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

Multi-echo single-shot spectroscopy combined with simultaneous 2D model fitting for fast and accurate measurement of metabolite-specific concentrations and T2 relaxation times

The purpose of the current study was to develop a novel single-voxel MR spectroscopy acquisition scheme to simultaneously determine metabolite-specific concentrations and transverse relaxation times within realistic clinical scan times. Partly truncated multi-TE data are acquired as an echo train in a single acquisition (multi-echo single-shot [MESS]). A 2D multiparametric model fitting approach combines truncated, low-resolved short TE data with fully sampled, highly resolved, longer TE data to yield concentration and T2 estimates for major brain metabolites simultaneously. Cramer-Rao lower bounds (CRLB) are used as a measure of performance. The novel scheme was compared with traditional multi-echo multi-shot methods. In silico, in vitro, and in vivo experiments support the findings. MESS schemes, requiring only 2 min 12 s for the acquisition of three echo times, provide valid concentration and relaxation estimates for multiple metabolites and outperform traditional methods for simultaneous determinations of metabolite-specific T2 s and concentrations, with improvements ranging from 5% to 30% for T2 s and from 10% to 50% for concentrations. However, substantial unsuppressed residual water signals may hamper the method's reproducibility, as observed in an initial experiment setup that prioritizes short TEs with severely truncated acquisition for the benefit of signal-to-noise ratio (SNR). Nevertheless, CRLB have been confirmed to be well suited as design criteria, and within-session repeatability approaches CRLB when residual water is removed in postprocessing by exploiting longer and less truncated data recordings. MESS MRS combined with 2D model fitting promises comparable accuracy, increased precision, or inversely shorter experimental times compared with traditional approaches. However, the optimal design must be investigated as a trade-off between SNR, the truncation factor, and TE batch selections, all of which influence the robustness of estimations.

Absolute thermometry using hyperpolarized 129 Xe free-induction decay and spin-echo chemical-shift imaging in rats

PURPOSE

To implement and test variants of chemical shift imaging (CSI) acquiring both free induction decays (FIDs) showing all dissolved-phase compartments and spin echoes for specifically assessing 129 $$ {}^{129} $$ Xe in lipids in order to perform precise lipid-dissolved 129 $$ {}^{129} $$ Xe MR thermometry in a rat model of general hypothermia.

METHODS

Imaging was performed at 2.89 T. T 2 $$ {T}_2 $$ of 129 $$ {}^{129} $$ Xe in lipids was determined in one rat by fitting exponentials to decaying signals of global spin-echo spectra. Four rats (conventional CSI) and six rats (turbo spectroscopic imaging) were scanned at three time points with core body temperature 37/34/37 ∘ $$ {}^{\circ } $$ C. Lorentzian functions were fit to spectra from regions of interest to determine the water-referenced chemical shift of lipid-dissolved 129 $$ {}^{129} $$ Xe in the abdomen. Absolute 129 $$ {}^{129} $$ Xe-derived temperature was compared to values from a rectal probe.

RESULTS

Global T 2 $$ {T}_2 $$ of 129 $$ {}^{129} $$ Xe in lipids was determined as 251 . 3   ms ± 81 . 4   ms $$ 251.3\;\mathrm{ms}\pm 81.4\;\mathrm{ms} $$ . Friedman tests showed significant changes of chemical shift with time for both sequence variants and both FID and spin-echo acquisitions. Mean and SD of 129 $$ {}^{129} $$ Xe and rectal probe temperature differences were found to be - 0 . 1 5 ∘ C ± 0 . 9 3 ∘ C $$ -0.1{5}^{\circ}\mathrm{C}\pm 0.9{3}^{\circ}\mathrm{C} $$ (FID) and - 0 . 3 8 ∘ C ± 0 . 6 4 ∘ C $$ -0.3{8}^{\circ}\mathrm{C}\pm 0.6{4}^{\circ}\mathrm{C} $$ (spin echo) for conventional CSI as well as 0 . 0 3 ∘ C ± 0 . 7 7 ∘ C $$ 0.0{3}^{\circ}\mathrm{C}\pm 0.7{7}^{\circ}\mathrm{C} $$ (FID) and - 0 . 0 6 ∘ C ± 0 . 7 6 ∘ C $$ -0.0{6}^{\circ}\mathrm{C}\pm 0.7{6}^{\circ}\mathrm{C} $$ (spin echo) for turbo spectroscopic imaging.

CONCLUSION

129 $$ {}^{129} $$ Xe MRI using conventional CSI and turbo spectroscopic imaging of lipid-dissolved 129 $$ {}^{129} $$ Xe enables precise temperature measurements in the rat's abdomen using both FID and spin-echo acquisitions with acquisition of spin echoes enabling most precise temperature measurements.

In vivo brain MR spectroscopy in gliomas: clinical and pre-clinical chances

Purpose

Gliomas, the most common primary brain tumours, have recently been re-classified incorporating molecular aspects with important clinical, prognostic, and predictive implications. Concurrently, the reprogramming of metabolism, altering intracellular and extracellular metabolites affecting gene expression, differentiation, and the tumour microenvironment, is increasingly being studied, and alterations in metabolic pathways are becoming hallmarks of cancer. Magnetic resonance spectroscopy (MRS) is a complementary, non-invasive technique capable of quantifying multiple metabolites. The aim of this review focuses on the methodology and analysis techniques in proton MRS (1H MRS), including a brief look at X-nuclei MRS, and on its perspectives for diagnostic and prognostic biomarkers in gliomas in both clinical practice and preclinical research.

Methods

PubMed literature research was performed cross-linking the following key words: glioma, MRS, brain, in-vivo, human, animal model, clinical, pre-clinical, techniques, sequences, 1H, X-nuclei, Artificial Intelligence (AI), hyperpolarization.

Results

We selected clinical works (n = 51), preclinical studies (n = 35) and AI MRS application papers (n = 15) published within the last two decades. The methodological papers (n = 62) were taken into account since the technique first description.

Conclusions

Given the development of treatments targeting specific cancer metabolic pathways, MRS could play a key role in allowing non-invasive assessment for patient diagnosis and stratification, predicting and monitoring treatment responses and prognosis. The characterization of gliomas through MRS will benefit of a wide synergy among scientists and clinicians of different specialties within the context of new translational competences. Head coils, MRI hardware and post-processing analysis progress, advances in research, experts’ consensus recommendations and specific professionalizing programs will make the technique increasingly trustworthy, responsive, accessible.

