Improved sensitivity to overlapping multiplet signals in in vivo proton spectroscopy using a multiecho volume selective (CPRESS) experiment

High-resolution, 3D multi-TE 1 H MRSI using fast spatiospectral encoding and subspace imaging

PURPOSE

To develop a novel method to achieve fast, high-resolution, 3D multi-TE ¹ H-MRSI of the brain.

METHODS

A new multi-TE MRSI acquisition strategy was developed that integrates slab selective excitation with adiabatic refocusing for better volume coverage, rapid spatiospectral encoding, sparse multi-TE sampling, and interleaved water navigators for field mapping and calibration. Special data processing strategies were developed to interpolate the sparsely sampled data, remove nuisance signals, and reconstruct multi-TE spatiospectral distributions with high SNR. Phantom and in vivo experiments have been carried out to demonstrate the capability of the proposed method.

RESULTS

The proposed acquisition can produce multi-TE ¹ H-MRSI data with three TEs at a nominal spatial resolution of 3.4 × 3.4 × 5.3 mm³ in around 20 min. High-SNR brain metabolite spatiospectral reconstructions can be obtained from both a metabolite phantom and in vivo experiments by the proposed method.

CONCLUSION

High-resolution, 3D multi-TE ¹ H-MRSI of the brain can be achieved within clinically feasible time. This capability, with further optimizations, could be translated to clinical applications and neuroscience studies where simultaneously mapping metabolites and neurotransmitters and TE-dependent molecular spectral changes are of interest.

T2, T2* and spin coupling ratio as biomarkers for the study of lipomatous tumors

BACKGROUND

Subcutaneous fat may have variable signal intensity on T2w images depending on the choice of imaging parameters. However, fatty components within tumors have a different degree of signal dependence on the acquisition scheme. This study examined the use of T2, T2^* relaxometry and spin coupling related signal changes (Spin Coupling ratio, SCr) on two different imaging protocols as clinically relevant descriptors of benign and malignant lipomatous tumors.

MATERIALS AND METHODS

20 patients with benign lipomas or liposarcomas of variable histologic grade were examined at an 1.5 T scanner with Multi Echo Spin Echo (MESE) different echo spacing (ESP) in order to produce bright fat T2w images (ESP: 13.4 ms, 25 equidistant echoes) and dark fat images (ESP: 26.8 ms with 10 equidistant echoes). T2^* relaxometry acquisition comprises 4 sets of in-opposed echoes (2.4-19.2 ms, ESP: 2.4 ms) Multi Echo Gradient Echo (MEGRE) sequence. All parametric maps were calculated on a pixel basis.

RESULTS

Significant differences of SCr were found for five different types of lipomatous tumors (Pairwise t-test with Bonferroni correction): lipomas, well differentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and poorly differentiated liposarcomas. SCr surpassed the classification performance of T2 and T2^* relaxometry.

DATA CONCLUSION

A novel biomarker based on spin coupling related signal loss, SCr, is indicative of lipomatous tumor histological grading. We concluded that T2, T2^* and SCr can be used for the classification of fat containing tumors, which may be important for biopsy guidance in heterogeneous masses and treatment planning.

Improved resolution of glutamate, glutamine and γ-aminobutyric acid with optimized point-resolved spectroscopy sequence timings for their simultaneous quantification at 9.4 T

