODS: We examined 40 subjects, 18 of whom were AMD, abstinent more than 3 weeks and 22 were age matched controls. A Structured Clinical Interview was applied to exclude AMD with comorbid depression. We used TE-Averaged technique of MRS to uniquely identify and quantify the glutamate resonance at 2.35 ppm on a 3T clinical MR scanner. Statistics, including Bonferroni correction for multiple MRS variables were applied. RESULTS: Glu was significantly higher in frontal white matter of AMD (+19%, P = 0.01) and N-acetylaspartate (NAA), an axonal marker, was lower (-14%, P = 0.004). No significant MRS abnormalities were detected in posterior gray matter. Significant correlations were observed between NAA and Glu (P = 0.002 for AMD and P = 0.06 for controls in the posterior gray matter and P = 0.01 for controls and not significant for AMD in the frontal white matter). CONCLUSION: Our results demonstrate a significant excess of glutamate in frontal white matter of AMD subjects and offer support for the hypothesis that methamphetamine abuse may exert its long-term neuro-toxicity via glutamate.

Quantitative SENSE-MRSI of the human brain

PURPOSE

To develop a method for estimating metabolite concentrations using phased-array coils and sensitivity-encoded (SENSE) magnetic resonance spectroscopic images (MRSI) of the human brain.

MATERIALS AND METHODS

The method is based on the phantom replacement technique and uses receive coil sensitivity maps and body-coil loading factors to account for receive B(1) inhomogeneity and variable coil loading, respectively. Corrections for cerebrospinal fluid content from the MRSI voxel were also applied, and the total protocol scan time was less than 15 min. The method was applied to 10 normal human volunteers using a multislice 2D-MRSI sequence at 3 T, and seven different brain regions were quantified.

RESULTS

N-Acetyl aspartate (NAA) concentrations varied from 9.7 to 14.7 mM, creatine (Cr) varied from 6.6 to 10.6 mM and choline (Cho) varied from 1.6 to 3.0 mM, in good general agreement with prior literature values.

CONCLUSIONS

Quantitative SENSE-MRSI of the human brain is routinely possible using an adapted phantom-replacement technique. The method may also be applied to other MRSI techniques, including conventional phase encoding, with phased-array receiver coils, provided that coil sensitivity profiles can be measured.

Noise correlations and SNR in phased-array MRS

The acquisition of magnetic resonance spectroscopy (MRS) signals by multiple receiver coils can improve the signal-to-noise ratio (SNR) or alternatively can reduce the scan time maintaining a reliable SNR. However, using phased array coils in MRS studies requires efficient data processing and data combination techniques in order to exploit the sensitivity improvement of the phased array coil acquisition method. This paper describes a novel method for the combination of MRS signals acquired by phased array coils, even in presence of correlated noise between the acquisition channels. In fact, although it has been shown that electric and magnetic coupling mechanisms produce correlated noise in the coils, previous algorithms developed for MRS data combination have ignored this effect. The proposed approach takes advantage of a noise decorrelation stage to maximize the SNR of the combined spectra. In particular Principal Component Analysis (PCA) was exploited to project the acquired spectra in a subspace where the noise vectors are orthogonal. In this subspace the SNR weighting method will provide the optimal overall SNR. Performance evaluation of the proposed method is carried out on simulated (1)H-MRS signals and experimental results are obtained on phantom (1)H-MR spectra using a commercially available 8-element phased array coil. Noise correlations between elements were generally low due to the optimal coil design, leading to a fair SNR gain (about 0.5%) in the center of the field of view (FOV). A greater SNR improvement was found in the peripheral FOV regions.

Multi-voxel magnetic resonance spectroscopy of cerebral metabolites in healthy adults at 3 Tesla

RATIONALE AND OBJECTIVES

The objective of this study was to determine how metabolite values (total N-acetyl aspartate [tNAA], glutamate plus glutamine [Glx], total choline [tCho], myoinositol [mI], and total creatine [tCr]) vary across brain regions in healthy subjects. This study was implemented to create an internal reference database for patients with psychiatric disorders and epilepsy.