Fast, regional three-dimensional hybrid (1D-Hadamard 2D-rosette) proton MR spectroscopic imaging in the human temporal lobes

1 H-MRSI is commonly performed with gradient phase encoding, due to its simplicity and minimal radio frequency (RF) heating (specific absorption rate). Its two well-known main problems-(i) "voxel bleed" due to the intrinsic point-spread function, and (ii) chemical shift displacement error (CSDE) when slice-selective RF pulses are used, which worsens with increasing volume of interest (VOI) size-have long become accepted as unavoidable. Both problems can be mitigated with Hadamard multislice RF encoding. This is demonstrated and quantified with numerical simulations, in a multislice phantom and in five healthy young adult volunteers at 3 T, targeting a 2-cm thick temporal lobe VOI through the bilateral hippocampus. This frequently targeted region (e.g. in epilepsy and Alzheimer's disease) is subject to strong, 1-2 ppm.cm-1 regional B0, susceptibility gradients that can dramatically reduce the signal-to-noise ratio (SNR) and water suppression effectiveness. The chemical shift imaging (CSI) sequence used a 3-ms Shinnar-Le Roux (SLR) 90° RF pulse, acquiring eight steps in the slice direction. The Hadamard sequence acquired two overlapping slices using the same SLR 90° pulses, under twofold stronger gradients that proportionally halved the CSDE. Both sequences used 2D 20 × 20 rosette spectroscopic imaging (RSI) for in-plane spatial localization and both used RF and gradient performance characteristics that are easily met by all modern MRI instruments. The results show that Hadamard spectroscopic imaging (HSI) suffered dramatically less signal bleed within the VOI compared with CSI (<1% vs. approximately 26% in simulations; and 5%-8% vs. >50%) in a phantom specifically designed to test these effects. The voxels' SNR per unit volume per unit time was also 40% higher for HSI. In a group of five healthy volunteers, we show that HSI with in-plane 2D-RSI facilitates fast, 3D multivoxel encoding at submilliliter spatial resolution, over the bilateral human hippocampus, in under 10 min, with negligible CSDE, spectral and spatial contamination and more than 6% improved SNR per unit time per unit volume.

Applications of magnetic resonance imaging in chemical engineering

While there are many techniques to study phenomena that occur in chemical engineering applications, magnetic resonance imaging (MRI) receives increasing scientific interest. Its non-invasive nature and wealth of parameters with the ability to generate functional images and contrast favors the use of MRI for many purposes, in particular investigations of dynamic phenomena, since it is very sensitive to motion. Recent progress in flow-MRI has led to shorter acquisition times and enabled studies of transient phenomena. Reactive systems can easily be imaged if NMR parameters such as relaxation change along the reaction coordinate. Moreover, materials and devices can be examined, such as batteries by mapping the magnetic field around them.

Fast data acquisition techniques in magnetic resonance spectroscopic imaging

Magnetic resonance spectroscopic imaging (MRSI) is an important technique for assessing the spatial variation of metabolites in vivo. The long scan times in MRSI limit clinical applicability due to patient discomfort, increased costs, motion artifacts, and limited protocol flexibility. Faster acquisition strategies can address these limitations and could potentially facilitate increased adoption of MRSI into routine clinical protocols with minimal addition to the current anatomical and functional acquisition protocols in terms of imaging time. Not surprisingly, a lot of effort has been devoted to the development of faster MRSI techniques that aim to capture the same underlying metabolic information (relative metabolite peak areas and spatial distribution) as obtained by conventional MRSI, in greatly reduced time. The gain in imaging time results, in some cases, in a loss of signal-to-noise ratio and/or in spatial and spectral blurring. This review examines the current techniques and advances in fast MRSI in two and three spatial dimensions and their applications. This review categorizes the acceleration techniques according to their strategy for acquisition of the k-space. Techniques such as fast/turbo-spin echo MRSI, echo-planar spectroscopic imaging, and non-Cartesian MRSI effectively cover the full k-space in a more efficient manner per T_R . On the other hand, techniques such as parallel imaging and compressed sensing acquire fewer k-space points and employ advanced reconstruction algorithms to recreate the spatial-spectral information, which maintains statistical fidelity in test conditions (ie no statistically significant differences on voxel-wise comparisions) with the fully sampled data. The advantages and limitations of each state-of-the-art technique are reviewed in detail, concluding with a note on future directions and challenges in the field of fast spectroscopic imaging.

Reduction of Acquisition time using Partition of the sIgnal Decay in Spectroscopic Imaging technique (RAPID-SI)

To overcome long acquisition times of Chemical Shift Imaging (CSI), a new Magnetic Resonance Spectroscopic Imaging (MRSI) technique called Reduction of Acquisition time by Partition of the sIgnal Decay in Spectroscopic Imaging (RAPID-SI) using blipped phase encoding gradients inserted during signal acquisition was developed. To validate the results using RAPID-SI and to demonstrate its usefulness in terms of acquisition time and data quantification; simulations, phantom and in vivo studies were conducted, and the results were compared to standard CSI. The method was based upon the partition of a magnetic resonance spectroscopy (MRS) signal into sequential sub-signals encoded using blipped phase encoding gradients inserted during signal acquisition at a constant time interval. The RAPID-SI technique was implemented on a clinical 3 T Siemens scanner to demonstrate its clinical utility. Acceleration of data collection was performed by inserting R (R = acceleration factor) blipped gradients along a given spatial direction during data acquisition. Compared to CSI, RAPID-SI reduced acquisition time by the acceleration factor R. For example, a 2D 16x16 data set acquired in about 17 min with CSI, was reduced to approximately 2 min with the RAPID-SI (R = 8). While the SNR of the acquired RAPID-SI signal was lower compared to CSI by approximately the factor √R, it can be improved after data pre-processing and reconstruction. Compared to CSI, RAPID-SI reduces acquisition time, while preserving metabolites information. Furthermore, the method is flexible and could be combined with other acceleration methods such as Parallel Imaging.

Dephasing optimization through coherence order pathway selection (DOTCOPS) for improved crusher schemes in MR spectroscopy

PURPOSE

To develop an algorithm which can robustly eliminate all unwanted coherence pathways for an arbitrary magnetic resonance spectroscopy experiment through the adjustment of the relative amplitudes of crusher gradients, thereby reducing the effects of spurious echoes and mislocalization.

THEORY AND METHODS

The effect of crushing gradients for all coherence pathways was modeled according to the associated physics, and a cost function was optimized which maximally crushes all unwanted coherence pathways, while unaffecting the desired coherence pathway(s). The efficacy of the method was tested versus literature schemes from 2 separate MR spectroscopy (MRS) sequences: sLASER and MEGA-sLASER with both phantom and in vivo experiments.

