Restoration of motion-related signal loss and line-shape deterioration of proton MR spectra using the residual water as intrinsic reference

Model-based frequency-and-phase correction of 1H MRS data with 2D linear-combination modeling

PURPOSE

Retrospective frequency-and-phase correction (FPC) methods attempt to remove frequency-and-phase variations between transients to improve the quality of the averaged MR spectrum. However, traditional FPC methods like spectral registration struggle at low SNR. Here, we propose a method that directly integrates FPC into a 2D linear-combination model (2D-LCM) of individual transients ("model-based FPC"). We investigated how model-based FPC performs compared to the traditional approach, i.e., spectral registration followed by 1D-LCM in estimating frequency-and-phase drifts and, consequentially, metabolite level estimates.

METHODS

We created synthetic in-vivo-like 64-transient short-TE sLASER datasets with 100 noise realizations at 5 SNR levels and added randomly sampled frequency and phase variations. We then used this synthetic dataset to compare the performance of 2D-LCM with the traditional approach (spectral registration, averaging, then 1D-LCM). Outcome measures were the frequency/phase/amplitude errors, the SD of those ground-truth errors, and amplitude Cramér Rao lower bounds (CRLBs). We further tested the proposed method on publicly available in-vivo short-TE PRESS data.

RESULTS

2D-LCM estimates (and accounts for) frequency-and-phase variations directly from uncorrected data with equivalent or better fidelity than the conventional approach. Furthermore, 2D-LCM metabolite amplitude estimates were at least as accurate, precise, and certain as the conventionally derived estimates. 2D-LCM estimation of FPC and amplitudes performed substantially better at low-to-very-low SNR.

CONCLUSION

Model-based FPC with 2D linear-combination modeling is feasible and has great potential to improve metabolite level estimation for conventional and dynamic MRS data, especially for low-SNR conditions, for example, long TEs or strong diffusion weighting.

Simultaneous frequency and phase corrections of single-shot MRS data using cross-correlation

PURPOSE

The objective of this study was to propose a novel preprocessing approach to simultaneously correct for the frequency and phase drifts in MRS data using cross-correlation technique.

METHODS

The performance of the proposed method was first investigated at different SNR levels using simulation. Random frequency and phase offsets were added to a previously acquired STEAM human data at 7 T, simulating two different noise levels with and without baseline artifacts. Alongside the proposed spectral cross-correlation (SC) method, three other simultaneous alignment approaches were evaluated. Validation was performed on human brain data at 3 T and mouse brain data at 16.4 T.

RESULTS

The results showed that the SC technique effectively corrects for both small and large frequency and phase drifts, even at low SNR levels. Furthermore, the mean square measurement error of the SC algorithm was comparable to the other three methods used, with much faster processing time. The efficacy of the proposed technique was successfully demonstrated in both human brain MRS data and in a noisy MRS dataset acquired from a small volume-of-interest in the mouse brain.

CONCLUSION

The study demonstrated the availability of a fast and robust technique that accurately corrects for both small and large frequency and phase shifts in MRS.

Single-shot diffusion trace-weighted MR spectroscopy: Comparison with unipolar and bipolar diffusion-weighted point-resolved spectroscopy

This study demonstrates the feasibility and performance of the point-resolved spectroscopy (PRESS)-based, single-shot diffusion trace-weighted sequence in quantifying the trace apparent diffusion coefficient (ADC) in phantom and in vivo using a 3-T MRI/MRS scanner. The single-shot diffusion trace-weighted PRESS sequence was implemented and compared with conventional diffusion-weighted (DW)-PRESS variants using bipolar and unipolar diffusion-sensitizing gradients. Nine phantom datasets were acquired using each sequence, and seven volunteers were scanned in three different brain regions to determine the range and variability of trace ADC values, and to allow a comparison of trace ADCs among the sequences. This sequence results in a comparatively stable range of trace ADC values that are statistically significantly higher than those produced from unipolar and bipolar DW-PRESS sequences. Only total n-acetylaspartate, total creatine, and total choline were reliably estimated in all sequences with Cramér-Rao lower bounds of, at most, 20%. The larger trace ADCs from the single-shot sequences are probably attributable to the shorter diffusion time relative to the other sequences. Overall, this study presents the first demonstration of the single-shot diffusion trace-weighted sequence in a clinical scanner at 3 T. The results show excellent agreement of phantom trace ADCs computed with all sequences, and in vivo ADCs agree well with the expected differences between gray and white matter. The diffusion trace-weighted sequence could provide an estimate of the trace ADC in a shorter scan time (by nearly a factor of 3) compared with conventional DW-PRESS approaches that require three separate orthogonal directions.

Model-based frequency-and-phase correction of 1H MRS data with 2D linear-combination modeling

Purpose

Retrospective frequency-and-phase correction (FPC) methods attempt to remove frequency-and-phase variations between transients to improve the quality of the averaged MR spectrum. However, traditional FPC methods like spectral registration struggle at low SNR. Here, we propose a method that directly integrates FPC into a two-dimensional linear-combination model (2D-LCM) of individual transients ('model-based FPC'). We investigated how model-based FPC performs compared to the traditional approach, i.e., spectral registration followed by 1D-LCM in estimating frequency-and-phase drifts and, consequentially, metabolite level estimates.

Methods

We created synthetic in-vivo-like 64-transient short-TE sLASER datasets with 100 noise realizations at 5 SNR levels and added randomly sampled frequency and phase variations. We then used this synthetic dataset to compare the performance of 2D-LCM with the traditional approach (spectral registration, averaging, then 1D-LCM). Outcome measures were the frequency/phase/amplitude errors, the standard deviation of those ground-truth errors, and amplitude Cramér Rao Lower Bounds (CRLBs). We further tested the proposed method on publicly available in-vivo short-TE PRESS data.

Results

2D-LCM estimates (and accounts for) frequency-and-phase variations directly from uncorrected data with equivalent or better fidelity than the conventional approach. Furthermore, 2D-LCM metabolite amplitude estimates were at least as accurate, precise, and certain as the conventionally derived estimates. 2D-LCM estimation of frequency and phase correction and amplitudes performed substantially better at low-to-very-low SNR.

Conclusion

Model-based FPC with 2D linear-combination modeling is feasible and has great potential to improve metabolite level estimation for conventional and dynamic MRS data, especially for low-SNR conditions, e.g., long TEs or strong diffusion weighting.

Prospective motion correction for cervical spinal cord MRS

PURPOSE

To develop prospective motion correction for single-voxel MRS in the human cervical spinal cord.

METHODS

A motion MR navigator was implemented using reduced field-of-view 2D-selective RF excitation together with EPI readout. A short-echo semi-LASER sequence (TE  = 30 ms) was updated to incorporate this real-time image-based motion navigator, as well as real-time shim and frequency navigators. Five healthy participants were studied at 3 T with a 64-channel head-neck receive coil. Single-voxel MRS data were measured in a voxel located at the C3-5 vertebrae level. The motion navigator was used to correct for translations in the X-Y plane and was validated by assessing spectral quality with and without prospective correction in the presence of subject motion.

RESULTS

Without prospective correction, motion resulted in severe lipid contamination in the MR spectra. With prospective correction, the quality of spinal cord MR spectra in the presence of motion was similar to that obtained in the absence of motion, with comparable spectral signal-to-noise ratio and linewidth and no significant lipid contamination.