Glutamine (Gln), glutamate (Glu) and γ-aminobutyric acid (GABA) are relevant brain metabolites that can be measured with magnetic resonance spectroscopy (MRS). This work optimizes the point-resolved spectroscopy (PRESS) sequence echo times, TE₁ and TE₂ , for improved simultaneous quantification of the three metabolites at 9.4 T. Quantification was based on the proton resonances of Gln, Glu and GABA at ≈2.45, ≈2.35 and ≈2.28 ppm, respectively. Glu exhibits overlap with both Gln and GABA; in addition, the Gln peak is contaminated by signal from the strongly coupled protons of N-acetylaspartate (NAA), which resonate at about 2.49 ppm. J-coupling evolution of the protons was characterized numerically and verified experimentally. A {TE₁ , TE₂ } combination of {106 ms, 16 ms} minimized the NAA signal in the Gln spectral region, whilst retaining Gln, Glu and GABA peaks. The efficacy of the technique was verified on phantom solutions and on rat brain in vivo. LCModel was employed to analyze the in vivo spectra. The average T₂ -corrected Gln, Glu and GABA concentrations were found to be 3.39, 11.43 and 2.20 mM, respectively, assuming a total creatine concentration of 8.5 mM. LCModel Cramér-Rao lower bounds (CRLBs) for Gln, Glu and GABA were in the ranges 14-17%, 4-6% and 16-19%, respectively. The optimal TE resulted in concentrations for Gln and GABA that agreed more closely with literature concentrations compared with concentrations obtained from short-TE spectra acquired with a {TE₁ , TE₂ } combination of {12 ms, 9 ms}. LCModel estimations were also evaluated with short-TE PRESS and with the optimized long TE of {106 ms, 16 ms}, using phantom solutions of known metabolite concentrations. It was shown that concentrations estimated with LCModel can be inaccurate when combined with short-TE PRESS, where there is peak overlap, even when low (<20%) CRLBs are reported.

Localized one-dimensional single voxel magnetic resonance spectroscopy without J coupling modulations

PURPOSE

To acquire single voxel localized one-dimensional ¹ H magnetic resonance spectroscopy (MRS) without J coupling modulations, free from amplitude and phase distortions.

METHODS

A pulse sequence, named PRESSIR, is developed for volume localized MRS without J modulations at arbitrary echo time (TE). The J coupling evolution is suppressed by the J-refocused module that uses a 90° pulse at the midpoint of a double spin echo.

RESULTS

The localization performance of the PRESSIR sequence was tested with a two-compartment phantom. The proposed sequence shows similar voxel localization accuracy as PRESS. Both PRESSIR and PRESS sequences were performed on MRS brain phantom and pig brain tissue. PRESS spectra suffer from amplitude and phase distortions due to J modulations, especially under moderate and long TEs, while PRESSIR spectra are almost free from distortions.

CONCLUSION

The PRESSIR sequence proposed herein enables the acquisition of single voxel in-phase MRS within a single scan. It allows an enhanced signal intensity of J coupling metabolites and reducing undesired broad resonances with short T2s while suppressing J modulations. Moreover, it provides an approach for direct measurement of nonoverlapping J coupling peaks and of transverse relaxation times T2s. Magn Reson Med 76:1661-1667, 2016. © 2015 International Society for Magnetic Resonance in Medicine.

Effect of Carr-Purcell refocusing pulse trains on transverse relaxation times of metabolites in rat brain at 9.4 Tesla

PURPOSE

To investigate the effect of Carr-Purcell (CP) pulse trains on transverse relaxation times, T2, of tissue water and metabolites (both noncoupled and J-coupled spins) in the rat brain at 9.4 Tesla (T) using LASER, CP-LASER, and T2ρ-LASER sequences.

METHODS

Proton NMR spectra were measured in rat brain in vivo at 9.4T. Spectra were acquired at multiple echo times ranging from 18 to 402 ms. All spectra were analyzed using LCModel with simulated basis sets. Signals of metabolites as a function of echo time were fitted using a mono-exponential function to determine their T2 relaxation times.

RESULTS

Measured T2 s for tissue water and all metabolites were significantly longer with CP-LASER and T2ρ-LASER compared with LASER. The T2 increased by a factor of ∼ 1.3 for noncoupled and weakly coupled spins (e.g., N-acetylaspartate and total creatine) and by a factor of ∼ 2 (e.g., glutamine and taurine) to ∼ 4 (e.g., glutamate and myo-inositol) for strongly coupled spins.

CONCLUSION

Application of a CP pulse train results in a larger increase in T2 relaxation times for strongly coupled spins than for noncoupled (singlet) and weakly coupled spins. This needs to be taken into account when correcting for T2 relaxation in CP-like sequences such as LASER.