RESULTS

Improved crushing power for 2 separate MRS sequences was demonstrated for 2 crushing schemes adopted from the literature in both phantom and in vivo data.

CONCLUSION

A novel algorithm and associated software was developed based on rigorous treatment of all coherence pathways, which can be applied to any arbitrary magnetic resonance spectroscopic pulse sequence of interest and any arbitrary coupled spin system. This developed method solves a long-standing problem in in vivo MRS and is expected to critically improve the data quality of virtually all MRS applications.

Magnetic Resonance Spectroscopy and its Clinical Applications: A Review

In vivo NMR spectroscopy is known as magnetic resonance spectroscopy (MRS). MRS has been applied as both a research and a clinical tool in order to detect visible or nonvisible abnormalities. The adaptability of MRS allows a technique that can probe a wide variety of metabolic uses across different tissues. Although MRS is mostly applied for brain tissue, it can be used for detection, localization, staging, tumour aggressiveness evaluation, and tumour response assessment of breast, prostate, hepatic, and other cancers. In this article, the medical applications of MRS in the brain, including tumours, neural and psychiatric disorder studies, breast, prostate, hepatic, gastrointestinal, and genitourinary investigations have been reviewed.

Echo-Planar J-resolved Spectroscopic Imaging using Dual Read-outs: Implementation and Quantitation of Human Brain Metabolites

Attempts have been made to reduce the total scan time in multi-dimensional J-resolved spectroscopic imaging (JRESI) using an echo-planar (EP) readout gradient, but acquisition duration remains a limitation for routine clinical use in the brain. We present here a significant acceleration achieved with a 4D EP-JRESI sequence that collects dual phase encoded lines within a single repetition time (TR) using two bipolar read-out trains. The performance and reliability of this novel 4D sequence, called Multi-Echo based Echo-Planar J-resolved Spectroscopic Imaging (ME-EP-JRESI), was evaluated in 10 healthy controls and a brain phantom using a 3 T MRI/MRS scanner. The prior knowledge fitting (ProFit) algorithm, with a new simulated basis set consisting of macromolecules and lipids apart from metabolites of interest, was used for quantitation. Both phantom and in-vivo data demonstrated that localization and spatial/spectral profiles of metabolites from the ME-EP-JRESI sequence were in good agreement with that of the EP-JRESI sequence. Both in the occipital and temporal lobe, metabolites with higher physiological concentrations including Glx (Glu+Gln), tNAA (NAA+NAAG), mI all had coefficient of variations between 9-25%. In summary, we have implemented, validated and tested the ME-EP-JRESI sequence, demonstrating that multi-echo acquisition can successfully reduce the total scan duration for EP-JRESI sequences.

Fast magnetic resonance spectroscopic imaging techniques in human brain- applications in multiple sclerosis

Multi voxel magnetic resonance spectroscopic imaging (MRSI) is an important imaging tool that combines imaging and spectroscopic techniques. MRSI of the human brain has been beneficially applied to different clinical applications in neurology, particularly in neurooncology but also in multiple sclerosis, stroke and epilepsy. However, a major challenge in conventional MRSI is the longer acquisition time required for adequate signal to be collected. Fast MRSI of the brain in vivo is an alternative approach to reduce scanning time and make MRSI more clinically suitable.Fast MRSI can be categorised into spiral, echo-planar, parallel and turbo imaging techniques, each with its own strengths. After a brief introduction on the basics of non-invasive examination (¹H-MRS) and localization techniques principles, different fast MRSI techniques will be discussed from their initial development to the recent innovations with particular emphasis on their capacity to record neurochemical changes in the brain in a variety of pathologies.The clinical applications of whole brain fast spectroscopic techniques, can assist in the assessment of neurochemical changes in the human brain and help in understanding the roles they play in disease. To give a good example of the utilities of these techniques in clinical context, MRSI application in multiple sclerosis was chosen. The available up to date and relevant literature is discussed and an outline of future research is presented.

Fast frequency-sweep spectroscopic imaging with an ultra-low flip angle

Magnetic resonance (MR) spectroscopic imaging has become an important tool in clinical settings for noninvasively obtaining spatial and metabolic information on a molecular scale. Conventional spectroscopic imaging is acquired in the time domain, and its clinical application is limited by the long acquisition time, restricted spatial coverage, and complex suppression and reconstruction procedures. We introduce a fast MR spectroscopic imaging technique in the frequency domain, termed phase-cycled spectroscopic imaging (PCSI). PCSI uses a balanced steady-state free precession (bSSFP) sequence with an ultra-low flip angle to achieve very high acquisition efficiency with a short repetition time. This approach enables faster frequency sweeping by changing the cycled RF phase and using flexible non-uniform sampling, and it greatly reduces the RF energy deposition in tissue. With its intrinsic water and fat suppression, PCSI more closely resembles routine clinical scans because it eliminates the suppression steps. We demonstrate that it is feasible to acquire PCSI spectra in a phantom and in humans and that PCSI provides an efficient spectroscopic imaging method, even for J-coupled metabolites. PCSI may enable spectroscopic imaging to play a larger role in the clinical assessment of the spatial tissue distribution of metabolites.

Joint effects of gray matter atrophy and altered functional connectivity on cognitive deficits in amnestic mild cognitive impairment patients

BACKGROUND

Gray matter (GM) atrophy and disrupted intrinsic functional connectivity (IFC) are often present in patients with amnestic mild cognitive impairment (aMCI), which shows high risk of developing into Alzheimer's disease. Little is known, however, about the relationship between GM atrophy and altered IFC, and whether they are related to cognitive decline.

METHOD

A total of 30 aMCI and 26 cognitively normal (CN) subjects were recruited for this study. Optimized voxel-based morphometric and resting-state functional connectivity magnetic resonance imaging approaches were performed to measure the GM volumes (GMVs) and atrophy-related IFC, respectively. Multivariate linear regression analysis was used to examine the effects of GM atrophy and IFC on cognitive performance across subjects, after controlling for the effects of age, education, gender and group.

RESULTS

Compared with CN subjects, aMCI subjects showed significantly reduced GMVs and decreased IFC in the frontal-parietal and medial temporal lobe systems. Multivariate regression analysis further demonstrated that the GMVs and decreased IFC simultaneously affected the cognitive function. Specifically, GMVs were positively correlated with cognitive performances, including global cognition and episodic memory, and showed a strong trend in correlation between GMVs and non-episodic memory, whilst IFC was positively correlated with the above three cognitive measures, across all subjects. In addition, significant correlation was found between GMVs and altered IFC strength across all subjects.