CONCLUSION

Prospective motion and B0 correction allow acquisition of good-quality MR spectra in the human cervical spinal cord in the presence of motion. This new technique should facilitate reliable acquisition of spinal cord MR spectra in both research and clinical settings.

Model-informed unsupervised deep learning approaches to frequency and phase correction of MRS signals

PURPOSE

A supervised deep learning (DL) approach for frequency and phase correction (FPC) of MRS data recently showed encouraging results, but obtaining transients with labels for supervised learning is challenging. This work investigates the feasibility and efficiency of unsupervised deep learning-based FPC.

METHODS

Two novel deep learning-based FPC methods (deep learning-based Cr referencing and deep learning-based spectral registration), which use a priori physics domain knowledge, are presented. The proposed networks were trained, validated, and evaluated using simulated, phantom, and publicly accessible in vivo MEGA-edited MRS data. The performance of our proposed FPC methods was compared with other generally used FPC methods, in terms of precision and time efficiency. A new measure was proposed in this study to evaluate the FPC method performance. The ability of each of our methods to carry out FPC at varying SNR levels was evaluated. A Monte Carlo study was carried out to investigate the performance of our proposed methods.

RESULTS

The validation using low-SNR manipulated simulated data demonstrated that the proposed methods could perform FPC comparably with other methods. The evaluation showed that the deep learning-based spectral registration over a limited frequency range method achieved the highest performance in phantom data. The applicability of the proposed method for FPC of GABA-edited in vivo MRS data was demonstrated. Our proposed networks have the potential to reduce computation time significantly.

CONCLUSIONS

The proposed physics-informed deep neural networks trained in an unsupervised manner with complex data can offer efficient FPC of large MRS data in a shorter time.

Frequency drift in MR spectroscopy at 3T

PURPOSE

Heating of gradient coils and passive shim components is a common cause of instability in the B0 field, especially when gradient intensive sequences are used. The aim of the study was to set a benchmark for typical drift encountered during MR spectroscopy (MRS) to assess the need for real-time field-frequency locking on MRI scanners by comparing field drift data from a large number of sites.

METHOD

A standardized protocol was developed for 80 participating sites using 99 3T MR scanners from 3 major vendors. Phantom water signals were acquired before and after an EPI sequence. The protocol consisted of: minimal preparatory imaging; a short pre-fMRI PRESS; a ten-minute fMRI acquisition; and a long post-fMRI PRESS acquisition. Both pre- and post-fMRI PRESS were non-water suppressed. Real-time frequency stabilization/adjustment was switched off when appropriate. Sixty scanners repeated the protocol for a second dataset. In addition, a three-hour post-fMRI MRS acquisition was performed at one site to observe change of gradient temperature and drift rate. Spectral analysis was performed using MATLAB. Frequency drift in pre-fMRI PRESS data were compared with the first 5:20 minutes and the full 30:00 minutes of data after fMRI. Median (interquartile range) drifts were measured and showed in violin plot. Paired t-tests were performed to compare frequency drift pre- and post-fMRI. A simulated in vivo spectrum was generated using FID-A to visualize the effect of the observed frequency drifts. The simulated spectrum was convolved with the frequency trace for the most extreme cases. Impacts of frequency drifts on NAA and GABA were also simulated as a function of linear drift. Data from the repeated protocol were compared with the corresponding first dataset using Pearson's and intraclass correlation coefficients (ICC).

RESULTS

Of the data collected from 99 scanners, 4 were excluded due to various reasons. Thus, data from 95 scanners were ultimately analyzed. For the first 5:20 min (64 transients), median (interquartile range) drift was 0.44 (1.29) Hz before fMRI and 0.83 (1.29) Hz after. This increased to 3.15 (4.02) Hz for the full 30 min (360 transients) run. Average drift rates were 0.29 Hz/min before fMRI and 0.43 Hz/min after. Paired t-tests indicated that drift increased after fMRI, as expected (p < 0.05). Simulated spectra convolved with the frequency drift showed that the intensity of the NAA singlet was reduced by up to 26%, 44 % and 18% for GE, Philips and Siemens scanners after fMRI, respectively. ICCs indicated good agreement between datasets acquired on separate days. The single site long acquisition showed drift rate was reduced to 0.03 Hz/min approximately three hours after fMRI.

DISCUSSION

This study analyzed frequency drift data from 95 3T MRI scanners. Median levels of drift were relatively low (5-min average under 1 Hz), but the most extreme cases suffered from higher levels of drift. The extent of drift varied across scanners which both linear and nonlinear drifts were observed.

Water-suppression cycling 3-T cardiac 1 H-MRS detects altered creatine and choline in patients with aortic or mitral stenosis

Cardiac proton spectroscopy (1 H-MRS) is widely used to quantify lipids. Other metabolites (e.g. creatine and choline) are clinically relevant but more challenging to quantify because of their low concentrations (approximately 10 mmol/L) and because of cardiac motion. To quantify cardiac creatine and choline, we added water-suppression cycling (WSC) to two single-voxel spectroscopy sequences (STEAM and PRESS). WSC introduces controlled residual water signals that alternate between positive and negative phases from transient to transient, enabling robust phase and frequency correction. Moreover, a particular weighted sum of transients eliminates residual water signals without baseline distortion. We compared WSC and the vendor's standard 'WET' water suppression in phantoms. Next, we tested repeatability in 10 volunteers (seven males, three females; age 29.3 ± 4.0 years; body mass index [BMI] 23.7 ± 4.1 kg/m2 ). Fat fraction, creatine concentration and choline concentration when quantified by STEAM-WET were 0.30% ± 0.11%, 29.6 ± 7.0 μmol/g and 7.9 ± 6.7 μmol/g, respectively; and when quantified by PRESS-WSC they were 0.30% ± 0.15%, 31.5 ± 3.1 μmol/g and 8.3 ± 4.4 μmol/g, respectively. Compared with STEAM-WET, PRESS-WSC gave spectra whose fitting quality expressed by Cramér-Rao lower bounds improved by 26% for creatine and 32% for choline. Repeatability of metabolite concentration measurements improved by 72% for creatine and 40% for choline. We also compared STEAM-WET and PRESS-WSC in 13 patients with severe symptomatic aortic or mitral stenosis indicated for valve replacement surgery (10 males, three females; age 75.9 ± 6.3 years; BMI 27.4 ± 4.3 kg/m2 ). Spectra were of analysable quality in eight patients for STEAM-WET, and in nine for PRESS-WSC. We observed comparable lipid concentrations with those in healthy volunteers, significantly reduced creatine concentrations, and a trend towards decreased choline concentrations. We conclude that PRESS-WSC offers improved performance and reproducibility for the quantification of cardiac lipids, creatine and choline concentrations in healthy volunteers at 3 T. It also offers improved performance compared with STEAM-WET for detecting altered creatine and choline concentrations in patients with valve disease.

Preprocessing, analysis and quantification in single-voxel magnetic resonance spectroscopy: experts' consensus recommendations

Once an MRS dataset has been acquired, several important steps must be taken to obtain the desired metabolite concentration measures. First, the data must be preprocessed to prepare them for analysis. Next, the intensity of the metabolite signal(s) of interest must be estimated. Finally, the measured metabolite signal intensities must be converted into scaled concentration units employing a quantitative reference signal to allow meaningful interpretation. In this paper, we review these three main steps in the post-acquisition workflow of a single-voxel MRS experiment (preprocessing, analysis and quantification) and provide recommendations for best practices at each step.

