Quantitation of metabolites by 1H NMR

Mr Spectroscopy in Clinical Research

MR spectroscopy (MRS) offers unique possibilities for non-invasive evaluation of biochemistry in vivo. During recent years there has been a growing body of evidence from clinical research studies on human beings using 31P and 1H MRS. The results indicate that it is possible to evaluate phosphorous energy metabolism, loss of neurones, and lactate production in a large number of brain diseases. Furthermore, 31P and 1H MRS may be particularly clinically useful in evaluation of various disorders in skeletal muscle. In the heart 31P MRS seems at the moment the most suitable for evaluation of global affections of the myocardium. In the liver 31P MRS appears to be rather insensitive and non-specific, but absolute quantification of metabolite concentrations and using metabolic “stress models” may prove useful in the future. The clinical role of MRS in oncology is still unclear, but it may be useful for noninvasive follow-up of treatment.

Taken together, the evidence obtained so far certainly shows some trends for clinical applications of MRS. Methods are now available for the clinical research necessary for establishing routine clinical MRS examinations.

Noninvasive monitoring of lactate dynamics in human forearm muscle after exhaustive exercise by (1)H-magnetic resonance spectroscopy at 7 tesla

Despite its importance in energy metabolism, lactate in human skeletal muscle has been difficult to detect by noninvasive (1)H-magnetic resonance spectroscopy mainly due to interference from large water and lipid signals. Long echo-time acquisitions at 7 T effectively attenuates the water and lipid signals in forearm muscle allowing direct observation of both lactate resonances, the methine at 4.09 ppm and the methyl at 1.31 ppm. Using this approach, we were able to monitor lactate dynamics at a temporal resolution of 32 s. While lactate was not detectable at rest, immediately after an acute period of exercise to fatigue the forearm muscle, lactate rose to a level comparable to that of creatine (∼30 mmol/kg wet weight). In a typical (1)H-magnetic resonance spectrum collected using a echo-time of 140 ms, the lactate methine and methyl resonances both appear as doublets with an unusually large splitting of ∼20 Hz due to residual dipolar coupling. During muscle recovery following exercise, the lactate signals decay rapidly with a time constant of t½ = 2.0 ± 0.6 min (n = 12 subjects). This fast and simple lactate detection method may prove valuable for monitoring lactate metabolism in cancer and in sports medicine applications.

RF shimming for spectroscopic localization in the human brain at 7 T

Spectroscopic imaging of the human head at short echo times (<or=15 ms) typically requires suppression of signals from extracerebral tissues. However, at 7 T, decreasing efficiency in B1+ generation (hertz/watt) and increasing spectral bandwidth result in dramatic increases in power deposition and increased chemical shift registration artifacts for conventional gradient-based in-plane localization. In this work, we describe a novel method using radiofrequency shimming and an eight-element transceiver array to generate a B1+ field distribution that excites a ring about the periphery of the head and leaves central brain regions largely unaffected. We have used this novel B1+ distribution to provide in-plane outer volume suppression (>98% suppression of extracerebral lipids) without the use of gradients. This novel B1+ distribution is used in conjunction with a double inversion recovery method to provide suppression of extracerebral resonances with T1s greater than 400 ms, while having negligible effect on metabolite ratios of cerebral resonances with T1s>1000 ms. Despite the use of two adiabatic pulses, the high efficiency of the ring distribution allows radiofrequency power deposition to be limited to 3-4 W for a pulse repetition time of 1.5 sec. The short echo time enabled the acquisition of images of the human brain, displaying glutamate, glutamine, macromolecules, and other major cerebral metabolites.

Quantitative analysis of anaerobic metabolism in resting anoxic muscle by 31P and 1H MRS

31P and 1H MRS high resolution measurements at 4.7 T were carried out in isolated frog (Rana esculenta) gastrocnemius muscle during anoxia to assess, using reference compounds, the concentration of high energy phosphates (approximately P = phosphocreatine (PC) plus adenosinetriphosphate (ATP)), inorganic phosphate (P(i)), phosphomonoesters (PME) and lactate (La): Two sets of measurements were performed, with (p) and without (up) muscle IAA poisoning and the time course of the metabolite concentration changes was described. The rate of phosphocreatine hydrolysis during the first phase of anaerobiosis, when no lactate is accumulated in either case, appears to be greater in p than in up preparations. This finding can be explained with the sizeable accumulation of phosphomonoesters (PME) in the former. The efficiency of anaerobic glycolysis, i.e. the approximately P/La ratio, recalculated taking into account also PME changes, was found to be 1.48 +/- 0.28, a value higher than that obtained by previous chemical measurements and close to the maximum stoichiometric approximately P/La value. Hence, the in vivo substrate of glycolysis, in the resting anoxic frog gastrocnemius, appears to be almost exclusively glycogen.