CONCLUSIONS

Our findings demonstrated that GMVs and IFC jointly contribute to cognitive performance, and combining quantitative information about GMVs and the strength of functional connectivity may serve as an indicator of cognitive deficits in non-demented elderly.

Evaluation of normal changes in pons metabolites due to aging using turbo spectroscopic imaging

BACKGROUND AND PURPOSE

To date, MRS study of both normal and pathologic brains have focused mainly on the supratentorial regions; few studies have investigated the infratentorial regions. However, the pons, an important structure of the brain, is associated with many neurodegenerative diseases and is often damaged by brain trauma. For MRS study of pontine disease, one must obtain MRS reference data on normal metabolite levels in the pons, including data on how these levels vary with age. The aim of this study was to analyze normal, age-related, metabolic changes in the pons by using turbo spectroscopic imaging.

MATERIALS AND METHODS

Seventy-eight healthy subjects with ages ranging from 5 days to 78 years were included in this study. NAA/Cr, Cho/Cr, and Cho/NAA ratios were measured by using turbo spectroscopic imaging. The 78 cases were divided into 4 groups by age: 0-5, 6-20, 21-50, and older than 50 years. The metabolite levels were compared with observed age-related changes among the groups.

RESULTS

The normal mean pontine metabolite ratios obtained for the combined age groups were NAA/Cr, 2.44 ± 0.45 (mean); Cho/Cr, 1.93 ± 0.25; and Cho/NAA, 0.83 ± 0.28. Statistically significant differences were found in the NAA/Cr between the 0- to 5- and 6- to 20-year-old groups, and among the 6- to 20-, 21- to 50-, and older than 50-year-old groups. A statistically significant difference was found in Cho/Cr between the 0- to 5- and 6- to 20-year-old subjects; however, no differences were found among the 6- to 20-, 21- to 50-, and older than 50-year-old groups. Statistically significant differences in Cho/NAA were also found among the 4 age groups. The NAA/Cr at birth was low, it rose rapidly at 0-5 years, reaching a peak at approximately 10-20 years, and then gradually decreased. The Cho/Cr decreased rapidly at 0-5 years, then continued to decline, and was stable after 20 years of age.

CONCLUSIONS

Turbo spectroscopic imaging is a good method for analyzing normal changes in the pons metabolites during growth, maturation, and aging.

A pilot validation of multi-echo based echo-planar correlated spectroscopic imaging in human calf muscles

A current limitation of MR spectroscopic imaging of multiple skeletal muscles is prolonged scan duration. A significant reduction in the total scan duration using the echo-planar correlated spectroscopic imaging (EP-COSI) sequence was accomplished using two bipolar readout trains with different phase-encoded echoes for one of two spatial dimensions within a single repetition time (TR). The second bipolar readout was used for spatially encoding the outer k-space, whereas the first readout was used for the central k-space only. The performance of this novel sequence, called multi-echo based echo-planar correlated spectroscopic imaging (ME-EPCOSI), was demonstrated by localizing specific key features in calf muscles and bone marrow of 11 healthy volunteers and five subjects with type 2 diabetes (T2D). A 3 T MRI-MRS scanner equipped with a transmit-receive extremity coil was used. Localization of the ME-EPCOSI sequence was in good agreement with the earlier single-readout based EP-COSI sequence and the required scan time was reduced by a factor of two. In agreement with an earlier report using single-voxel based 2D MRS, significantly increased unsaturated pools of intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) and decreased IMCL and EMCL unsaturation indices (UIs) were observed in the soleus and tibialis anterior muscle regions of subjects with T2D compared with healthy controls. In addition, significantly decreased choline content was observed in the soleus of T2D subjects compared with healthy controls. Multi-voxel characterization of IMCL and EMCL ratios and UI in the calf muscle may be useful for the non-invasive assessment of altered lipid metabolism in the pathophysiology of T2D.

Accelerated 1 H MRSI using randomly undersampled spiral-based k-space trajectories

PURPOSE

To develop and evaluate the performance of an acquisition and reconstruction method for accelerated MR spectroscopic imaging (MRSI) through undersampling of spiral trajectories.

THEORY AND METHODS

A randomly undersampled spiral acquisition and sensitivity encoding (SENSE) with total variation (TV) regularization, random SENSE+TV, is developed and evaluated on single-slice numerical phantom, in vivo single-slice MRSI, and in vivo three-dimensional (3D)-MRSI at 3 Tesla. Random SENSE+TV was compared with five alternative methods for accelerated MRSI.

RESULTS

For the in vivo single-slice MRSI, random SENSE+TV yields up to 2.7 and 2 times reduction in root-mean-square error (RMSE) of reconstructed N-acetyl aspartate (NAA), creatine, and choline maps, compared with the denoised fully sampled and uniformly undersampled SENSE+TV methods with the same acquisition time, respectively. For the in vivo 3D-MRSI, random SENSE+TV yields up to 1.6 times reduction in RMSE, compared with uniform SENSE+TV. Furthermore, by using random SENSE+TV, we have demonstrated on the in vivo single-slice and 3D-MRSI that acceleration factors of 4.5 and 4 are achievable with the same quality as the fully sampled data, as measured by RMSE of reconstructed NAA map, respectively.

CONCLUSION

With the same scan time, random SENSE+TV yields lower RMSEs of metabolite maps than other methods evaluated. Random SENSE+TV achieves up to 4.5-fold acceleration with comparable data quality as the fully sampled acquisition. Magn Reson Med 74:13-24, 2015. © 2014 Wiley Periodicals, Inc.

