Fully adiabatic 31P 2D-CSI with reduced chemical shift displacement error at 7 T--GOIA-1D-ISIS/2D-CSI

Phosphorus MRS of healthy human spleen

Phosphorus (³¹ P-) MRS in vivo enables detection and quantification of important phosphorus-containing metabolites in biological tissues. ³¹ P-MRS of the normal spleen is challenging due to the relatively small volume and the larger distance between the spleen and surface coil. However, reference spectra of the healthy spleen are invaluable in studies of splenic malignancies and benign causes of splenomegaly, as well as in the study of its physiology. The purpose of this work was to investigate the feasibility of localized ³¹ P-MRS of healthy spleen in situ in a clinically acceptable measurement time using a clinical 3 T MR scanner. In this work, ³¹ P spectra of five healthy volunteers were measured using single-voxel image-selected in vivo spectroscopy (ISIS). The measurement sequence was augmented by broadband proton decoupling and nuclear Overhauser effect enhancement. It is demonstrated that localized ³¹ P-MRS of the spleen in situ using single-voxel ISIS is feasible on a clinical 3 T scanner in a clinically acceptable acquisition time. However, results have to be corrected for the transmitter excitation profile, and chemical shift displacement errors need to be taken into consideration during placement of the volume of interest. Results presented here could be used as a reference in future studies of splenomegaly caused by haematological malignancies.

Assessment of measurement precision in single-voxel spectroscopy at 7 T: Toward minimal detectable changes of metabolite concentrations in the human brain in vivo

PURPOSE

To introduce a study design and statistical analysis framework to assess the repeatability, reproducibility, and minimal detectable changes (MDCs) of metabolite concentrations determined by in vivo MRS.

METHODS

An unbalanced nested study design was chosen to acquire in vivo MRS data within different repeatability and reproducibility scenarios. A spin-echo, full-intensity acquired localized (SPECIAL) sequence was employed at 7 T utlizing three different inversion pulses: a hyperbolic secant (HS), a gradient offset independent adiabaticity (GOIA), and a wideband, uniform rate, smooth truncation (WURST) pulse. Metabolite concentrations, Cramér-Rao lower bounds (CRLBs) and coefficients of variation (CVs) were calculated. Both Bland-Altman analysis and a restricted maximum-likelihood estimation (REML) analysis were performed to estimate the different variance contributions of the repeatability and reproducibility of the measured concentration. A Bland-Altmann analysis of the spectral shape was performed to assess the variance of the spectral shape, independent of quantification model influences.

RESULTS

For the used setup, minimal detectable changes of brain metabolite concentrations were found to be between 0.40 µmol/g and 2.23 µmol/g. CRLBs account for only 16 % to 74 % of the total variance of the metabolite concentrations. The application of gradient-modulated inversion pulses in SPECIAL led to slightly improved repeatability, but overall reproducibility appeared to be limited by differences in positioning, calibration, and other day-to-day variations throughout different sessions.

CONCLUSION

A framework is introduced to estimate the precision of metabolite concentrations obtained by MRS in vivo, and the minimal detectable changes for 13 metabolite concentrations measured at 7 T using SPECIAL are obtained.

Comparison of four 31P single-voxel MRS sequences in the human brain at 9.4 T

PURPOSE

In this study, different single-voxel localization sequences were implemented and systematically compared for the first time for phosphorous MRS (³¹ P-MRS) in the human brain at 9.4 T.