Glutamate and glutamine: a review of in vivo MRS in the human brain

Our understanding of the roles that the amino acids glutamate (Glu) and glutamine (Gln) play in the mammalian central nervous system has increased rapidly in recent times. Many conditions are known to exhibit a disturbance in Glu-Gln equilibrium, and the exact relationships between these changed conditions and these amino acids are not fully understood. This has led to increased interest in Glu/Gln quantitation in the human brain in an array of conditions (e.g. mental illness, tumor, neuro-degeneration) as well as in normal brain function. Accordingly, this review has been undertaken to describe the increasing number of in vivo techniques available to study Glu and Gln separately, or pooled as 'Glx'. The present MRS methods used to assess Glu and Gln vary in approach, complexity, and outcome, thus the focus of this review is on a description of MRS acquisition approaches, and an indication of relative utility of each technique rather than brain pathologies associated with Glu and/or Gln perturbation. Consequently, this review focuses particularly on (1) one-dimensional (1)H MRS, (2) two-dimensional (1)H MRS, and (3) one-dimensional (13)C MRS techniques.

Increase of hippocampal glutamate after electroconvulsive treatment: a quantitative proton MR spectroscopy study at 9.4 T in an animal model of depression

OBJECTIVES

Recent evidence suggests that alterations in hippocampal glutamate and γ-aminobutyric acid (GABA) are associated with the pathomechanism of depression and treatment effects of electroconvulsive therapy (ECT). Thus, proton magnetic resonance spectroscopy (¹H MRS) at a 9.4 T animal system seems a promising tool to study underlying mechanisms since it allows for an accurate quantification of metabolites with distinction of glutamate, GABA and glutamine, as well as separation of taurine from choline.

METHODS

A well-validated animal model of treatment resistant depression (congenital learned helpless rats = cLH) was investigated by hippocampal in vivo ¹H MRS with and without a 1-week course of electroconvulsive shocks (ECS), an animal model of ECT, and compared to wild type (WT) animals, while saline and clomipramine injections served as additional controls.

RESULTS

Untreated cLH rats showed significantly lower glucose and higher taurine concentrations compared to WT animals. Besides alterations on these metabolites, ECS increased glutamate in WT and cLH and choline in cLH rats. Moreover, correlations between glutamate and GABA concentrations with learned helpless behaviour were revealed.

CONCLUSIONS

These findings support the idea of disordered hippocampal metabolism in an animal model of treatment resistant depression and suggest an early impact of ECS on MR-detectable hippocampal metabolites.

The case of the missing glutamine

A theoretical study was performed to determine the accuracy and repeatability of multiple one-dimensional pulse sequences in the quantification of glutamine concentration at 3 T. Variable repeatability (12% to > 50%) and significant absolute error (-50% to +70%) were noted for the eight pulse sequences considered. Data acquired in vivo using three of the pulse sequences used for simulation matched the predicted repeatability well; among the pulse sequences considered, point-resolved spectroscopy (TE = 80 ms) offered minimal error and acceptable repeatability (12%) for brain glutamine measurements. Following correction for the expected bias of each pulse sequence, consistent glutamine measurements, in the 1-mM range, were reported with the three sequences. An explanation for the mismatch between in vivo (1)H MRS and in vitro (13)C/(1)H MRS at high field was attempted.

Improved myo-inositol detection through Carr-Purcell PRESS: a tool for more sensitive mild cognitive impairment diagnosis