MATERIALS AND METHODS

Using the multivoxel technique with a voxelwise phantom calibration on a 3-T magnetic resonance imaging scanner, metabolite levels of 29 healthy controls (13 men, 16 women; average age, 29 years) were obtained from the hippocampi, basal ganglia, insula cortex, cingulum, and precuneus. Additionally, gray and white matter metabolite values were obtained from the frontal and parietal lobes.

RESULTS

No significant effect of gender was noticed. The total magnitude of variation was greatest for Glx, followed by tNAA, mI, tCho, and tCr. Glx/tCr, Glx, and tCr were increased in gray matter, while tNAA/tCr, tCho/tCr, respectively tNAA and tCho, were elevated in white matter. These findings indicate (1) anterior-to-posterior increases of tNAA/tCr and Glx/tCr, respectively tNAA and Glx, along the midline in gray matter (cingulum); (2) increased tNAA/tCr, respectively tNAA, in white matter in the fiber tracts of the precentral region; (3) an accentuated anterior-to-posterior increase of tCr in the insula cortex; and (4) an anterior-to-posterior decrease of tCho/tCr and tCho in white matter.

CONCLUSIONS

There are significant metabolic differences within tissue types and within tissue types at different locations; therefore, the spectra and metabolite values presented should provide a useful internal reference for both clinical and research studies.

Time-resolved functional 1H MR spectroscopic detection of glutamate concentration changes in the brain during acute heat pain stimulation

Non-invasive in vivo detection of cortical neurotransmitter concentrations and their changes in the presence of pain may help to better understand the biochemical principles of pain processing in the brain. In the present study acute heat pain related changes of the excitatory neurotransmitter glutamate were investigated in the anterior insular cortex of healthy volunteers by means of time-resolved functional proton magnetic resonance spectroscopy ((1)H-MRS). Dynamic metabolite changes were estimated with a temporal resolution of five seconds by triggering data acquisition to the time course of the cyclic stimulus application. An overall increase of glutamate concentration up to 18% relative to the reference non-stimulus condition was observed during the application of short pain stimuli.

Amino acid neurotransmitters assessed by proton magnetic resonance spectroscopy: relationship to treatment resistance in major depressive disorder

BACKGROUND

Significant alterations in gamma-aminobutyric acid (GABA) and glutamate levels have been previously reported in major depressive disorder (MDD); however, no studies to date have investigated associations between these amino acid neurotransmitters and treatment resistance.

METHODS

The objective of this study was to compare occipital cortex (OCC) and anterior cingulate cortex (ACC) GABA and glutamate+glutamine (Glx) levels measured by proton magnetic resonance spectroscopy ((1)H MRS) in 15 medication-free treatment-resistant depression (TRD) patients with those in 18 nontreatment-resistant MDD (nTRD) patients and 24 healthy volunteers (HVs).

RESULTS

Levels of OCC GABA relative to voxel tissue water (W) were decreased in TRD patients compared with both HV (20.2% mean reduction; p = .001; Cohen's d = 1.3) and nTRD subjects (16.4% mean reduction; p = .007; Cohen's d = 1.4). There was a similar main effect of diagnosis for ACC GABA/W levels (p = .047; Cohen's d = .76) with TRD patients exhibiting reduced GABA in comparison with the other two groups (22.4% to 24.5% mean reductions). Group differences in Glx/W were not significant in either brain region. Only GABA results in OCC survived correction for multiple comparisons.

CONCLUSIONS

Our findings corroborate previous reports of decreased GABA in MDD and provide initial evidence for a distinct neuronal amino acid profile in patients who have failed to respond to several standard antidepressants, possibly indicative of abnormal glutamate/glutamine/GABA cycling. Given interest in novel antidepressant mechanisms in TRD that selectively target amino acid neurotransmitter function, the translational relevance of these findings awaits further study.