METHODS

Two multishot sequences, image-selected in vivo spectroscopy (ISIS) and a conventional slice-selective excitation combined with localization by adiabatic selective refocusing (semiLASER) variant of the spin-echo full intensity-acquired localized spectroscopy (SPECIAL-semiLASER), and two single-shot sequences, semiLASER and stimulated echo acquisition mode (STEAM), were implemented and optimized for ³¹ P-MRS in the human brain at 9.4 T. Pulses and coil setup were optimized, localization accuracy was tested in phantom experiments, and absolute SNR of the sequences was compared in vivo. The SNR per unit time (SNR/t) was derived and compared for all four sequences and verified experimentally for ISIS in two different voxel sizes (3 × 3 × 3 cm³ , 5 × 5 × 5 cm³ , 10-minute measurement time). Metabolite signals obtained with ISIS were quantified. The possible spectral quality in vivo acquired in clinically feasible time (3:30 minutes, 3 × 3 × 3 cm³ ) was explored for two different coil setups.

RESULTS

All evaluated sequences performed with good localization accuracy in phantom experiments and provided well-resolved spectra in vivo. However, ISIS has the lowest chemical shift displacement error, the best localization accuracy, the highest SNR/t for most metabolites, provides metabolite concentrations comparable to literature values, and is the only one of the sequences that allows for the detection of the whole ³¹ P spectrum, including β-adenosine triphosphate, with the used setup. The SNR/t of STEAM is comparable to the SNR/t of ISIS. The semiLASER and SPECIAL-semiLASER sequences provide good results for metabolites with long T₂ .

CONCLUSION

At 9.4 T, high-quality single-voxel localized ³¹ P-MRS can be performed in the human brain with different localization methods, each with inherent characteristics suitable for different research issues.

Creatine kinase rate constant in the human heart at 7T with 1D-ISIS/2D CSI localization

PURPOSE

Creatine Kinase (CK) reaction plays an important role in energy metabolism and estimate of its reaction rate constant in heart provides important insight into cardiac energetics. Fast saturation transfer method ([Formula: see text] nominal) to measure CK reaction rate constant (kf) was previously demonstrated in open chest swine hearts. The goal of this work is to further develop this method for measuring the kf in human myocardium at 7T. [Formula: see text] approach is combined with 1D-ISIS/2D-CSI for in vivo spatial localization and myocardial CK forward rate constant was then measured in 7 volunteers at 7T.

METHODS

[Formula: see text] method uses two partially relaxed saturation transfer (ST) spectra and correction factor to determine CK rate constant. Correction factor is determined by numerical simulation of Bloch McConnell equations using known spin and experimental parameters. Optimal parameters and error estimate in calculation of CK reaction rate constant were determined by simulations. The technique was validated in calf muscles by direct comparison with saturation transfer measurements. [Formula: see text] pulse sequence was incorporated with 1D-image selected in vivo spectroscopy, combined with 2D-chemical shift spectroscopic imaging (1D-ISIS/2D-CSI) for studies in heart. The myocardial CK reaction rate constant was then measured in 7 volunteers.

RESULTS

Skeletal muscle kf determined by conventional approach and [Formula: see text] approach were the same 0.31 ± 0.02 s-1 and 0.30 ± 0.04 s-1 demonstrating the validity of the technique. Results are reported as mean ± SD. Myocardial CK reaction rate constant was 0.29 ± 0.05 s-1, consistent with previously reported studies.

CONCLUSION

[Formula: see text] method enables acquisition of 31P saturation transfer MRS under partially relaxed conditions and enables 2D-CSI of kf in myocardium. This work enables applications for in vivo CSI imaging of energetics in heart and other organs in clinically relevant acquisition time.

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.

Dynamic 31 P spectroscopic imaging of skeletal muscles combining flyback echo-planar spectroscopic imaging and compressed sensing

PURPOSE

Dynamic phosphorus MR spectroscopic imaging (³¹ P-MRSI) experiments require temporal resolution on the order of seconds to concurrently assess different muscle groups. A highly accelerated pulse sequence combining flyback echo-planar spectroscopic imaging (EPSI) and compressed sensing was developed and tested in a phantom and healthy humans during an exercise-recovery challenge of the lower leg muscles, using a clinical 3T MRI.