A 3-T study is presented, comparing the ability of two (1) H spectroscopy pulse sequences, Carr-Purcell point resolved spectroscopy (CPRESS; TE = 45 msec), and conventional PRESS (TE = 35 msec), to separate between groups of 20 normal control (NC) and 20 mild cognitive impairment (MCI) subjects. Both sequences showed higher myo-inositol (mI) and mI/N-acetyl-aspartate (NAA) levels in the posterior cingulate gyrus of the MCI subjects. The increased intrasubject repeatability of mI and mI/NAA CPRESS measurements (∼ 6% vs. 9% for PRESS) translated into decreased intraclass variability. A 22% intraclass mI PRESS variability was reduced to 16% for CPRESS, and an 18% intraclass mI/NAA PRESS variability was reduced to 12% for CPRESS for the group of NC subjects. Similar results were observed for the MCI subjects. Decreased intraclass variability led to improved separation between NC and MCI subjects (P = 0.017 for PRESS and P < 0.0001 for CPRESS mI/NAA, the best NC/MCI discriminant for each method). Seventy-five percent sensitivity at eighty percent specificity was demonstrated by mI/NAA CPRESS measurements in separating NC from MCI subjects. High correlations were also observed between subject performance on a number of neuropsychological tests (probing verbal memory, visuoconstruction performance, and visual motor integration) and the mI/NAA ratio; higher correlation coefficients (with stronger statistical significance) were consistently evident for CPRESS than for PRESS data.

J-refocused coherence transfer spectroscopic imaging at 7 T in human brain

Short echo spectroscopy is commonly used to minimize signal modulation due to J-evolution of the cerebral amino acids. However, short echo acquisitions suffer from high sensitivity to macromolecules which make accurate baseline determination difficult. In this report, we describe implementation at 7 T of a double echo J-refocused coherence transfer sequence at echo time (TE) of 34 msec to minimize J-modulation of amino acids while also decreasing interfering macromolecule signals. Simulation of the pulse sequence at 7 T shows excellent resolution of glutamate, glutamine, and N-acetyl aspartate. B(1) sufficiency at 7 T for the double echo acquisition is achieved using a transceiver array with radiofrequency (RF) shimming. Using an alternate RF distribution to minimize receiver phase cancellation in the transceiver, accurate phase determination for the coherence transfer is achieved with rapid single scan calibration. This method is demonstrated in spectroscopic imaging mode with n = 5 healthy volunteers resulting in metabolite values consistent with literature and in a patient with epilepsy.

Optimized glutamate detection at 3T

PURPOSE

To identify the pulse sequence and acquisition parameters that result in the most accurate and repeatable measurements of glutamate (Glu) concentration in the brain at 3T.

MATERIALS AND METHODS

Simulations were performed to compare the accuracy and repeatability of 11 pulse sequences and acquisition parameters, within four general classes (PRESS, STEAM, Carr-Purcell PRESS [CPRESS] and TE averaged PRESS [JPRESS]), the majority of which were previously suggested as optimal for Glu detection. Three of the simulated acquisitions were implemented in a clinical scanner and measures of repeatability in vivo were compared to their simulated values.

RESULTS

Good agreement was demonstrated between simulated and experimentally determined measures of repeatability. Among the acquisitions considered, a CPRESS sequence with minimal echo time, together with, possibly, a short TE PRESS sequence, result in the most repeatable within session Glu measurements, while slightly overestimating the Glu concentration. Excellent accuracy is demonstrated by the simulations for a JPRESS sequence, at the expense of lower repeatability than optimal PRESS or CPRESS sequences.

CONCLUSION

Further proof of concept is presented toward validation of a simulation approach to understand pulse sequence performance in measuring the concentration of a given metabolite. Improved within session Glu measurement repeatability is predicted for CPRESS and demonstrated in vivo.

Which pulse sequence is optimal for myo-inositol detection at 3T?

Optimized myo-inositol (mI) detection is important for diagnosing and monitoring a multitude of pathological conditions of the brain. Simulations are presented in this work, performed to decide which pulse sequence has the most significant advantage in terms of improving repeatability and accuracy of mI measurements at 3T over the pulse sequence used typically in the clinic, a TE = 35 ms PRESS sequence. Five classes of pulse sequences, four previously suggested for optimized mI detection (a short TE PRESS, a Carr-Purcell PRESS sequence, an optimized STEAM sequence, an optimized zero quantum filter), and one optimized for mI detection in this work (a single quantum filter) were compared to a standard, TE = 35 ms pulse sequence. While limiting the SNR of an acquisition to the equivalent SNR of a spectrum acquired in 5 min from an 8 cc voxel, it was found through simulations that the most repeatable mI measurements would be obtained with a Carr-Purcell sequence. This sequence was implemented in a clinical scanner, and improved mI measurements were demonstrated in vivo.