Motion correction methods for MRS: experts' consensus recommendations

Long acquisition times due to intrinsically low signal-to-noise ratio and the need for highly homogeneous B₀ field make MRS particularly susceptible to motion or scanner instability compared with MRI. Motion-induced changes in both localization and shimming (ie B₀ homogeneity) degrade MRS data quality. To mitigate the effects of motion three approaches can be employed: (1) subject immobilization, (2) retrospective correction, and (3) prospective real-time correction using internal and/or external tracking methods. Prospective real-time correction methods can simultaneously update localization and the B₀ field to improve MRS data quality. While localization errors can be corrected with both internal (navigators) and external (optical camera, NMR probes) tracking methods, the B₀ field correction requires internal navigator methods to measure the B₀ field inside the imaged volume and the possibility to update the scanner shim hardware in real time. Internal and external tracking can rapidly update the MRS localization with submillimeter and subdegree precision, while scanner frequency and first-order shims of scanner hardware can be updated by internal methods every sequence repetition. These approaches are most well developed for neuroimaging, for which rigid transformation is primarily applicable. Real-time correction greatly improves the stability of MRS acquisition and quantification, as shown in clinical studies on subjects prone to motion, including children and patients with movement disorders, enabling robust measurement of metabolite signals including those with low concentrations, such as gamma-aminobutyric acid and glutathione. Thus, motion correction is recommended for MRS users and calls for tighter integration and wider availability of such methods by MR scanner manufacturers.

Frequency and phase correction of J-difference edited MR spectra using deep learning

PURPOSE

To investigate whether a deep learning-based (DL) approach can be used for frequency-and-phase correction (FPC) of MEGA-edited MRS data.

METHODS

Two neural networks (1 for frequency, 1 for phase) consisting of fully connected layers were trained and validated using simulated MEGA-edited MRS data. This DL-FPC was subsequently tested and compared to a conventional approach (spectral registration [SR]) and to a model-based SR implementation (mSR) using in vivo MEGA-edited MRS datasets. Additional artificial offsets were added to these datasets to further investigate performance.

RESULTS

The validation showed that DL-based FPC was capable of correcting within 0.03 Hz of frequency and 0.4°of phase offset for unseen simulated data. DL-based FPC performed similarly to SR for the unmanipulated in vivo test datasets. When additional offsets were added to these datasets, the networks still performed well. However, although SR accurately corrected for smaller offsets, it often failed for larger offsets. The mSR algorithm performed well for larger offsets, which was because the model was generated from the in vivo datasets. In addition, the computation times were much shorter using DL-based FPC or mSR compared to SR for heavily distorted spectra.

CONCLUSION

These results represent a proof of principle for the use of DL for preprocessing MRS data.

Motion correction in magnetic resonance spectroscopy

In vivo proton magnetic resonance spectroscopy and spectroscopic imaging (MRS/MRSI) are valuable tools to study normal and abnormal human brain physiology. However, they are sensitive to motion, due to strong crusher gradients, long acquisition times, reliance on high magnetic field homogeneity, and particular acquisition methods such as spectral editing. The effects of motion include incorrect spatial localization, phase fluctuations, incoherent averaging, line broadening, and ultimately quantitation errors. Several retrospective methods have been proposed to correct motion-related artifacts. Recent advances in hardware also allow prospective (real-time) correction of the effects of motion, including adjusting voxel location, center frequency, and magnetic field homogeneity. This article reviews prospective and retrospective methods available in the literature and their implications for clinical MRS/MRSI. In combination, these methods can attenuate or eliminate most motion-related artifacts and facilitate the acquisition of high-quality data in the clinical research setting.

Correcting frequency and phase offsets in MRS data using robust spectral registration

An algorithm for retrospective correction of frequency and phase offsets in MRS data is presented. The algorithm, termed robust spectral registration (rSR), contains a set of subroutines designed to robustly align individual transients in a given dataset even in cases of significant frequency and phase offsets or unstable lipid contamination and residual water signals. Data acquired by complex multiplexed editing approaches with distinct subspectral profiles are also accurately aligned. Automated removal of unstable lipid contamination and residual water signals is applied first, when needed. Frequency and phase offsets are corrected in the time domain by aligning each transient to a weighted average reference in a statistically optimal order using nonlinear least-squares optimization. The alignment of subspectra in edited datasets is performed using an approach that specifically targets subtraction artifacts in the frequency domain. Weighted averaging is then used for signal averaging to down-weight poorer-quality transients. Algorithm performance was assessed on one simulated and 67 in vivo pediatric GABA-/GSH-edited HERMES datasets and compared with the performance of a multistep correction method previously developed for aligning HERMES data. The performance of the novel approach was quantitatively assessed by comparing the estimated frequency/phase offsets against the known values for the simulated dataset or by examining the presence of subtraction artifacts in the in vivo data. Spectral quality was improved following robust alignment, especially in cases of significant spectral distortion. rSR reduced more subtraction artifacts than the multistep method in 64% of the GABA difference spectra and 75% of the GSH difference spectra. rSR overcomes the major challenges of frequency and phase correction.

Dynamic metabolic changes in human visual cortex in regions with positive and negative blood oxygenation level-dependent response

Dynamic metabolic changes were investigated by functional magnetic resonance spectroscopy (fMRS) during sustained stimulation of human primary visual cortex. Two established paradigms, consisting of either a full-field or a small-circle flickering checkerboard, were employed to generate wide-spread areas of positive or negative blood oxygenation level-dependent (BOLD) responses, respectively. Compared to baseline, the glutamate concentration increased by 5.3% (p = 0.007) during activation and decreased by -3.8% (p = 0.017) during deactivation. These changes were positively correlated with the amplitude of the BOLD response (R = 0.60, p = 0.002) and probably reflect changes of tricarboxylic acid cycle activity. During deactivation, the glucose concentration decreased by -7.9% (p = 0.025) presumably suggesting increased consumption or reduced glucose supply. Other findings included an increased concentration of glutathione (4.2%, p = 0.023) during deactivation and a negative correlation of glutathione and BOLD signal changes (R = -0.49, p = 0.012) as well as positive correlations of aspartate (R = 0.44, p = 0.035) and N-acetylaspartylglutamate (R = 0.42, p = 0.035) baseline concentrations with the BOLD response. It remains to be shown in future work if the observed effects on glutamate and glucose levels deviate from the assumption of a direct link between glucose utilization and regulation of blood flow or support previous suggestions that the hemodynamic response is mainly driven by feedforward release of vasoactive messengers.

Simultaneous editing of GABA and GSH with Hadamard-encoded MR spectroscopic imaging

PURPOSE

To evaluate the feasibility of simultaneous MR spectroscopic imaging (MRSI) of gamma-aminobutyric acid (GABA) and glutathione (GSH) in the human brain using Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy (HERMES).

METHODS

Point RESolved Spectroscopy (PRESS)-localized MRSI was performed in GABA and GSH phantoms and in the human brain (n = 3) using HERMES editing and compared to conventional MEGA editing of each metabolite. Multiplet patterns, signal intensities, and metabolite crosstalk were compared between methods. GABA+ and GSH levels were compared between methods for bias and variability. Linear regression of HERMES-MRSI GABA+/H₂ O and GSH/H₂ O versus gray matter (GM) fraction were performed to assess differences between GM and white matter (WM).