METHODS

A flyback EPSI readout designed to achieve 2.25 × 2.25 cm² resolution over a 18 × 18 cm² field of view (i.e., 8 × 8 matrix) was combined with compressed sensing through the inclusion of pseudorandom gradient blips to sub-sample the ky-kt dimensions by a factor of 2.7×, achieving a temporal resolution of 9 s. The sequence was first tested in a phantom to assess performance compared to fully sampled EPSI (fidEPSI) and phase encoded chemical shift imaging (fidCSI). Then, tests were performed in 11 healthy volunteers during an exercise-recovery challenge of the lower leg muscles. Voxels containing tissue from different muscle groups were evaluated measuring percentage phosphocreatine (%PCr) depletion, time constant of PCr recovery (τPCr) and intracellular pH at rest and following exercise.

RESULTS

The sequence was capable to track the dynamic PCr response of multiple muscles simultaneously. No statistical differences were found in the metabolite ratio, pH or linewidth when compared with fidEPSI and fidCSI in the phantom study. Dynamic experiments showed differences in PCr depletion when comparing soleus with gastrocnemius muscles. Intracellular pH, τPCr and %PCr decrease were consistent with reported values.

CONCLUSION

Highly accelerated ³¹ P-MRSI combining flyback EPSI and compressed sensing is capable of assessing concurrent energy metabolism in multiple muscle groups using a clinical 3T MR system.

Pros and cons of ultra-high-field MRI/MRS for human application

Magnetic resonance imaging and spectroscopic techniques are widely used in humans both for clinical diagnostic applications and in basic research areas such as cognitive neuroimaging. In recent years, new human MR systems have become available operating at static magnetic fields of 7 T or higher (≥300 MHz proton frequency). Imaging human-sized objects at such high frequencies presents several challenges including non-uniform radiofrequency fields, enhanced susceptibility artifacts, and higher radiofrequency energy deposition in the tissue. On the other side of the scale are gains in signal-to-noise or contrast-to-noise ratio that allow finer structures to be visualized and smaller physiological effects to be detected. This review presents an overview of some of the latest methodological developments in human ultra-high field MRI/MRS as well as associated clinical and scientific applications. Emphasis is given to techniques that particularly benefit from the changing physical characteristics at high magnetic fields, including susceptibility-weighted imaging and phase-contrast techniques, imaging with X-nuclei, MR spectroscopy, CEST imaging, as well as functional MRI. In addition, more general methodological developments such as parallel transmission and motion correction will be discussed that are required to leverage the full potential of higher magnetic fields, and an overview of relevant physiological considerations of human high magnetic field exposure is provided.

Evaluation of cardiac energetics by non-invasive 31P magnetic resonance spectroscopy

Alterations in myocardial energy metabolism have been implicated in the pathophysiology of cardiac diseases such as heart failure and diabetic cardiomyopathy. ³¹P magnetic resonance spectroscopy (MRS) is a powerful tool to investigate cardiac energetics non-invasively in vivo, by detecting phosphorus (³¹P)-containing metabolites involved in energy supply and buffering. In this article, we review the historical development of cardiac ³¹P MRS, the readouts used to assess cardiac energetics from ³¹P MRS, and how ³¹P MRS studies have contributed to the understanding of cardiac energy metabolism in heart failure and diabetes. This article is part of a Special issue entitled Cardiac adaptations to obesity, diabetes and insulin resistance, edited by Professors Jan F.C. Glatz, Jason R.B. Dyck and Christine Des Rosiers.

Ultra-high-field magnetic resonance spectroscopy in non-alcoholic fatty liver disease: Novel mechanistic and diagnostic insights of energy metabolism in non-alcoholic steatohepatitis and advanced fibrosis

BACKGROUND & AIMS

With the rising prevalence of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) non-invasive tools obtaining pathomechanistic insights to improve risk stratification are urgently needed. We therefore explored high- and ultra-high-field magnetic resonance spectroscopy (MRS) to obtain novel mechanistic and diagnostic insights into alterations of hepatic lipid, cell membrane and energy metabolism across the spectrum of NAFLD.