Numerical simulations of localized high field 1H MR spectroscopy

The limited bandwidths of volume selective RF pulses in localized in vivo MRS experiments introduce spatial artifacts that complicate spectral quantification of J-coupled metabolites. These effects are commonly referred to as a spatial interference or "four compartment" artifacts and are more pronounced at higher field strengths. The main focus of this study is to develop a generalized approach to numerical simulations that combines full density matrix calculations with 3D localization to investigate the spatial artifacts and to provide accurate prior knowledge for spectral fitting. Full density matrix calculations with 3D localization using experimental pulses were carried out for PRESS (TE=20, 70 ms), STEAM (TE=20, 70 ms) and LASER (TE=70 ms) pulse sequences and compared to non-localized simulations and to phantom solution data at 4 T. Additional simulations at 1.5 and 7 T were carried out for STEAM and PRESS (TE=20 ms). Four brain metabolites that represented a range from weak to strong J-coupling networks were included in the simulations (lactate, N-acetylaspartate, glutamate and myo-inositol). For longer TE, full 3D localization was necessary to achieve agreement between the simulations and phantom solution spectra for the majority of cases in all pulse sequence simulations. For short echo time (TE=20 ms), ideal pulses without localizing gradients gave results that were in agreement with phantom results at 4 T for STEAM, but not for PRESS (TE=20). Numerical simulations that incorporate volume localization using experimental RF pulses are shown to be a powerful tool for generation of accurate metabolic basis sets for spectral fitting and for optimization of experimental parameters.

Localized proton magnetic resonance spectroscopy of lipids in adipose tissue at high spatial resolution in mice in vivo

We describe a localized proton magnetic resonance spectroscopy ((1)H-MRS) method for in vivo measurement of lipid composition in very small voxels (1.5 mm x 1.5 mm x 1.5 mm) in adipose tissue in mice. The method uses localized point-resolved spectroscopy to collect (1)H spectra from voxels in intra-abdominal white adipose tissue (WAT) and brown adipose tissue (BAT) deposits. Nonlinear least-squares fits of the spectra in the frequency domain allow for accurate calculation of the relative amount of saturated, monounsaturated, and polyunsaturated fatty acids. All spectral data are corrected for spin-spin relaxation. The data show BAT of NMRI mice to be significantly different from BAT of NMRI nu/nu mice in all aspects except for the fraction of monounsaturated fatty acids (FM); for WAT, only the FM is different. BAT and WAT of NMRI mice differ in the amount of saturated and di-unsaturated fatty acids. This method provides a potential tool for studying lipid metabolism in small animal models of disease during the initiation, progression, and manifestation of obesity-related disorders in vivo. Our results clearly demonstrate that localized (1)H-MRS of adipose tissue in vivo is possible at high spatial resolution with voxel sizes down to 3.4 ml.

GAVA: spectral simulation for in vivo MRS applications

An application that provides a flexible and easy to use interface to the GAMMA spectral simulation package is described that is targeted at investigations using in vivo MR spectroscopic methods. The program makes available a number of widely used spatially localized MRS pulse sequences and NMR parameters for commonly observed tissue metabolites, enabling spectra to be simulated for any pulse sequence parameter and viewed in an integrated display. The application is interfaced with a database for storage of all simulation parameters and results of the simulations. This application provides a convenient method for generating a priori spectral information used in parametric spectral analyses and for visual examination of the effects of difference pulse sequences and parameter settings.