RESULTS

Phantom HERMES-MRSI scans gave comparable GABA+ and GSH signals to MEGA-MRSI across the PRESS-localized volume. In vivo, HERMES-reconstructed GABA+ and GSH values had minimal measurement bias and variability relative to MEGA-MRSI. Intersubject coefficients of variation (CV) from two regions within the PRESS-localized volume for HERMES and MEGA were 6-12% for GABA+ and 6-19% for GSH. Interregion CVs were 5-15% for GABA+ and 3-17% for GSH. The GABA+/H₂ O and GSH/H₂ O ratios were ~1.8 times higher and ~1.9 times higher, respectively, in GM than in WM.

CONCLUSION

HERMES-MRSI of GABA+ and GSH was found to be practical in the human brain with minimal measurement bias and comparable variability to separate MEGA-edited acquisitions of each metabolite performed in double the scan time. The HERMES-MRSI is a promising method for simultaneously mapping the distribution of multiple low-concentration metabolites.

Retrospective artifact elimination in MEGA-PRESS using a correlation approach

Purpose

To develop a method for retrospective artifact elimination of MRS data. This retrospective method was based on an approach that combines jackknife analyses with the correlation of spectral windows, and therefore termed “JKC.”

Methods

Twelve healthy volunteers performed 3 separate measurement protocols using a 3T MR system. One protocol consisted of 2 cerebellar MEGA‐PRESS measurements: 1 reference and 1 measurement including head movements. One‐third of the artifact‐influenced datasets were treated as training data for the implementation the JKC method, and the rest were used for validation.

Results

The implemented JKC method correctly characterized most of the validation data. Additionally, after elimination of the detected artifacts, the resulting concentrations were much closer to those computed for the reference datasets. Moreover, when the JKC method was applied to the reference data, the estimated concentrations were not affected, compared with standard averaging.

Conclusion

The implemented JKC method can be applied without any extra cost to MRS data, regardless of whether the dataset has been contaminated by artifacts. Furthermore, the results indicate that the JKC method could be used as a quality control of a dataset, or as an indication of whether a shift in voxel placement has occurred during the measurement.

Robust retrospective frequency and phase correction for single-voxel MR spectroscopy

PURPOSE

Subject motion and static field (B₀ ) drift are known to reduce the quality of single voxel MR spectroscopy data due to incoherent averaging. Retrospective correction has previously been shown to improve data quality by adjusting the phase and frequency offset of each average to match a reference spectrum. In this work, a new method (RATS) is developed to be tolerant to large frequency shifts (>7 Hz) and baseline instability resulting from inconsistent water suppression.

METHODS

In contrast to previous approaches, the variable-projection method and baseline fitting is incorporated into the correction procedure to improve robustness to fluctuating baseline signals and optimization instability. RATS is compared to an alternative method, based on time-domain spectral registration (TDSR), using simulated data to model frequency, phase, and baseline instability. In addition, a J-difference edited glutathione in-vivo dataset is processed using both approaches and compared.

RESULTS

RATS offers improved accuracy and stability for large frequency shifts and unstable baselines. Reduced subtraction artifacts are demonstrated for glutathione edited MRS when using RATS, compared with uncorrected or TDSR corrected spectra.

CONCLUSIONS

The RATS algorithm has been shown to provide accurate retrospective correction of SVS MRS data in the presence of large frequency shifts and baseline instability. The method is rapid, generic and therefore readily incorporated into MRS processing pipelines to improve lineshape, SNR, and aid quality assessment.

Clinical applications of in vivo magnetic resonance spectroscopy in oncology

Magnetic resonance spectroscopy (MRS) can be performed in vivo using commercial MRI systems to obtain biochemical information about tissues and cancers. Applications in brain, prostate and breast aid lesion detection and characterisation (differential diagnosis), treatment planning and response assessment. Multi-centre clinical trials have been performed in all these tissues. Single centre studies have been performed in many other tissues including cervix, uterus, musculoskeletal and liver. While generally MRS is used to study endogenous metabolites it has also been used in drug studies, for example those that include 19F as part of their structure. Recently the hyperpolarisation of compounds enriched with 13C such as [1-13C] pyruvate has been demonstrated in animal models and now in preliminary clinical studies, permitting the monitoring of biochemical processes with unprecedented sensitivity. This review briefly introduces the underlying methods and then discusses the current status of these applications.

Functional MRS with J-edited lactate in human motor cortex at 4 T

While functional MRI (fMRI) localizes regions of brain activation, functional MRS (fMRS) provides insights into metabolic underpinnings. Previous fMRS studies detected task-induced lactate increase using short echo-time non-edited ¹H-MRS protocols, where lactate changes depended on accurate exclusion of overlapping lactate and lipid/macromolecule signals. Because long echo-time J-difference ¹H-MRS detection of lactate is less susceptible to this shortcoming, we posited if J-edited fMRS protocol could reliably detect metabolic changes in the human motor cortex during a finger-tapping paradigm in relation to a reliable measure of basal lactate. Our J-edited fMRS protocol at 4T was guided by an fMRI pre-scan to determine the ¹H-MRS voxel placement in the motor cortex. Because lactate and β-hydroxybutyrate (BHB) follow similar J-evolution profiles we observed both metabolites in all spectra, but only lactate showed reproducible task-induced modulation by 0.07 mM from a basal value of 0.82 mM. These J-edited fMRS results demonstrate good sensitivity and specificity for task-induced lactate modulation, suggesting that J-edited fMRS studies can be used to investigate the metabolic underpinning of human cognition by measuring lactate dynamics associated with activation and deactivation fMRI paradigms across brain regions at magnetic field lower than 7T.

Frequency and phase correction for multiplexed edited MRS of GABA and glutathione

PURPOSE

Detection of endogenous metabolites using multiplexed editing substantially improves the efficiency of edited magnetic resonance spectroscopy. Multiplexed editing (i.e., performing more than one edited experiment in a single acquisition) requires a tailored, robust approach for correction of frequency and phase offsets. Here, a novel method for frequency and phase correction (FPC) based on spectral registration is presented and compared against previously presented approaches.

METHODS

One simulated dataset and 40 γ-aminobutyric acid-/glutathione-edited HERMES datasets acquired in vivo at three imaging centers were used to test four FPC approaches: no correction; spectral registration; spectral registration with post hoc choline-creatine alignment; and multistep FPC. The performance of each routine for the simulated dataset was assessed by comparing the estimated frequency/phase offsets against the known values, whereas the performance for the in vivo data was assessed quantitatively by calculation of an alignment quality metric based on choline subtraction artifacts.

RESULTS

The multistep FPC approach returned corrections that were closest to the true values for the simulated dataset. Alignment quality scores were on average worst for no correction, and best for multistep FPC in both the γ-aminobutyric acid- and glutathione-edited spectra in the in vivo data.

CONCLUSIONS

Multistep FPC results in improved correction of frequency/phase errors in multiplexed γ-aminobutyric acid-/glutathione-edited magnetic resonance spectroscopy experiments. The optimal FPC strategy is experiment-specific, and may even be dataset-specific. Magn Reson Med 80:21-28, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Effects of sildenafil and calcitonin gene-related peptide on brainstem glutamate levels: a pharmacological proton magnetic resonance spectroscopy study at 3.0 T

BACKGROUND

Studies involving human pharmacological migraine models have predominantly focused on the vasoactive effects of headache-inducing drugs, including sildenafil and calcitonin gene-related peptide (CGRP). However, the role of possible glutamate level changes in the brainstem and thalamus is of emerging interest in the field of migraine research bringing forth the need for a novel, validated method to study the biochemical effects in these areas.