Evidence of reduced glutamate in the frontal lobe of HIV-seropositive patients

Neurological complications associated with the acquired immunodeficiency syndrome, in particular, HIV-associated dementia, continue to plague those infected. We report our finding that the concentration of brain Glu is reduced in the frontal white matter region in this condition. In addition, our data appear to absolve highly active retroviral therapy (HAART) from blame, as drug-naïve patients were equally affected. Our findings suggest that Glu neurotransmission is abnormal and may be a key target for early interventions to reduce the later incidence of neurocognitive impairment and dementia among HIV-seropositive patients.

Fast three-dimensional 1H MR spectroscopic imaging at 7 Tesla using "spectroscopic missing pulse--SSFP"

The use of spectroscopic Missing Pulse--SSFP (spMP-SSFP) for fast three-dimensional (3D) proton MR spectroscopic imaging (MRSI) at 7 Tesla (T) is demonstrated. Sequence modifications were required regarding the limits of the specific absorption rate as well as hardware limitations with respect to maximum B(1) field strength and B(0) gradient slew rate, as compared to previous studies performed at 3T. The combination of two spatially selective radiofrequency (RF) pulses (with orthogonal slice orientation) and a dual-band chemical shift selective RF pulse for simultaneous water and lipid suppression proved to enable fast 3D MRSI measurements of the brain of healthy volunteers. Using a total measurement time of approximately 8.5 minutes and a nominal and real voxel size of 0.62 cm(3) and 2.6 cm(3), respectively, signals of N-acetyl aspartate, total creatine, choline containing compounds, myo-inositol, and glutamate+glutamine could be detected.

Proton MRS of the breast in the clinical setting

Information for determining whether a primary breast lesion is invasive and its receptor status and grade can be obtained before surgery by performing proton MRS on a fine-needle aspiration biopsy (FNAB) specimen and analyzing the MRS information by a pattern recognition method. Two-dimensional MRS, on either specimens or cells, allows the unambiguous assignment of most resonances. When correlated with the spectral regions selected by the pattern recognition method, there are strong indications for the biochemical markers responsible for prognostic information of invasive capacity and metastatic spread. Spectral assignments and biological correlations can be made using cell models. In vivo MRS can distinguish invasive from benign lesions. This pathological distinction can be made from the presence of resonances at discrete frequencies. To achieve this level of spectral resolution and signal-to-noise ratio, there are stringent requirements when acquiring and processing the data. The challenge now is to implement two-dimensional MRS in vivo. Until this is realized, the combination of in vivo MR, for diagnosis and spatial location, and MRS, for image-guided biopsy to provide information on tumor spread, promises to provide a higher level of preoperative diagnosis than previously achieved.

Optimal phased-array combination for spectroscopy

A method for making weighted linear combinations of the spectra acquired by a phased-array coil is described. Unlike most previous combination methods, no special reference points in the data are chosen to represent the coil weights. Instead, all the data points are used, which results in optimal signal-to-noise ratio more reliable estimation. The method uses singular value decomposition to identify the coil weights and extract the principal component of variation in the signal. Subsequent processing of the combined signal (e.g., Fourier transform, baseline correction, phasing) may proceed as per a single coil acquisition.

Short echo time 1H-MRSI of the human brain at 3T with minimal chemical shift displacement errors using adiabatic refocusing pulses

The chemical shift displacement error (CSDE) is an often-underestimated problem in slice selection for localized proton spectroscopy at higher fields. With the proposed semi-localized by adiabatic selective refocusing (LASER) pulse sequence, this problem is dealt with by using RF pulses with bandwidths in the order of 5 kHz. A combination of conventional nonadiabatic slice-selective excitation of proton spins, together with double slice-selective refocusing of the spins by two pairs of adiabatic full-passage (APF) pulses, produces a spin echo in a volume of interest (VOI) at an echo time down to 30 ms. An illustration of the CSDE of conventional point-resolved spectroscopy (PRESS) and the semi-LASER sequence is shown with a measurement of the brain of a volunteer at 3T. With one application of the technique to a patient with a glioblastoma multiforme (GBM), its clinical functionality is demonstrated. With sharp selection profiles and a small CSDE, voxels close to the edge of the VOI can also be used for evaluation. With the additional advantage of being relatively insensitive for B(1) inhomogeneities, the semi-LASER technique can be viewed as a superior substitute for conventional PRESS MR spectroscopic imaging (MRSI) at 3T and beyond.