A phase rotation scheme for achieving very short echo times with localized stimulated echo spectroscopy

In a single-voxel stimulated echo localization sequence in magnetic resonance spectroscopy, magnetic field gradients are inserted within the echo time (TE) to filter signals generated through coherence pathways other than that leading to the stimulated echo. There is a significant penalty for these gradients as they increase the minimum TE, thereby leading to significant signal loss from spin-spin relaxation and phase distortions in coupled spin systems. Here, an RF phase rotation technique is described for a stimulated echo localization sequence that allows removal of the gradients in the TE intervals and, subsequently, reduction of the minimum TE to only 6 ms. Experiments carried out on six healthy volunteers on a 1.5-T whole-body MR system show a significant signal increase in the metabolite concentrations when measured with a 6-ms TE (N-acetyl-aspartate, 12%, P=.002; creatine, 15%, P=.04; and glutamate+glutamine, 92%, P=.02) compared to concentrations measured with data collected at TEs of 15 and 20 ms.

Contribution of proton magnetic resonance spectroscopy to the evaluation of children with unexplained developmental delay

Developmental delay (DD) in children is a common socioeconomic problem with a prevalence of 1-2%. The cause of DD in children is often unknown, and magnetic resonance imaging plays an important role in evaluating children with DD, estimating long-term prognosis, and guiding therapeutic options. The aim of our study on children with DD was to elucidate 1) whether magnetic resonance spectroscopy (MRS) reveals abnormalities in cerebral metabolism and 2) whether there is a correlation between the cognitive performance and the concentration of brain metabolites, especially N-acetylaspartate (NAA), named in the literature a neuronal marker. Using proton MRS of deep gray and central white matter, we measured concentrations of brain metabolites in 48 children, who were aged 1 mo to 13 y and had unexplained DD [developmental quotient (DQ) between <50 and 85] and normal magnetic resonance imaging examinations, and compared them with those of 23 age-matched normal control children. Children with DD were divided into three groups: mild (DQ 76-85), moderate (DQ 51-75), and severe (DQ <50). We found no significant differences in metabolite concentrations, neither among the three groups of children with DD nor between patients and age-matched normal control children. Independent of the degree of mental retardation, the NAA concentrations of handicapped patients and normal children were comparable. We conclude that 1) brain metabolites, especially NAA, in children with unexplained DD are within normal limits, and 2) in most cases, proton MRS adds little information concerning cause of unexplained DD.

In vivo magnetic resonance spectroscopy in cancer

Magnetic resonance spectroscopy (MRS) has been used for more than two decades to interrogate metabolite distributions in living cells and tissues. Techniques have been developed that allow multiple spectra to be obtained simultaneously with individual volume elements as small as 1 uL of tissue (i.e., 1 x 1 x 1 mm(3)). The most common modern applications of in vivo MRS use endogenous signals from (1)H, (31)P, or (23)Na. Important contributions have also been made using exogenous compounds containing (19)F, (13)C, or (17)O. MRS has been used to investigate cardiac and skeletal muscle energetics, neurobiology, and cancer. This review focuses on the latter applications, with specific reference to the measurement of tissue choline, which has proven to be a tumor biomarker that is significantly affected by anticancer therapies.

Observation of coupled 1H metabolite resonances at long TE

A PRESS localization (1)H MRS acquisition sequence with a Carr-Purcell train of refocusing pulses (CP-PRESS) has been implemented using global refocusing "sandwich" pulses. The CP pulse train minimized the effects of J-coupled dephasing in metabolites with strongly coupled, multiplet resonance groups as demonstrated in both phantom data and in vivo single-voxel spectroscopy in normal volunteers. Metabolites with multiplet resonance patterns were maintained with greater signal to noise and a simpler resonance pattern at long echo times. T(2) decay times for metabolites with singlet and multiplet resonances were similar to published values, except for the NAA multiplet at 2.5 ppm, which had a significantly shorter T(2) value (147 ms) than that typically reported for the singlet at 2.01 ppm. Metabolite-nulled spectra were acquired in normal volunteers to evaluate the effects of CP-PRESS on baseline signal contributions from residual water, lipids, and macromolecules. The T(2) decay times in four baseline regions in data acquired with the CP-PRESS sequence showed longer decays than corresponding regions in metabolite-nulled spectra from a standard PRESS sequence, but were significantly diminished long before the metabolites of interest were gone. The spectral analysis for spectra with longer TE times also showed less variability due the higher metabolite SNR, simpler spectral patterns, and the decreased baseline contributions.