Two-dimensional proton chemical-shift imaging of human muscle metabolites

Large lipid signals and strong susceptibility gradients introduced by muscle-bone interfaces represent major technical challenges for in vivo proton MRS of human muscle. Here, the demonstration of two-dimensional proton chemical-shift imaging of human muscle metabolites is presented. This technique utilizes a chemical-shift-selective method for water and lipid suppression and automatic shimming for optimal homogeneity of the magnetic field. The 2D1H CSI technique described facilitates the acquisition of high-spatial-resolution spectra, and allows one to acquire data from multiple muscle groups in a single experiment. A preliminary investigation utilizing this technique in healthy adult males (n = 4) revealed a highly significant difference in the ratio of the creatine to trimethylamine resonance between the fast and slow twitch muscle groups examined. The technique is robust, can be implemented on a commercial scanner with relative ease, and should prove to be a useful tool for both clinical and basic investigators.

Correlation of lactate and pH in human skeletal muscle after exercise by 1H NMR

We have made in vivo 1H NMR measurements of the time course of pH and lactate in human skeletal muscle after exercise. Spectra were obtained in a 4.7-T 30-cm bore Bruker Biospec spectrometer with a 2.5-cm diameter single surface coil. pH was determined from the shift of the endogenous carnosine H-C2 peak while lactate concentrations were determined by comparison with endogenous total creatine, taken to be 28.5 mM/kg wet wt. Fitting the data shows that the exponential decay of lactate (-0.094 +/- 0.014 min-1. t1/2 = 10.6 min) is slower than that of pH (-0.147 +/- 0.015 min-1, t1/2 = 4.7 min), n = 7 with two different volunteers. These values are significantly different with P less than 0.0005. Relaxation times of lactate and creatine were also measured for lactate quantitation; creatine T1, 1.23 +/- 12 s, T2, 136.2 +/- 26.4 ms (both in resting human muscle); lactate T1 (in postmortem rabbit muscle), 1.0 +/- 11 s and T2, 80 ms (in postexercise human muscle). At the end of intense exercise, the lactate level reached was 25.3 +/- 4.0 mM and the average pH drop was 1.0 pH unit. We discuss the implications of these measurements in conjunction with existing data on other sources of H+ flux, phosphocreatine resynthesis, H+ transport, and contribution of inorganic phosphate to buffering.

Noninvasive measurements of activity-induced changes in muscle metabolism

Two noninvasive measurement techniques were used to monitor activity-induced changes in skeletal muscle in humans. Phosphorus magnetic resonance spectroscopy (P-MRS) was used to measure changes in energy metabolism by measuring the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) during steady level work in the wrist flexor muscles in a 30 cm bore, 1.9 Telsa magnet, and the rate of PCr recovery from exercise in the calf muscles in a 76 cm bore, 1.8 Tesla magnet. Near red spectroscopy (NRS) was used to measure changes in oxygen saturation of hemoglobin and myoglobin during and after exercise. Fourteen days of wrist flexion exercise resulted in significant improvement in muscle metabolism as measured by MRS. This improvement disappeared after 35 days of inactivity. Indications of muscle stress during training such as muscle soreness and decreased maximum strength were associated with increases in resting Pi/PCr. A similar training protocol using plantar flexion exercise resulted in an improved rate of PCr resynthesis, which returned to control values 42 days after training stopped. NRS measurements of the wrist flexor muscles during a ramp exercise protocol demonstrated a decrease in the oxygen saturation of hemoglobin-myoglobin from 60% at rest to 15% at the highest work levels. The half time of recovery of oxygen saturation was faster than that of PCr in both young and old subjects, supporting the hypothesis that oxygen delivery is not rate limiting in submaximal exercise in healthy individuals.