Multidimensional MR spectroscopic imaging of prostate cancer in vivo

Prostate cancer (PCa) is the second most common type of cancer among men in the United States. A major limitation in the management of PCa is an inability to distinguish, early on, cancers that will progress and become life threatening. One-dimensional (1D) proton ((1)H) MRS of the prostate provides metabolic information such as levels of choline (Ch), creatine (Cr), citrate (Cit), and spermine (Spm) that can be used to detect and diagnose PCa. Ex vivo high-resolution magic angle spinning (HR-MAS) of PCa specimens has revealed detection of more metabolites such as myo-inositol (mI), glutamate (Glu), and glutamine (Gln). Due to the J-modulation and signal overlap, it is difficult to quantitate Spm and other resonances in the prostate clearly by single- and multivoxel-based 1D MR spectroscopy. This limitation can be minimized by adding at least one more spectral dimension by which resonances can be spread apart, thereby increasing the spectral dispersion. However, recording of multivoxel-based two-dimensional (2D) MRS such as J-resolved spectroscopy (JPRESS) and correlated spectroscopy (L-COSY) combined with 2D or three-dimensional (3D) magnetic resonance spectroscopic imaging (MRSI) using conventional phase-encoding can be prohibitively long to be included in a clinical protocol. To reduce the long acquisition time required for spatial encoding, the echo-planar spectroscopic imaging (EPSI) technique has been combined with correlated spectroscopy to give four-dimensional (4D) echo-planar correlated spectroscopic imaging (EP-COSI) as well as J-resolved spectroscopic imaging (EP-JRESI) and the multi-echo (ME) variants. Further acceleration can be achieved using non-uniform undersampling (NUS) and reconstruction using compressed sensing (CS). Earlier versions of 2D MRS, theory of 2D MRS, spectral apodization filters, newer developments and the potential role of multidimensional MRS in PCa detection and management will be reviewed here.

Brain proton magnetic resonance spectroscopy: introduction and overview

Magnetic resonance (MR) spectroscopy offers a noninvasive means of assessing in vivo brain metabolites that shed light on cellular concentrations, cell function and dysfunction, cellular energetics, presence of ischemia, and presence of necrosis, among others. Studies obtained at higher field strengths are evolving toward sampling of smaller tissue volumes, greater signal-to-noise ratio, and higher metabolic spatial resolution. This article discusses the usefulness, from the clinical standpoint, of MR spectroscopy in various disorders. However, to be valid and significant the results of MR spectroscopy should always be correlated with their imaging counterparts.

On the utility of spectroscopic imaging as a tool for generating geometrically accurate MR images and parameter maps in the presence of field inhomogeneities and chemical shift effects

Lack of spatial accuracy is a recognized problem in magnetic resonance imaging (MRI) which severely detracts from its value as a stand-alone modality for applications that put high demands on geometric fidelity, such as radiotherapy treatment planning and stereotactic neurosurgery. In this paper, we illustrate the potential and discuss the limitations of spectroscopic imaging as a tool for generating purely phase-encoded MR images and parameter maps that preserve the geometry of an object and allow localization of object features in world coordinates. Experiments were done on a clinical system with standard facilities for imaging and spectroscopy. Images were acquired with a regular spin echo sequence and a corresponding spectroscopic imaging sequence. In the latter, successive samples of the acquired echo were used for the reconstruction of a series of evenly spaced images in the time and frequency domain. Experiments were done with a spatial linearity phantom and a series of test objects representing a wide range of susceptibility- and chemical-shift-induced off-resonance conditions. In contrast to regular spin echo imaging, spectroscopic imaging was shown to be immune to off-resonance effects, such as those caused by field inhomogeneity, susceptibility, chemical shift, f(0) offset and field drift, and to yield geometrically accurate images and parameter maps that allowed object structures to be localized in world coordinates. From these illustrative examples and a discussion of the limitations of purely phase-encoded imaging techniques, it is concluded that spectroscopic imaging offers a fundamental solution to the geometric deficiencies of MRI which may evolve toward a practical solution when full advantage will be taken of current developments with regard to scan time reduction. This perspective is backed up by a demonstration of the significant scan time reduction that may be achieved by the use of compressed sensing for a simple phantom.

Correlation chemical shift imaging with low-power adiabatic pulses and constant-density spiral trajectories

In this work we introduce the concept of correlation chemical shift imaging (CCSI). Novel CCSI pulse sequences are demonstrated on clinical scanners for two-dimensional Correlation Spectroscopy (COSY) and Total Correlation Spectroscopy (TOCSY) imaging experiments. To date there has been limited progress reported towards a feasible and robust multivoxel 2D COSY. Localized 2D TOCSY imaging is shown for the first time in this work. Excitation with adiabatic GOIA-W(16,4) pulses (Gradient Offset Independent Adiabaticity Wurst modulation) provides minimal chemical shift displacement error, reduced lipid contamination from subcutaneous fat, uniform optimal flip angles, and efficient mixing for coupled spins, while enabling short repetition times due to low power requirements. Constant-density spiral readout trajectories are used to acquire simultaneously two spatial dimensions and f(2) frequency dimension in (k(x),k(y),t(2)) space in order to speed up data collection, while f(1) frequency dimension is encoded by consecutive time increments of t(1) in (k(x),k(y),t(1),t(2)) space. The efficient spiral sampling of the k-space enables the acquisition of a single-slice 2D COSY dataset with an 8 × 8 matrix in 8:32  min on 3 T clinical scanners, which makes it feasible for in vivo studies on human subjects. Here we present the first results obtained on phantoms, human volunteers and patients with brain tumors. The patient data obtained by us represent the first clinical demonstration of a feasible and robust multivoxel 2D COSY. Compared to the 2D J-resolved method, 2D COSY and TOCSY provide increased spectral dispersion which scales up with increasing main magnetic field strength and may have improved ability to unambiguously identify overlapping metabolites. It is expected that the new developments presented in this work will facilitate in vivo application of 2D chemical shift correlation MRS in basic science and clinical studies.

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.

Multi-Echo-Based Echo-Planar Spectroscopic Imaging Using a 3T MRI Scanner

The use of spin-echoes has been employed in an Echo-Planar Spectroscopic Imaging (EPSI) sequence to collect multiple phase encoded lines within a single TR in a Multi-Echo-based Echo-Planar Spectroscopic Imaging technique (MEEPSI). Despite the T₂ dependence on the amplitude of the spin-echoes, the Full Width at Half Maximum (FWHM) of the derived multi-echo Point Spread Function (PSF) is shown to decrease, indicating an improved overall spatial resolution without requiring any additional scan time. The improved spatial resolution is demonstrated in the one-dimensional (1D) spatial profiles of the N-Acetyl Aspartate (NAA) singlet along the phase encode dimension in a gray matter phantom. Although the improved spatial resolution comes at the expense of spectral resolution, it is shown in vivo that peak broadening due to T₂* decay is more significant than the loss of resolution from using spin-echoes and therefore does not affect the ability to quantify metabolites using the LCModel fitting algorithm.