METHODS

We applied an optimized in vivo human pharmacological proton (¹H) magnetic resonance spectroscopy (MRS) protocol (PRESS, repetition time 3000 ms, echo time 37.6-38.3 ms) at 3.0 T in combination with sildenafil and CGRP in a double-blind, placebo-controlled, randomized, double-dummy, three-way cross-over design. Seventeen healthy participants were scanned with the ¹H-MRS protocol at baseline and twice (at 40 min and 140 min) after drug administration to investigate the sildenafil- and CGRP-induced glutamate changes in both brainstem and thalamus.

RESULTS

The glutamate levels increased transiently in the brainstem at 40-70 min after sildenafil administration compared to placebo (5.6%, P = 0.039). We found no sildenafil-induced glutamate changes in the thalamus, and no CGRP-induced glutamate changes in the brainstem or thalamus compared to placebo. Both sildenafil and CGRP induced headache in 53%-62% of participants. We found no interaction in the glutamate levels in the brainstem or thalamus between participants who developed sildenafil and/or CGRP-induced headache as compared to participants who did not.

CONCLUSIONS

The transient sildenafil-induced glutamate change in the brainstem possibly reflects increased excitability of the brainstem neurons. CGRP did not induce brainstem or thalamic glutamate changes, suggesting that it rather exerts its headache-inducing effects on the peripheral trigeminal pain pathways.

Prospective frequency correction using outer volume suppression-localized navigator for MR spectroscopy and spectroscopic imaging

PURPOSE

New frequency correction methods are required to achieve the accurate measurement of frequency drifts in MRS and MRSI. We present a prospective frequency correction method with outer volume suppression (OVS)-based localization and selective water excitation for effective frequency correction with better SNR improvement compared to other techniques.

METHODS

An OVS-localized navigator was developed to prospectively correct frequency drifts during MRS and MRSI measurements. The performance of the navigator was tested on the human brain and a solution phantom for frequency drifts induced by head motion or gradient heating by a preceding DWI experiment at 3T.

RESULTS

The OVS-localized navigator could accurately track motion-induced frequency drifts with an RMS error of 0.5 Hz. The SNR of MRS signals was not affected by use of the OVS-localized navigator when compared with and without the navigator (P > 0.05). The frequency drifts induced by DWI experiments were 5.1 ± 0.3 Hz/min during MRSI measurements on humans, resulting in increased spectral linewidth, significant bias in metabolite concentrations, and significantly increased Cramér-Rao lower bounds (P < 0.05). After prospective frequency corrections, the quality of MRSI was recovered to the level of those without any DWI-induced frequency drifts, judged by the spectral linewidth, metabolite concentrations, and Cramér-Rao lower bounds.

CONCLUSION

The OVS-localized navigator demonstrated effective prospective frequency corrections for large frequency drifts (5 Hz/min) without introducing any saturation-induced SNR loss. These benefits can be particularly beneficial for the acquisition of MRS signals with long T₁ and/or short TR, and spectral editing.

DCE-MRI, DW-MRI, and MRS in Cancer: Challenges and Advantages of Implementing Qualitative and Quantitative Multi-parametric Imaging in the Clinic

Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice.

Synchronous Radial 1H and 23Na Dual-Nuclear MRI on a Clinical MRI System, Equipped With a Broadband Transmit Channel

The purpose of this work was to synchronously acquire proton (1H) and sodium (23Na) image data on a 3T clinical MRI system within the same sequence, without internal modification of the clinical hardware, and to demonstrate synchronous acquisition with 1H/23Na-GRE imaging with Cartesian and radial k-space sampling. Synchronous dual-nuclear imaging was implemented by: mixing down the 1H signal so that both the 23Na and 1H signal were acquired at 23Na frequency by the conventional MRI system; interleaving 1H/23Na transmit pulses in both Cartesian and radial sequences; and using phase stabilization on the 1H signal to remove mixing effects. The synchronous 1H/23Na setup obtained images in half the time necessary to sequentially acquire the same 1H and 23Na images with the given setup and parameters. Dual-nuclear hardware and sequence modifications were used to acquire 23Na images within the same sequence as 1H images, without increases to the 1H acquisition time. This work demonstrates a viable technique to acquire 23Na image data without increasing 1H acquisition time using minor additional custom hardware, without requiring modification of a commercial scanner with multinuclear capability.

Correcting for Frequency Drift in Clinical Brain MR Spectroscopy

PURPOSE

Averaging multiple repetitions to improve signal-to-noise ratio is common practice in magnetic resonance spectroscopy (MRS). However, temporal variations in scanner B0 due to motion or gradient heating may cause spectra to become misaligned, broadening and distorting peaks and impacting on processing and quantification. We present a comparison using in vivo data of different methods for correcting these errors.

METHODS

Three different correction methods were applied to 53 brain scans: residual water peak alignment, creatine fitting, and spectral registration. In 32 of 53 subjects, diffusion tensor imaging (DTI) was acquired prior to the MRS scan. We compared the resulting linewidths to find the most effective technique. In addition, the impact on metabolite concentration estimates was evaluated.

RESULTS

MRS data acquired after DTI imaging exhibited a frequency drift four times higher than data without DTI, resulting in changes to metabolite concentrations, particularly glutamate/glutamine. All three correction methods produced significantly improved linewidths relative to uncorrected data, with spectral registration performing best by a small margin.

CONCLUSION

Frequency correction is an important step in processing MRS data, significantly impacting metabolite quantification, particularly after echo-planar imaging that often occurs with MRS scans in clinical studies. Spectral registration proved most effective at frequency correction.

Improving spectral quality in fetal brain magnetic resonance spectroscopy using constructive averaging

PURPOSE

A common source of loss in signal-to-noise ratio (SNR) in fetal brain magnetic resonance spectroscopy (MRS) is from fetal movement and temporal magnetic field drift. We investigated the feasibility of using constructive averaging strategies for improving the spectral quality and recovering the SNR loss from these effects.

MATERIALS AND METHODS

Eight fetuses, between 20 3/7 and 38 2/7 weeks' gestation, were scanned with MRS at 1.5 T. Single-voxel point-resolved spectroscopy of the fetal brain with TE = 144 ms (in one case additional TE = 288 ms) was performed in a dynamic mode, and individual spectra of 128 acquisitions were saved. With constructive averaging strategy individual acquisitions were corrected for phase variations and frequency drift before averaging. Constructively averaged spectra were compared to those using conventional averaging to evaluate differences in spectral quality and SNR.

RESULTS

The definition of key metabolite peaks was qualitatively improved using constructive averaging, including the doublet structure of lactate in one case. Constructive averaging was associated with SNR increases, ranging from 11% to 40%, and the SNR further improved in one case when outliers from severe motion were rejected before averaging.

CONCLUSION

Our results demonstrate the feasibility of using constructive averaging for improving SNR in fetal MRS, which is likely to improve the characterization of fetal brain metabolites.

Adaptively optimized combination (AOC) of magnetic resonance spectroscopy data from phased array coils

PURPOSE

MR spectroscopy (MRS) can benefit from multi-element coil arrays with enhanced signal-to-noise ratio (SNR). However, how to combine the MRS data in an optimized way from a multi-element coil array has been studied much less than MRI. A recently published method and routine combination methods have detrimental effects on SNR. We present herein a new method for optimal combination of multi-coil MRS data.

METHODS

Based on an analytical solution for maximizing the SNR of the combined spectrum, a new method called "adaptively optimized combination (AOC)" of MRS data from phased array coils was developed in which the inversion of the full noise correlation matrix was incorporated into the coil weighting coefficients. Simulations were carried out to demonstrate the superior performance of the proposed AOC method in various noise scenarios. Validation experiments on human subjects were performed with different voxel locations and sizes on a 3T MRI scanner using an eight-element phased array head coil.