METHODS

MRS and liver biopsy were performed in 30 NAFLD patients with NAFL (n=8) or NASH (n=22). Hepatic lipid content and composition were measured using 3-Tesla proton (¹ H)-MRS. 7-Tesla phosphorus (³¹ P)-MRS was applied to determine phosphomonoester (PME) including phosphoethanolamine (PE), phosphodiester (PDE) including glycerophosphocholine (GPC), phosphocreatine (PCr), nicotinamide adenine dinucleotide phosphate (NADPH), inorganic phosphate (Pi), γ-ATP and total phosphorus (TP). Saturation transfer technique was used to quantify hepatic ATP flux.

RESULTS

Hepatic steatosis in ¹ H-MRS highly correlated with histology (P<.001) showing higher values in NASH than NAFL (P<.001) without differences in saturated or unsaturated fatty acid indices. PE/TP ratio increased with advanced fibrosis (F3/4) (P=.002) whereas GPC/PME+PDE decreased (P=.05) compared to no/mild fibrosis (F0-2). γ-ATP/TP was lower in advanced fibrosis (P=.049), while PCr/TP increased (P=.01). NADPH/TP increased with higher grades of ballooning (P=.02). Pi-to-ATP exchange rate constant (P=.003) and ATP flux (P=.001) were lower in NASH than NAFL.

CONCLUSIONS

Ultra-high-field MRS, especially saturation transfer technique uncovers changes in energy metabolism including dynamic ATP flux in inflammation and fibrosis in NASH. Non-invasive profiling by MRS appears feasible and may assist further mechanistic and therapeutic studies in NAFLD/NASH.

High-resolution 31 P echo-planar spectroscopic imaging in vivo at 7T

PURPOSE

Conventional ³¹ P chemical shift imaging is time-consuming and yields only limited spatial resolution. The purpose of this study was to demonstrate feasibility of ³¹ P echo-planar spectroscopic imaging (EPSI) in vivo at 7T.

METHODS

A 3D ³¹ P EPSI sequence with trapezoidal-shaped gradient pulses was implemented on a 7T MR scanner. To increase spectral width with reduced demand on gradient performance, a multishot approach was chosen. Acquisition weighting and ³¹ P-{¹ H} double resonance for nuclear Overhauser signal enhancement were applied to increase sensitivity.

RESULTS

3D ³¹ P-{¹ H} EPSI data from model solution and from human calf muscle and brain were obtained from voxels with effective sizes of 4.1 to 16.2 cm³ in measurement times of approximately 10 min. Individual spectra showed well-resolved resonances of endogenous ³¹ P-metabolites without artifacts. Volumetric high-resolution ³¹ P-metabolite maps in vivo showed metabolic heterogeneity of different tissues.

CONCLUSION

In vivo ³¹ P EPSI at 7T yields high-quality metabolic images. The proposed multishot EPSI technique reduces the measurement times for acquisition of volumetric high-resolution maps of ³¹ P-metabolites or intracellular pH in human studies. Magn Reson Med 79:1251-1259, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

In-vivo31P-MRS of skeletal muscle and liver: A way for non-invasive assessment of their metabolism

In addition to direct assessment of high energy phosphorus containing metabolite content within tissues, phosphorus magnetic resonance spectroscopy (³¹P-MRS) provides options to measure phospholipid metabolites and cellular pH, as well as the kinetics of chemical reactions of energy metabolism in vivo. Even though the great potential of ³¹P-MR was recognized over 30 years ago, modern MR systems, as well as new, dedicated hardware and measurement techniques provide further opportunities for research of human biochemistry. This paper presents a methodological overview of the ³¹P-MR techniques that can be used for basic, physiological, or clinical research of human skeletal muscle and liver in vivo. Practical issues of ³¹P-MRS experiments and examples of potential applications are also provided. As signal localization is essential for liver ³¹P-MRS and is important for dynamic muscle examinations as well, typical localization strategies for ³¹P-MR are also described.