MR spectroscopy and spectroscopic imaging of the brain

Magnetic resonance spectroscopy (MRS) and the related technique of magnetic resonance spectroscopic imaging (MRSI) are widely used in both clinical and preclinical research for the non-invasive evaluation of brain metabolism. They are also used in medical practice, although their ultimate clinical value continues to be a source of discussion. This chapter reviews the general information content of brain spectra and commonly used protocols for both MRS and MRSI and also touches on data analysis methods and quantitation. The main focus is on proton MRS for application in humans, but many of the methods are also applicable to other nuclei and studies of animal models as well.

Early assessment of pulmonary inflammation by 19F MRI in vivo

BACKGROUND

Emulsified perfluorocarbons (PFCs) are preferentially phagocytized by monocytes/macrophages and are readily detected by (19)F MRI. This study tests the hypothesis that (19)F MRI can be used to quantitate pulmonary inflammation by tracking of infiltrating PFC-loaded monocytes.

METHODS AND RESULTS

Pneumonia was induced in mice by intratracheal instillation of lipopolysaccharides (LPS) followed by intravenous injection of PFCs. Whereas regular (1)H MRI provided no evidence of lung injury 24 hours after LPS, the concurrent (19)F images clearly show PFC accumulation in both pulmonary lobes. Imaging at 48 hours after LPS revealed signals in (1)H images at the same location as the 24-hour (19)F signals. Thus, progressive pneumonia was first predicted by (19)F MRI early after PFC administration. Without LPS, at no time were (19)F signals observed within the lung. Histology and fluorescence-activated cell sorting (FACS) combined with (19)F MRI confirmed the presence of infiltrating PFC-loaded monocytes/macrophages after LPS challenge. Additional experiments with graded doses of LPS demonstrated that (19)F signal intensity strongly correlated with both LPS dose and pathological markers of lung inflammation. In separate studies, dexamethasone and CGS21680 (adenosine 2A receptor agonist) were used to demonstrate the ability of (19)F MRI to monitor anti-inflammatory therapies.

CONCLUSIONS

PFCs serve as a contrast agent for the prognostic and quantitative assessment of pulmonary inflammation by in vivo (19)F MRI, which is characterized by a high degree of specificity due to the lack of any (19)F background. Because PFCs are biochemically inert, this approach may also be suitable for human applications.

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.

Sensitive J-coupled metabolite mapping using Sel-MQC with selective multi-spin-echo readout

The selective multiple quantum coherence technique is combined with a read gradient to accelerate the measurement of a specific scalar-coupled metabolite. The sensitivities of the localization using pure phase encoding and localization with the read gradient are compared in experiments at high magnetic field strength (17.6 T). Multiple spin-echoes of the selective multiple quantum coherence edited metabolite are acquired using frequency-selective refocusing of the specified molecule group. The frequency-selective refocusing does not affect the J-modulation of a coupled spin system, and the echo time is not limited to a multiple of 1/J to acquire pure in-phase or antiphase signal. The multiple echoes can be used to accelerate the metabolite imaging experiment or to measure the apparent transverse relaxation T(2). A simple phase-shifting scheme is presented, which enables the suppression of editing artifacts resulting from the multiple spin-echoes of the water resonance. The experiments are carried out on phantoms, in which lactate and polyunsaturated fatty acids are edited, and in vivo on tumors, in which lactate content and T(2) are imaged. The method is of particular interest when a fast and sensitive selective multiple quantum coherence editing is necessary, e.g., for spatial three dimensional experiments.

In vivo magnetic resonance spectroscopy: basic methodology and clinical applications

The clinical use of in vivo magnetic resonance spectroscopy (MRS) has been limited for a long time, mainly due to its low sensitivity. However, with the advent of clinical MR systems with higher magnetic field strengths such as 3 Tesla, the development of better coils, and the design of optimized radio-frequency pulses, sensitivity has been considerably improved. Therefore, in vivo MRS has become a technique that is routinely used more and more in the clinic. In this review, the basic methodology of in vivo MRS is described-mainly focused on (1)H MRS of the brain-with attention to hardware requirements, patient safety, acquisition methods, data post-processing, and quantification. Furthermore, examples of clinical applications of in vivo brain MRS in two interesting fields are described. First, together with a description of the major resonances present in brain MR spectra, several examples are presented of deviations from the normal spectral pattern associated with inborn errors of metabolism. Second, through examples of MR spectra of brain tumors, it is shown that MRS can play an important role in oncology.

Ultrashort TE spectroscopic imaging (UTESI): application to the imaging of short T2 relaxation tissues in the musculoskeletal system

PURPOSE

To investigate ultrashort TE spectroscopic imaging (UTESI) of short T2 tissues in the musculoskeletal (MSK) system.

MATERIALS AND METHODS

Ultrashort TE pulse sequence is able to detect rapidly decaying signals from tissues with a short T2 relaxation time. Here a time efficient spectroscopic imaging technique based on a multiecho interleaved variable TE UTE acquisition is proposed for high-resolution spectroscopic imaging of the short T2 tissues in the MSK system. The projections were interleaved into multiple groups with the data for each group being collected with progressively increasing TEs. The small number of projections in each group sparsely but uniformly sampled k-space. Spectroscopic images were generated through Fourier transformation of the time domain images at variable TEs. T2* was quantified through exponential fitting of the time domain images or line shape fitting of the magnitude spectrum. The feasibility of this technique was demonstrated in volunteer and cadaveric specimen studies on a clinical 3T scanner.

RESULTS

UTESI was applied to six cadaveric specimens and four human volunteers. High spatial resolution and contrast images were generated for the deep radial and calcified layers of articular cartilage, menisci, ligaments, tendons, and entheses, respectively. Line shape fitting of the UTESI magnitude spectroscopic images show a short T2* of 1.34 +/- 0.56 msec, 4.19 +/- 0.68 msec, 3.26 +/- 0.34 msec, 1.96 +/- 0.47 msec, and 4.21 +/- 0.38 msec, respectively.

CONCLUSION

UTESI is a time-efficient method to image and characterize the short T2 tissues in the MSK system with high spatial resolution and high contrast.