RESULTS

Compared with a recently published method (i.e., weighting with the ratio of signal to the square of noise) and routine methods, our proposed AOC method adaptively and robustly produced significant SNR improvement in the combined spectra.

CONCLUSION

The simulation and human experiments demonstrate that the proposed AOC method represents the theoretical optimal combination of MR spectroscopic data from multi-element coil arrays. Magn Reson Med 75:2235-2244, 2016. © 2015 Wiley Periodicals, Inc.

Proton MRS and MRSI of the brain without water suppression

Water suppression (WS) techniques have played a vital role in the commencement and development of in vivo proton magnetic resonance spectroscopy (MRS, including spectroscopic imaging - MRSI). WS not only made in vivo proton MRS functionally available but also made its applications conveniently accessible, and it has become an indispensable tool in most of the routine applications of in vivo proton MR spectroscopy. On the other hand, WS brought forth some challenges. Therefore, various techniques of proton MRS without WS have been developed since the pioneering work in the late 1990s. After more than one and a half decades of advances in both hardware and software, non-water-suppressed proton MRS is coming to the stage of maturity and seeing increasing application in biomedical research and clinical diagnosis. In this article, we will review progress in the technical development and applications of proton MRS without WS.

A comparison of spectral quality in magnetic resonance spectroscopy data acquired with and without a novel EPI-navigated PRESS sequence in school-aged children with fetal alcohol spectrum disorders

Single voxel spectroscopy (SVS) can generate useful information regarding metabolite concentrations provided that the MR signal can be averaged over several minutes during which the subject remains stationary. This requirement can be particularly challenging for children who cannot otherwise be scanned without sedation. To address this problem we developed an EPI volume navigated (vNav) SVS PRESS sequence, which applies real-time head pose (location and orientation), frequency, and first-order B0 shim adjustments. A water-independent preprocessing algorithm removes residual frequency and phase shifts resulting from within-TR movements. We compare results and performance of the standard and vNav PRESS sequences in a sample of 9- to 10-year-olds from a South African cohort of children with fetal alcohol spectrum disorders (FASD) and healthy controls. Magnetic resonance spectroscopy (MRS) data in the deep cerebellar nuclei were initially acquired with the standard PRESS sequence. The children were re-scanned 1 year later with the vNav PRESS sequence. Good quality data were acquired in 73% using the vNav PRESS sequence, compared to only 50% for the standard PRESS sequence. Additionally, tighter linewidths and smaller variances in the measured concentrations were observed. These findings confirm previous reports demonstrating the efficacy of our innovative vNav sequence with healthy volunteers and young children with HIV and expand its application to a school-aged population with FASD-disorders often associated with attention problems and hyperactivity. This study provides the most direct evidence to date regarding degree to which these new methods can improve data quality in research studies employing MRS.

Frequency and phase drift correction of magnetic resonance spectroscopy data by spectral registration in the time domain

PURPOSE

Frequency and phase drifts are a common problem in the acquisition of in vivo magnetic resonance spectroscopy (MRS) data. If not accounted for, frequency and phase drifts will result in artifactual broadening of spectral peaks, distortion of spectral lineshapes, and a reduction in signal-to-noise ratio (SNR). We present herein a new method for estimating and correcting frequency and phase drifts in in vivo MRS data.

METHODS

We used a simple method of fitting each spectral average to a reference scan (often the first average in the series) in the time domain through adjustment of frequency and phase terms. Due to the similarity with image registration, this method is referred to as "spectral registration." Using simulated data with known frequency and phase drifts, the performance of spectral registration was compared with two existing methods at various SNR levels.

RESULTS

Spectral registration performed well in comparison with the other methods tested in terms of both frequency and phase drift estimation.

CONCLUSIONS

Spectral registration provides an effective method for frequency and phase drift correction. It does not involve the collection of navigator echoes, and does not rely on any specific resonances, such as residual water or creatine, making it highly versatile.

Impact of frequency drift on gamma-aminobutyric acid-edited MR spectroscopy

PURPOSE

To investigate the quantitative impact of frequency drift on Gamma-Aminobutyric acid (GABA+)-edited MRS of the human brain at 3 Tesla (T).

METHODS

Three sequential GABA+-edited MEGA-PRESS acquisitions were acquired in fifteen sessions; in ten of these, MRS was preceded by functional MRI (fMRI) to induce frequency drift, which was estimated from the creatine resonance at 3.0 ppm. Simulations were performed to examine the effects of frequency drift on the editing efficiency of GABA and co-edited macromolecules (MM) and of subtraction artifacts on GABA+ quantification. The efficacy of postprocessing frequency correction was also investigated.

RESULTS

Gradient-induced frequency drifts affect GABA+ quantification for at least 30 min after imaging. Average frequency drift was low in control sessions and as high as -2 Hz/min after fMRI. Uncorrected frequency drift has an approximately linear effect on GABA+ measurements with a -10 Hz drift resulting in a 16% decrease in GABA+, primarily due to subtraction artifacts.

CONCLUSION

Imaging acquisitions with high gradient duty cycles can impact subsequent GABA+ measurements. Postprocessing can address subtraction artifacts, but not changes in editing efficiency or GABA:MM signal ratios; therefore, protocol design should avoid intensive gradient sequences before edited MRS Magn Reson Med 72:941-948, 2014. © 2013 Wiley Periodicals, Inc.

Real-time motion- and B0-correction for LASER-localized spiral-accelerated 3D-MRSI of the brain at 3T

The full potential of magnetic resonance spectroscopic imaging (MRSI) is often limited by localization artifacts, motion-related artifacts, scanner instabilities, and long measurement times. Localized adiabatic selective refocusing (LASER) provides accurate B1-insensitive spatial excitation even at high magnetic fields. Spiral encoding accelerates MRSI acquisition, and thus, enables 3D-coverage without compromising spatial resolution. Real-time position- and shim/frequency-tracking using MR navigators correct motion- and scanner instability-related artifacts. Each of these three advanced MRI techniques provides superior MRSI data compared to commonly used methods. In this work, we integrated in a single pulse sequence these three promising approaches. Real-time correction of motion, shim, and frequency-drifts using volumetric dual-contrast echo planar imaging-based navigators were implemented in an MRSI sequence that uses low-power gradient modulated short-echo time LASER localization and time efficient spiral readouts, in order to provide fast and robust 3D-MRSI in the human brain at 3T. The proposed sequence was demonstrated to be insensitive to motion- and scanner drift-related degradations of MRSI data in both phantoms and volunteers. Motion and scanner drift artifacts were eliminated and excellent spectral quality was recovered in the presence of strong movement. Our results confirm the expected benefits of combining a spiral 3D-LASER-MRSI sequence with real-time correction. The new sequence provides accurate, fast, and robust 3D metabolic imaging of the human brain at 3T. This will further facilitate the use of 3D-MRSI for neuroscience and clinical applications.

Quality of 186 child brain spectra using motion and B0 shim navigated single voxel spectroscopy

PURPOSE

To evaluate B0 shim and motion navigated single voxel spectroscopy in children. Assess the repeatability of metabolite concentrations in three regions: medial frontal grey matter, peritrigonal white matter, and basal ganglia. Determine the extent of intra- and interacquisition movement in this population.