Sequence design for magnetic resonance spectroscopic imaging of prostate cancer at 3 T

Magnetic resonance spectroscopic imaging (MRSI) has proven to be a powerful tool for the metabolic characterization of prostate cancer in patients before and following therapy. The metabolites that are of particular interest are citrate and choline because an increased choline-to-citrate ratio can be used as a marker for cancer. High-field systems offer the advantage of improved spectral resolution as well as increased magnetization. Initial attempts at extending MRSI methods to 3 T have been confounded by the J-modulation of the citrate resonances. A new pulse sequence is presented that controls the J-modulation of citrate at 3 T such that citrate is upright, with high amplitude, at a practical echo time. The design of short (14 ms) spectral-spatial refocusing pulses and trains of nonselective refocusing pulses are described. Phantom studies and simulations showed that upright citrate with negligible sidebands is observed at an echo time of 85 ms. Studies in a human subject verified that this behavior is reproduced in vivo and demonstrated that the water and lipid suppression of the new pulse sequence are sufficient for application in prostate cancer patients.

In vivo 1H NMR spectroscopy of individual human brain metabolites at moderate field strengths

This article reviews spectral editing techniques for in vivo 1H NMR spectroscopy of human brain tissue at moderate field strengths of 1.5-3 Tesla. Various aspects of 1H NMR spectroscopy are discussed with regard to in vivo applications. The parameter set [delta, J, n] (delta being the relative chemical shift, J the scalar coupling constant and n the number of coupled spins) is used to characterize the spin systems under investigation and to classify the editing techniques that are used in in vivo 1H NMR spectroscopy.

1H MRS of a boron neutron capture therapy 10B-carrier, L-p-boronophenylalanine-fructose complex, BPA-F: phantom studies at 1.5 and 3.0 T

The quantification of a BNCT 10B-carrier, L-p-boronophenylalanine-fructose complex (BPA-F), was evaluated using 1H magnetic resonance spectroscopy (1H MRS) with phantoms at 1.5 and 3.0 T. For proper quantification, relaxation times T1 and T2 are needed. While T1 is relatively easy to determine, the determination of T2 of a coupled spin system of aromatic protons of BPA is not straightforward with standard MRS sequences. In addition, an uncoupled concentration reference for aromatic protons of BPA must be used with caution. In order to determine T2, the response of an aromatic proton spin system to the MRS sequence PRESS with various echo times was calculated and the product of the response curve with exponential decay was fitted to the measured intensities. Furthermore, the response curve can be used to correct the intensities, when an uncoupled resonance is used as a concentration reference. BPA was quantified using both phantom replacement and internal water referencing methods with accuracies of +/- 5% and +/- 15%. Our phantom results suggest that in vivo studies on BPA concentration determination will be feasible.

Proton magnetic resonance spectroscopy in the brain: report of AAPM MR Task Group #9

AAPM Magnetic Resonance Task Group #9 on proton magnetic resonance spectroscopy (MRS) in the brain was formed to provide a reference document for acquiring and processing proton (1H) MRS acquired from brain tissue. MRS is becoming a common adjunct to magnetic resonance imaging (MRI), especially for the differential diagnosis of tumors in the brain. Even though MR imaging is an offshoot of MR spectroscopy, clinical medical physicists familiar with MRI may not be familiar with many of the common practical issues regarding MRS. Numerous research laboratories perform in vivo MRS on other magnetic nuclei, such as 31P, 13C, and 19F. However, most commercial MR scanners are generally only capable of spectroscopy using the signals from protons. Therefore this paper is of limited scope, giving an overview of technical issues that are important to clinical proton MRS, discussing some common clinical MRS problems, and suggesting how they might be resolved. Some fundamental issues covered in this paper are common to many forms of magnetic resonance spectroscopy and are written as an introduction for the reader to these methods. These topics include shimming, eddy currents, spatial localization, solvent saturation, and post-processing methods. The document also provides an extensive review of the literature to guide the practicing medical physicist to resources that may be useful for dealing with issues not covered in the current article.