Three-dimensional Proton MR Spectroscopy of Human Prostate at 3 T without Endorectal Coil: Feasibility

PURPOSE

To evaluate sensitivity and specificity of proton magnetic resonance (MR) spectroscopy of the prostate with external surface coil elements at 3 T for differentiation of cancer from healthy tissue within an acceptable measurement time, by using histopathologic findings as the reference standard.

MATERIALS AND METHODS

The study was approved by the institutional review board; informed consent was obtained. Forty-five men (age range, 51-70 years) underwent 3-T MR imaging with external radiofrequency surface coils for signal reception. MR spectroscopy was performed with acquisition-weighted three-dimensional water- and lipid-suppressed point-resolved spectroscopy pulse sequence. Voxels were classified into healthy peripheral zone, central gland, and periurethral zone and cancer tissue. Cancer voxels were classified according to cancer size and certainty in matching histopathologic findings with MR images. After visual inspection of automated fitting of classified voxels, the choline plus creatine-to-citrate (Cho + Cr/Cit) ratio was calculated for all tissues. Area under the receiver operating characteristic curves (A(z)) values were used to assess accuracy of discrimination of cancer from healthy tissues. P < .05 indicated a significant difference.

RESULTS

After exclusion of four patients with no voxels that passed visual inspection of the automated fit, a median of 82% of the classified voxels per patient was used in the analysis. Mean Cho + Cr/Cit ratios for healthy tissues were 0.22 +/- 0.12 (standard deviation) for peripheral zone, 0.34 +/- 0.14 for central gland, and 0.36 +/- 0.20 for periurethral area; all were significantly different from that of cancer (P < .001). A(z) for discrimination of probable and definite cancer tissue from healthy tissue for the peripheral zone (0.84) was significantly higher than that for the central gland (0.69) (P < .05).

CONCLUSION

Three-dimensional proton MR spectroscopy of the prostate, with a combination of only external radiofrequency surface coils at 3 T, can be used to discriminate cancer from healthy tissue.

Prostate and lymph node proton magnetic resonance (MR) spectroscopic imaging with external array coils at 3 T to detect recurrent prostate cancer after radiation therapy

In a patient suspected of having recurrent prostate cancer after radiation therapy, we demonstrate the feasibility of noninvasive proton magnetic resonance spectroscopic (1H-MRS) imaging of the prostate and a lymph node at 3 T using a matrix of external surface coils. Written informed consent was obtained from the patient. With 1H-MRS imaging, high choline with low citrate signal was observed in the prostate, and in the lymph node a signal of choline-containing compounds was identified. The tissue level of the compounds in the enlarged lymph node was estimated to be 8.1 mmol/kg water. Subsequent histopathological analysis of systematic transrectal ultrasound-guided prostate biopsy and computed tomography-guided biopsy of the lymph node confirmed the presence of prostate cancer in both.

Recent advances in magnetic resonance neurospectroscopy

Over the past two decades, proton magnetic resonance spectroscopy (proton MRS) of the brain has made the transition from research tool to a clinically useful modality. In this review, we first describe the localization methods currently used in MRS studies of the brain and discuss the technical and practical factors that determine the applicability of the methods to particular clinical studies. We also describe each of the resonances detected by localized solvent-suppressed proton MRS of the brain and discuss the metabolic and biochemical information that can be derived from an analysis of their concentrations. We discuss spectral quantitation and summarize the reproducibility of both single-voxel and multivoxel methods at 1.5 and 3-4 T. We have selected three clinical neurologic applications in which there has been a consensus as to the diagnostic value of MRS and summarize the information relevant to clinical applications. Finally, we speculate about some of the potential technical developments, either in progress or in the future, that may lead to improvements in the performance of proton MRS.