METHODS

Linewidth and signal to noise ratio were calculated to assess spectral quality of 186 spectra at 3 Tesla. Repeatability was assessed on 31 repeat scans. Navigator images were used to assess localization errors, while navigator motion and shim logs were used to demonstrate the efficacy of correction needed during the scans.

RESULTS

Average linewidths ± standard deviations of N-acetyl aspartate are 3.8 ± 0.6 Hz, 4.4 ± 0.5 Hz, and 4.7 ± 0.8 Hz in each region, respectively. Scan-to-scan measurement variance in metabolite concentrations closely resembled the expected variance. A total of 73% and 32% of children moved before and during the acquisition, causing a voxel shift of more than 10% of the voxel volume, 1.5 mm. The predominant movement directions were sliding out of the coil and nodding (up-down rotation). First-order B0 corrections were significant (>10 μT/m) in 18 % of acquisitions.

CONCLUSION

Prospective motion and B0 correction provides high quality repeatable spectra. The study found that most children moved between acquisitions and a substantial number moved during acquisitions.

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.

Real-time dynamic frequency and shim correction for single-voxel magnetic resonance spectroscopy

Subject motion during brain magnetic resonance spectroscopy acquisitions generally reduces the magnetic field (B₀) homogeneity across the volume of interest or voxel. This is the case even if prospective motion correction ensures that the voxel follows the head. We introduce a novel method for rapidly mapping linear variations in B₀ across a small volume using two-dimensional excitations. The new field mapping technique was integrated into a prospectively motion-corrected single-voxel ¹H magnetic resonance spectroscopy sequence. Interference with the magnetic resonance spectroscopy measurement was negligible, and there was no penalty in scan time. Frequency shifts were also measured continuously, and both frequency and first-order shim corrections were applied in real time. Phantom experiments and in vivo studies demonstrated that the resulting motion- and shim-corrected sequence is able to mitigate line broadening and maintain spectral quality even in the presence of large-amplitude subject motion.

Direct B0 field monitoring and real-time B0 field updating in the human breast at 7 Tesla

Large dynamic fluctuations of the static magnetic field (B(0)) are observed in the human body during MR scanning, compromising image quality and detection sensitivity in several MR imaging and spectroscopy sequences. Partially, these dynamic B(0) fluctuations are due to physiological motion such as breathing, but other sources of temporal B(0) field fluctuations are also present in the MR system (e.g., eddy currents). Especially at ultrahigh field (≥7 T), the increased susceptibility effects lead to large B(0) field variations over time. Direct measurement and correction of these temporal field variations of up to 70 Hz will lead to a significant reduction of artifacts and improved measurement stability/reproducibility. For direct measurement of the temporally changing B(0) field, a simple field probe was developed, that was placed in proximity to the tissue of interest. In this work, it is shown how such a field probe system can be used to monitor temporal B(0) field variations in the human body during MRI and magnetic resonance spectroscopy. Furthermore, it is shown how the acquired temporal B(0) field information can drive a dynamic shim module to directly correct the B(0) magnetic field in real time.

Correction of frequency drifts induced by gradient heating in 1H spectra using interleaved reference spectroscopy

PURPOSE

To evaluate the impact of heating-induced frequency drifts on single-voxel spectroscopy and to demonstrate correction strategies based on the interleaved reference scan technique.

MATERIALS AND METHODS

Frequency drifts induced by gradient heating are assessed for two clinical 3 Tesla (T) whole body MR systems. The interleaved reference scan (IRS) method is used for correcting these frequency drifts in 1H spectra in vitro and in vivo. For severely drift-affected spectroscopy experiments, a feedback-based version of the IRS sequence is proposed, which adds the functionality of a frequency lock to prevent a degradation of the water suppression.

RESULTS

It is shown that the line widths of the spectral resonances can be largely reduced with the interleaved reference scan method, resulting in considerably improved peak resolution and signal-to-noise ratio. The feedback-based IRS method additionally allows for stable water suppression, even in the presence of very strong frequency drifts.

CONCLUSION

If spectroscopy scans are combined with imaging scans with a high gradient duty cycle such as diffusion-weighted imaging or functional MRI, a drift correction with IRS can considerably improve the validity of data analysis in research studies.

Real-time motion and B0 corrected single voxel spectroscopy using volumetric navigators

In population groups where head pose cannot be assumed to be constant during a magnetic resonance spectroscopy examination or in difficult-to-shim regions of the brain, real-time volume of interest, frequency, and shim optimization may be necessary. We investigate the effect of pose change on the B0 homogeneity of a (2 cm)3 volume and observe typical first-order shim changes of 1 μT/m per 1° rotation (chin down to up) in four different volumes of interest in a single volunteer. An echo planar imaging volume navigator was constructed to measure and apply in real-time within each pulse repetition time: volume of interest positioning, frequency adjustment, and first-order shim adjustment. This volume navigator is demonstrated in six healthy volunteers and achieved a mean linewidth of 4.4 Hz, similar to that obtained by manual shim adjustment of 4.9 Hz. Furthermore, this linewidth is maintained by the volume navigator at 4.9 Hz in the presence of pose change. By comparison, a mean linewidth of 7.5 Hz was observed, when no correction was applied.

A novel phase and frequency navigator for proton magnetic resonance spectroscopy using water-suppression cycling

Magnetic resonance spectroscopy is sensitive to movements, in part, because of motion-induced phase and frequency variations that lead to incoherent averaging. For in vivo proton magnetic resonance spectroscopy, the unsuppressed or under-suppressed water signal can be used to restore coherent averaging; however, this approach results in baseline distortions due to the large water peak. Therefore, a novel water-suppression cycling scheme was developed that alternates between positive and negative residual water signal. Using the residual water signal, the method allows for shot-to-shot phase and frequency correction of individual free induction decays and restoration of signal losses due to incoherent averaging, yet near-complete elimination of residual water. It is demonstrated that the residual water signal can be used to restore metabolite peaks in a brain spectrum from a subject who performed intentional head movements. The ability to correct phase and frequency fluctuations during subject motion is vital for use with adaptive motion correction approaches that ensure proper voxel positioning during head movements.

Gradient moment compensated magnetic resonance spectroscopic imaging

Spectroscopic imaging applications outside of the brain can suffer from artifacts due to inherent long scan times and susceptibility to motion. A fast spectroscopic imaging sequence has been devised with reduced sensitivity to motion. The sequence uses oscillating readout gradients and acquires k-space data in a spiral out-in fashion, which allows fast k-space coverage. We show that a spiral out-in readout acquisition is characterized by small gradient moments, reducing sensitivity to motion-induced artifacts. Data are acquired comparing the sequence to normal phase encoded spectroscopic imaging and conventional spiral spectroscopic imaging protocols. In addition, in vivo data are acquired from the liver, demonstrating potential usage as a multivoxel fat/water spectroscopic imaging tool. Results indicate that in the presence of motion, ghosting effects are reduced while metabolite signal increases of approximately 10% can be achieved.

Metabolite quantification and high-field MRS in breast cancer

In vivo 1H MRS is rapidly developing as a clinical tool for diagnosing and characterizing breast cancers. Many in vivo and in vitro experiments have demonstrated that alterations in concentrations of choline-containing metabolites are associated with malignant transformation. In recent years, considerable efforts have been made to evaluate the role of 1H MRS measurements of total choline-containing compounds in the management of patients with breast cancer. Current technological developments, including the use of high-field MR scanners and quantitative spectroscopic analysis methods, promise to increase the sensitivity and accuracy of breast MRS. This article reviews the literature describing in vivo MRS in breast cancer, with an emphasis on the development of high-field MR scanning and quantitative methods. Potential applications of these technologies for diagnosing suspicious lesions and monitoring response to chemotherapy are discussed.