Single-shot magnetic resonance spectroscopic imaging with partial parallel imaging

A magnetic resonance spectroscopic imaging (MRSI) pulse sequence based on proton-echo-planar-spectroscopic-imaging (PEPSI) is introduced that measures two-dimensional metabolite maps in a single excitation. Echo-planar spatial-spectral encoding was combined with interleaved phase encoding and parallel imaging using SENSE to reconstruct absorption mode spectra. The symmetrical k-space trajectory compensates phase errors due to convolution of spatial and spectral encoding. Single-shot MRSI at short TE was evaluated in phantoms and in vivo on a 3-T whole-body scanner equipped with a 12-channel array coil. Four-step interleaved phase encoding and fourfold SENSE acceleration were used to encode a 16 x 16 spatial matrix with a 390-Hz spectral width. Comparison with conventional PEPSI and PEPSI with fourfold SENSE acceleration demonstrated comparable sensitivity per unit time when taking into account g-factor-related noise increases and differences in sampling efficiency. LCModel fitting enabled quantification of inositol, choline, creatine, and N-acetyl-aspartate (NAA) in vivo with concentration values in the ranges measured with conventional PEPSI and SENSE-accelerated PEPSI. Cramer-Rao lower bounds were comparable to those obtained with conventional SENSE-accelerated PEPSI at the same voxel size and measurement time. This single-shot MRSI method is therefore suitable for applications that require high temporal resolution to monitor temporal dynamics or to reduce sensitivity to tissue movement.

Detection of glutamate and glutamine (Glx) by turbo spectroscopic imaging

Turbo spectroscopic imaging (TSI) is a spin echo spectroscopic imaging technique in which two or more echoes are acquired per excitation to reduce the acquisition time. The application of TSI has primarily been limited to the detection of uncoupled spins because the signal from coupled spins is modulated as a function of echo time. In this work we demonstrate how the TSI sequence can be modified to observe spins like the C(2) protons of Glx (approximately 3.75 ppm) which are involved solely in weak-coupling interactions. The technique exploits the chemical shift displacement effect by employing TSI refocusing pulses that have bandwidths which are less than the chemical shift difference between the target spins and the spins to which they are weakly coupled. The modified TSI sequence rewinds the J-evolution of the target protons in the slice of interest independently of the echo time or echo spacing, thereby removing any signal variation between successive echoes (apart from T(2) relaxation effects). In this study we tailored the narrow-bandwidth TSI sequence for observation of the C(2) Glx protons. The echo time was experimentally optimized to minimize signal contamination from myo-inositol, and the efficacy of the method was verified on phantom solutions of Glx and on brain in vivo.

Medial temporal N-acetyl-aspartate in pediatric major depression

The medial temporal cortex (MTC) has been implicated in the pathogenesis of pediatric major depressive disorder (MDD). Eleven MDD case-control pairs underwent proton magnetic resonance spectroscopic imaging. N-acetyl-aspartate was lower in the left MTC (27%) in MDD patients versus controls. Lower N-acetyl-aspartate concentrations in MDD patients may reflect reduced neuronal viability.

In vivo monitoring of inflammation after cardiac and cerebral ischemia by fluorine magnetic resonance imaging

BACKGROUND

In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).

METHODS AND RESULTS

Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton ((1)H) and fluorine ((19)F) images enabled an exact anatomic localization of PFCs after application. Repetitive (1)H/(19)F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.

CONCLUSIONS

PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic (1)H image and an excellent degree of specificity resulting from the lack of any (19)F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states.

Fast nosological imaging using canonical correlation analysis of brain data obtained by two-dimensional turbo spectroscopic imaging

A new fast and accurate tissue typing technique has recently been successfully applied to prostate MR spectroscopic imaging (MRSI) data. This technique is based on canonical correlation analysis (CCA), a statistical method able to simultaneously exploit the spectral and spatial information characterizing the MRSI data. Here, the performance of CCA is further investigated by using brain data obtained by two-dimensional turbo spectroscopic imaging (2DTSI) from patients affected by glioblastoma. The purpose of this study is to investigate the applicability of CCA when typing tissues of heterogeneous tumors. The performance of CCA is also compared with that of ordinary correlation analysis on simulated as well as in vivo data. The results show that CCA outperforms ordinary correlation analysis in terms of robustness and accuracy.

Sensitivity-encoded (SENSE) proton echo-planar spectroscopic imaging (PEPSI) in the human brain

Magnetic resonance spectroscopic imaging (MRSI) provides spatially resolved metabolite information that is invaluable for both neuroscience studies and clinical applications. However, lengthy data acquisition times, which are a result of time-consuming phase encoding, represent a major challenge for MRSI. Fast MRSI pulse sequences that use echo-planar readout gradients, such as proton echo-planar spectroscopic imaging (PEPSI), are capable of fast spectral-spatial encoding and thus enable acceleration of image acquisition times. Combining PEPSI with recent advances in parallel MRI utilizing RF coil arrays can further accelerate MRSI data acquisition. Here we investigate the feasibility of ultrafast spectroscopic imaging at high field (3T and 4T) by combining PEPSI with sensitivity-encoded (SENSE) MRI using eight-channel head coil arrays. We show that the acquisition of single-average SENSE-PEPSI data at a short TE (15 ms) can be accelerated to 32 s or less, depending on the field strength, to obtain metabolic images of choline (Cho), creatine (Cre), N-acetyl-aspartate (NAA), and J-coupled metabolites (e.g., glutamate (Glu) and inositol (Ino)) with acceptable spectral quality and localization. The experimentally measured reductions in signal-to-noise ratio (SNR) and Cramer-Rao lower bounds (CRLBs) of metabolite resonances were well explained by both the g-factor and reduced measurement times. Thus, this technology is a promising means of reducing the scan times of 3D acquisitions and time-resolved 2D measurements.

Fast mapping of theT2 relaxation time of cerebral metabolites using proton echo-planar spectroscopic imaging (PEPSI)

Metabolite T2 is necessary for accurate quantification of the absolute concentration of metabolites using long-echo-time (TE) acquisition schemes. However, lengthy data acquisition times pose a major challenge to mapping metabolite T2. In this study we used proton echo-planar spectroscopic imaging (PEPSI) at 3T to obtain fast T2 maps of three major cerebral metabolites: N-acetyl-aspartate (NAA), creatine (Cre), and choline (Cho). We showed that PEPSI spectra matched T2 values obtained using single-voxel spectroscopy (SVS). Data acquisition for 2D metabolite maps with a voxel volume of 0.95 ml (32 x 32 image matrix) can be completed in 25 min using five TEs and eight averages. A sufficient spectral signal-to-noise ratio (SNR) for T2 estimation was validated by high Pearson's correlation coefficients between logarithmic MR signals and TEs (R2 = 0.98, 0.97, and 0.95 for NAA, Cre, and Cho, respectively). In agreement with previous studies, we found that the T2 values of NAA, but not Cre and Cho, were significantly different between gray matter (GM) and white matter (WM; P < 0.001). The difference between the T2 estimates of the PEPSI and SVS scans was less than 9%. Consistent spatial distributions of T2 were found in six healthy subjects, and disagreement among subjects was less than 10%. In summary, the PEPSI technique is a robust method to obtain fast mapping of metabolite T2.