The rapid and automatic combination of proton MRSI data using multi-channel coils without water suppression

The use of multi-channel coils can efficiently increase the signal-to-noise ratio (SNR) of magnetic resonance spectroscopy data if the signals from multiple channels are optimally combined. Combining multi-channel signals requires proper alignment of the phases of the signals from each of the elements of the coil and then accurately weighting the summation of those signals. We present a procedure for acquiring proton magnetic resonance spectroscopic imaging (MRSI) data using an eight-channel coil without water suppression and a rapid and robust method that uses unsuppressed water signal as a reference both for aligning the phases and for weighting the summation of signals that originate in the multiple coil elements. We use both computer simulation and in vivo proton MRSI data to demonstrate the advantages of our method for optimizing the SNR of the combined signal compared with the SNRs of signals that were acquired either using a standard volume head coil or using an eight-channel coil with a metabolite signal as the reference for combination.

TE-Averaged two-dimensional proton spectroscopic imaging of glutamate at 3 T

Glutamate and glutamine are important neurochemicals in the central nervous system and the neurotoxic properties of excess glutamate have been associated with several neurodegenerative diseases. The TE-Averaged PRESS technique has been shown by our group to detect an unobstructed glutamate signal at 3 T that is resolved from glutamine and NAA at 2.35 ppm. TE-Averaged PRESS therefore provides an unambiguous measurement of glutamate as well as other metabolites such as NAA, choline, creatine, and myo-inositol. In this study, we extend the single voxel TE-Averaged PRESS technique for two-dimensional (2D) spectroscopic imaging (TE-Averaged MRSI) to generate 2D glutamate maps. To facilitate TE-Averaged MRSI within a reasonable time, a fast encoding trajectory was used. This enabled rapid acquisition of TE-Averaged spectral arrays with good spectral bandwidth (977 Hz) and resolution (approximately 2 Hz). MRSI data arrays of 10 x 16 were acquired with 1.8 cm3 spatial resolution over a approximately 110 cm3 volume in a scan time of approximately 21 min. Two-dimensional metabolite maps were obtained with good SNR and clear differentiation in glutamate levels was observed between gray and white matter with significantly higher glutamate in gray matter relative to white matter as anticipated.

Vertebrae adjacent to spinal bone lesion are inconsistent reference markers: A magnetic resonance spectroscopic viewpoint

PURPOSE

To ascertain the suitability of vertebrae adjacent to spinal bone lesions as a signal intensity reference on MRI, and compare the MR spectroscopic appearance of vertebral body compression fractures due to malignant tumor infiltration, bone weakening (e.g., osteoporosis), and/or minor trauma.

MATERIALS AND METHODS

Twenty-five patients with spinal compression fractures underwent routine spinal MRI with an additional 1H MRS study protocol to assess the percent fat fraction of the compressed vertebrae as well as the adjacent bony environment. Peak areas for water and total lipid were calculated from short-TE single-voxel 1H MR spectra using the LCModel analyzing tool.

RESULTS

There were consistent water-only patterns in the fractured vertebra suggesting either near complete marrow replacement by malignant tissue or local edematous fluid/hemorrhage within the marrow spaces. However, the adjacent vertebrae showed a wide range of patterns from a dominant lipid signal to the inverse of a pronounced water level. These results far exceed the normal variation expected based on age and sex.

CONCLUSION

The results suggest that the adjacent vertebrae may not be an accurate reference, especially in diffusion-weighted imaging (DWI), because of the large difference between the two compartments. Furthermore, in the case of gradient-echo measurements, the in-phase vs. opposed-phase effects are significant.