Characterization of the macromolecule baseline in localized (1)H-MR spectra of human brain

Short-echo-time magnetic resonance spectra of human brain contain broad contributions from macromolecules. As they are a priori of unknown shape and intensity, they pose a problem if one wants to quantitate the overlying spectral features from low-molecular-weight metabolites. On the other hand, the macromolecular contributions may provide relevant clinical information themselves, if properly evaluated. Several methods, based on T(1), T(2), or spectral shape, have previously been suggested to suppress or edit the macromolecule contributions. Here, a method is presented based on a series of saturation recovery scans and that allows for simultaneous recording of the macromolecular baseline and the fully relaxed metabolite spectrum. In comparison to an inversion recovery technique aimed at nulling signals from long-T(1) components, the saturation recovery method is less susceptible to T(1) differences inherent in signals from different metabolites or introduced by pathology. The saturation recovery method was used to quantitate the macromolecular baseline in white and/or gray matter locations of the human brain in 40 subjects. It was found that the content and composition of MR visible macromolecules depends on cerebral location, as well as the age of the investigated subject, while no gender dependence could be found.

A new method for fast proton spectroscopic imaging: spectroscopic GRASE

A new fast spectroscopic imaging method is presented which allows both a very short minimum total measurement time and effective homonuclear decoupling. After each excitation, all data points from N(GE) k(x)-k(y)-slices at different k(omega)-values are acquired by using a gradient and spin echo (GRASE) imaging sequence. The delay between consecutive gradient echoes, which are measured with uniform phase encoding between consecutive refocusing alpha-pulses, is the inverse of the spectral width (SW). A refocusing 180 degrees pulse, which is applied within a constant delay between excitation and the GRASE sequence, is shifted in a series of measurements by an increment N(GE)/(2 * SW) to cover the whole k(omega)-k(x)-k(y)-space. Spectroscopic GRASE was implemented on a 4.7 T imaging system and tested on phantoms and normal rat brain in vivo. Measurements were performed with a nominal voxel size of 1.5 x 1.5 x 3 mm(3) and a spatial 64 x 64 matrix. The total measurement time was 2 or 4 min using a repetition time of 1.9 sec, 96 chemical shift encoding steps, SW = 800 Hz, N(GE) = 3, and 2 or 4 accumulations.

Reduced glutamate in the anterior cingulate cortex in depression: an in vivo proton magnetic resonance spectroscopy study

BACKGROUND

Functional imaging studies suggest a specific role of the anterior brain regions in the pathogenesis of major depression. The aim of this study was to evaluate possible neurochemical alterations in the frontomesial cortex in patients with major depressive episode using in vivo proton magnetic resonance spectroscopy ((1)H-MRS).

METHODS

Single voxel (1)H-MRS was performed in 19 patients with major depressive episodes and 18 age-matched healthy controls within the anterior cingulate cortex and the parietal white matter. Absolute concentrations were estimated for N-acetyl-aspartate, choline-containing compounds, total creatine, myo-inositol, unresolved glutamate and glutamine (Glx) and glutamate alone (Glu). Voxel composition was analyzed by image segmentation into cerebrospinal fluid (CSF), grey and white matter.

RESULTS

MANOVA test for Glx and Glu using age, percent CSF and percent grey matter contribution as covariates yielded a significant group effect within the anterior cingulate due to decrease of Glx in patients (-10.4%, p =.013). Considering only severely depressed patients, both Glx and Glu (-14.3%, p =.03) showed a significant decrease. There was no significant group effect for the neuronal marker NAA, creatine, choline or myo-inositol in either localization.

CONCLUSIONS

This study suggests a possible role of altered glutamatergic neurotransmission within the anterior cingulate in the pathogenesis of mood disorders. The otherwise unremarkable findings of major brain metabolites confirms lack of neurodegenerative or membrane metabolic changes in major depression.