Optimizing the efficiency of high-field multivoxel spectroscopic imaging by multiplexing in space and time

A new strategy to yield information from the maximum number of voxels, each at the optimum signal-to-noise ratio (SNR) per unit time, in MR spectroscopic imaging (MRSI) is introduced. In the past, maximum acquisition duty-cycle was obtained by multiplexing in time several single slices each repetition time (TR), while optimal SNR was achieved by encoding the entire volume of interest (VOI) each TR. We show that optimal SNR and acquisition efficiency can both be achieved simultaneously by multiplexing in space and time several slabs of several slices, each. Since coverage of common VOIs in 3D proton MRSI in the human brain typically requires eight or more slices, at 3 T or higher magnetic fields, two or more slabs can fit into the optimum TR (approximately 1.6 s). Since typically four or less slices would then fit into each slab, Hadamard encoding is favored in that direction for slice profile reasons. It is demonstrated that per fixed examination length, the new method gives, at 3 T, twice as many voxels, each of the same SNR and size, compared with current 3D chemical shift imaging techniques. It is shown that this gain will increase for more extensive spatial coverage or higher fields.

Fast 1 H spectroscopic imaging using steady state free precession and spectral–spatial RF pulses

Recently, new methods for fast (1)H spectroscopic imaging based on the condition of steady state free precession (SSFP) were introduced to achieve a high signal-to-noise ratio at short minimum measurement times. In this work, a major improvement is presented to overcome a crucial drawback in some of the former sequences: the lack of spatial selectivity. Good spectral selectivity at very high sampling efficiency can be achieved by using spectral-spatial RF pulses, and combined with localised shimming. Results are shown from both phantom experiments and in vivo studies on the rat brain acquired at 4.7 T.

MR spectroscopy and spectroscopic imaging: comparing 3.0 T versus 1.5 T

In vivo magnetic resonance spectroscopy (MR spectroscopy) offers the unique possibility to monitor human brain metabolism in a noninvasive way. At 3.0 T, MR spectroscopy not only profits from higher available signal compared with 1.5 T, but from increased chemical shift dispersion as well. These gains may be exchanged into increased spatial resolution or speed in MR spectroscopic imaging. However, some adverse effects related to the higher field strength, such as increased field inhomogeneities and sequence restrictions caused by safety limitations need to be considered. These require protocol adaptations and technical advances that have not yet fully found their way onto the clinical platform. If neglected, effects such as chemical shift misregistration at higher field strength can lead to wrong localizations or loss of signals of certain metabolites, which can intervene with the diagnostic value of a spectrum. This article tries to give an understanding of the potentials and challenges of MR spectroscopy at the higher field strength of 3.0 T, and to give insight into new techniques that hopefully soon will become available in daily clinical routine to fully exploit all benefits of the higher field strength.

Cerebral metabolic alterations in McLeod syndrome

The X-linked McLeod neuroacanthocytosis syndrome is a multisystem disorder with central nervous system manifestations resembling Huntington's disease. We examined 5 McLeod patients and 5 asymptomatic heterozygous females with fast multiple spin-echo spectroscopic imaging. Three patients with pronounced psychiatric or cognitive manifestations had pathological N-acetyl aspartate/(creatine + choline) ratios in frontal, temporal, and insular areas, with an individual pattern. Two patients with a severe choreatic movement disorder had unilateral thalamic alterations. One patient with moderate movement disorder and personality disorder had bilateral occipital alterations. One female heterozygote had unilateral insular metabolic alterations, possibly indicating subclinical cerebral involvement. Although the prominent psychiatric and cognitive manifestations in McLeod patients suggest significant and widespread cortical abnormalities, previous neuroradiological and histopathological data had not revealed definite extrastriatal pathology. Our findings demonstrating metabolic abnormalities in different brain regions of McLeod patients might either reflect neuronal dysfunction due to impaired basal ganglia-thalamo-cortical circuits or subtle structural alterations in the particular cerebral areas.

Spatial localization in nuclear magnetic resonance spectroscopy

The ability to select a discrete region within the body for signal acquisition is a fundamental requirement of in vivo NMR spectroscopy. Ideally, it should be possible to tailor the selected volume to coincide exactly with the lesion or tissue of interest, without loss of signal from within this volume or contamination with extraneous signals. Many techniques have been developed over the past 25 years employing a combination of RF coil properties, static magnetic field gradients and pulse sequence design in an attempt to meet these goals. This review presents a comprehensive survey of these techniques, their various advantages and disadvantages, and implications for clinical applications. Particular emphasis is placed on the reliability of the techniques in terms of signal loss, contamination and the effect of nuclear relaxation and J-coupling. The survey includes techniques based on RF coil and pulse design alone, those using static magnetic field gradients, and magnetic resonance spectroscopic imaging. Although there is an emphasis on techniques currently in widespread use (PRESS, STEAM, ISIS and MRSI), the review also includes earlier techniques, in order to provide historical context, and techniques that are promising for future use in clinical and biomedical applications.

Increased medial thalamic creatine-phosphocreatine found by proton magnetic resonance spectroscopy in children with obsessive-compulsive disorder versus major depression and healthy controls

Altered brain creatine-phosphocreatine levels might reflect changes in brain energy use and have been implicated in the pathogenesis of obsessive-compulsive disorder and major depressive disorder. We used proton magnetic resonance spectroscopy to measure absolute concentrations of creatine-phosphocreatine in the right and left medial thalami in 18 pediatric patients with major depressive disorder 9 to 17 years of age, 18 case-matched healthy controls, and 27 patients with obsessive-compulsive disorder 7 to 16 years old. The two patient groups were psychotropic drug naive and were not comorbid for the diagnosis of the comparison group. We found significantly increased left and right medial thalamic creatine-phosphocreatine concentrations in patients with obsessive-compulsive disorder compared with both healthy controls and patients with major depression. Creatine-phosphocreatine concentrations did not differ significantly between patients with major depression and healthy controls. Our data suggest that increased medial thalamic creatine-phosphocreatine concentrations in patients with untreated obsessive-compulsive disorder reflect altered energy use in the medial thalamus and might differentiate patients with obsessive-compulsive disorder from healthy controls and patients with major depression. Although these results must be considered preliminary, further study of the diagnostic specificity of creatine-phosphocreatine in obsessive-compulsive disorder is indicated.