Respiratory motion-corrected proton magnetic resonance spectroscopy of the liver

PURPOSE

To develop a post-processing, respiratory-motion correction algorithm for magnetic resonance spectroscopy (MRS) of the liver and to determine the incidence and impact of respiratory motion in liver MRS.

MATERIALS AND METHODS

One hundred thirty-two subjects (27 healthy, 31 with nonalcoholic fatty liver disease and 74 HIV-infected with or without hepatitis C) were scanned with free breathing MRS at 1.5 T. Two spectral time series were acquired on an 8-ml single voxel using TR/TE=2500 ms/30 ms and (1) water suppression, 128 acquisitions, and (2) no water suppression, 8 acquisitions. Individual spectra were phased and frequency aligned to correct for intrahepatic motion. Next, water peaks more than 50% different from the median water peak area were identified and removed, and remaining spectra averaged to correct for presumed extrahepatic motion. Total CH(2)+CH(3) lipids to unsuppressed water ratios were compared before and after corrections.

RESULTS

Intrahepatic-motion correction increased the signal to noise ratio (S/N) in all cases (median=11-fold). Presumed extrahepatic motion was present in 41% (54/132) of the subjects. Its correction altered the lipids/water magnitude (magnitude change: median=2.6%, maximum=290%, and was >5% in 25% of these subjects). The incidence and effect of respiratory motion on lipids/water magnitude were similar among the three groups.

CONCLUSION

Respiratory-motion correction of free breathing liver MRS greatly increased the S/N and, in a significant number of subjects, changed the lipids/water ratios, relevant for monitoring subjects.

Reproducibility of magnetic resonance spectroscopy in correlation with signal-to-noise ratio

An increased amount of myoinositol (mI) relative to creatine (Cr) by proton MR spectroscopy ((1)H-MRS) measurement gives a useful aid for the diagnosis of Alzheimer's disease (AD). Previous results of test-retest measurement of mI, however, have shown variability more than twice as large as for other metabolites. The aims of this study were to analyze test-retest variability of (1)H-MRS measurements in correlation with signal-to-noise ratio (SNR). Ten subjects clinically suspected of mild AD were examined twice (2-14 days apart) with (1)H-MRS measurements of voxels placed at anterior and posterior cingulate cortex. The percent differences between two measurements (%differences) of mI/Cr showed a significant linear trend to decrease as average SNR increased, but %differences of N-acetylaspartate (NAA)/Cr and choline (Cho)/Cr did not. The average of %differences was 10.5, 15.0 and 20.8 for NAA/Cr, Cho/Cr, and mI/Cr, respectively, indicating a prominent deterioration of mI/Cr measurement reproducibility, which decreased to 6.96, 15.4 and 9.87, respectively, when the analysis was limited to measurements with SNR over 25. The results indicate that MRS measurements with high SNR should be used to obtain reliable assessments of mI/Cr as accurate diagnostic indicator of AD in clinical MR examinations.

On restoring motion-induced signal loss in single-voxel magnetic resonance spectra

Destructive interference from phase fluctuations caused by motion during (1)H magnetic resonance spectroscopy (MRS) stimulated-echo acquisition mode (STEAM) and point-resolved spectroscopy (PRESS) acquisitions can significantly diminish the traditional radicalN-gain in signal-to-noise ratio (SNR) afforded by averaging N signals, especially in the torso. The SNR loss is highly variable among individuals, even when identical acquisition protocols are used. This paper presents a theory for the SNR loss, assuming that the phase fluctuates randomly. It is shown that SNR in conventional averaging is reduced by the factor sinc(sigma(phi) radical3/pi), where sigma(phi) is the standard deviation (SD) of the phase. "Constructive averaging," whereby each individual acquisition is phase-corrected using the phase of a high-SNR peak before averaging, reverses the SNR loss from motion-induced dephasing, resulting in a {1/sinc(sigma(phi) radical3/pi)}-fold SNR improvement. It is also shown that basing phase corrections on an average of radicalN adjacent points both improves correction accuracy and effectively eliminates false signal artifacts when corrections are based on low-SNR peaks. The theory is validated over a sevenfold range of variation in signal loss due to motion observed in (1)H STEAM and PRESS data acquired from 17 human subjects (heart: N = 16; leg: N = 1). Constructive averaging should be incorporated as a routine tool for in vivo (1)H MRS.

1H MR spectroscopy of the brain: absolute quantification of metabolites

Hydrogen 1 (1H) magnetic resonance (MR) spectroscopy enables noninvasive in vivo quantification of metabolite concentrations in the brain. Currently, metabolite concentrations are most often presented as ratios (eg, relative to creatine) rather than as absolute concentrations. Despite the success of this approach, it has recently been suggested that relative quantification may introduce substantial errors and can lead to misinterpretation of spectral data and to erroneous metabolite values. The present review discusses relevant methods to obtain absolute metabolite concentrations with a clinical MR system by using single-voxel spectroscopy or chemical shift imaging. Important methodological aspects in an absolute quantification strategy are addressed, including radiofrequency coil properties, calibration procedures, spectral fitting methods, cerebrospinal fluid content correction, macromolecule suppression, and spectral editing. Techniques to obtain absolute concentrations are now available and can be successfully applied in clinical practice. Although the present review is focused on 1H MR spectroscopy of the brain, a large part of the methodology described can be applied to other tissues as well.

Increased thalamus levels of glutamate and glutamine (Glx) in patients with idiopathic generalised epilepsy

OBJECTIVE

Abnormal thalamo-cortical oscillations underlie idiopathic generalised epilepsy (IGE). Although thalamic involvement has long been indicated by electrophysiological data, it has only recently become feasible to test this with independent methods. In this magnetic resonance (MR) study, we investigated the metabolic and structural integrity of the thalamus. Possible changes in glutamine and glutamate concentrations and signs of neuronal damage were of particular interest.

METHOD

Forty three IGE patients and 38 age and sex matched healthy controls were investigated. Quantitative single volume MR spectroscopy (MRS, 1.5 T) was used to measure concentrations of glutamate and glutamine (Glx) and N-acetyl aspartate (NAA) in thalamus and occipital cortex. We also measured thalamic volumes on high resolution gradient-echo images and estimated fractions of thalamic grey and white matter with voxel based morphometry (VBM).

RESULTS

IGE patients showed elevated Glx and reduced NAA concentrations in the thalamus compared to controls (12.2+/-2.6 v 8.9+/-4.1 mM, p = 0.0022 for Glx, and 9.9+/-1.0 v 10.7+/-0.9 mM, p = 0.017 for NAA). Thalamic grey matter fraction was reduced in IGE patients, and white matter fraction was increased with the greatest increase in the dorso-medial thalamus. Mean thalamic volume was reduced in patients (6.7+/-0.7 v 7.2+/-0.6 ml in controls, p = 0.0001), as was mean cerebral volume (1163+/-128 v 1250+/-102 ml, p = 0.0003). Patients' thalamus/whole brain ratios were normal.

CONCLUSION

Quantitative MRS and VBM provide further evidence for involvement of the thalamus in IGE. The observed elevation of Glx levels together with reductions in NAA levels and grey matter fractions are consistent with epilepsy related excitoxicity as a possible underlying mechanism.