Dynamic 31 P-MRSI using spiral spectroscopic imaging can map mitochondrial capacity in muscles of the human calf during plantar flexion exercise at 7 T

Phosphorus MRSI (³¹ P-MRSI) using a spiral-trajectory readout at 7 T was developed for high temporal resolution mapping of the mitochondrial capacity of exercising human skeletal muscle. The sensitivity and localization accuracy of the method was investigated in phantoms. In vivo performance was assessed in 12 volunteers, who performed a plantar flexion exercise inside a whole-body 7 T MR scanner using an MR-compatible ergometer and a surface coil. In five volunteers the knee was flexed (~60°) to shift the major workload from the gastrocnemii to the soleus muscle. Spiral-encoded MRSI provided 16-25 times faster mapping with a better point spread function than elliptical phase-encoded MRSI with the same matrix size. The inevitable trade-off for the increased temporal resolution was a reduced signal-to-noise ratio, but this was acceptable. The phosphocreatine (PCr) depletion caused by exercise at 0° knee angulation was significantly higher in both gastrocnemii than in the soleus (i.e. 64.8 ± 19.6% and 65.9 ± 23.6% in gastrocnemius lateralis and medialis versus 15.3 ± 8.4% in the soleus). Spiral-encoded ³¹ P-MRSI is a powerful tool for dynamic mapping of exercising muscle oxidative metabolism, including localized assessment of PCr concentrations, pH and maximal oxidative flux with high temporal and spatial resolution.

(31)P CSI of the human brain in healthy subjects and tumor patients at 9.4 T with a three-layered multi-nuclear coil: initial results

OBJECTIVE

Investigation of the feasibility and performance of phosphorus ((31)P) magnetic resonance spectroscopic imaging (MRSI) at 9.4 T with a three-layered phosphorus/proton coil in human normal brain tissue and tumor.

MATERIALS AND METHODS

A multi-channel (31)P coil was designed to enable MRSI of the entire human brain. The performance of the coil was evaluated by means of electromagnetic field simulations and actual measurements. A 3D chemical shift imaging approach with a variable repetition time and flip angle was used to increase the achievable signal-to-noise ratio of the acquired (31)P spectra. The impact of the resulting k-space modulation was investigated by simulations. Three tumor patients and three healthy volunteers were scanned and differences between spectra from healthy and cancerous tissue were evaluated qualitatively.

RESULTS

The high sensitivity provided by the 27-channel (31)P coil allowed acquiring CSI data in 22 min with a nominal voxel size of 15 × 15 × 15 mm(3). Shimming and anatomical localization could be performed with the integrated four-channel proton dipole array. The amplitudes of the phosphodiesters and phosphoethanolamine appeared reduced in tumorous tissue for all three patients. A neutral or slightly alkaline pH was measured within the brain lesions.

CONCLUSION

These initial results demonstrate that (31)P 3D CSI is feasible at 9.4 T and could be performed successfully in healthy subjects and tumor patients in under 30 min.

Optimized (31)P MRS in the human brain at 7 T with a dedicated RF coil setup

The design and construction of a dedicated RF coil setup for human brain imaging ((1)H) and spectroscopy ((31)P) at ultra-high magnetic field strength (7 T) is presented. The setup is optimized for signal handling at the resonance frequencies for (1)H (297.2 MHz) and (31)P (120.3 MHz). It consists of an eight-channel (1)H transmit-receive head coil with multi-transmit capabilities, and an insertable, actively detunable (31)P birdcage (transmit-receive and transmit only), which can be combined with a seven-channel receive-only (31)P array. The setup enables anatomical imaging and (31)P studies without removal of the coil or the patient. By separating transmit and receive channels and by optimized addition of array signals with whitened singular value decomposition we can obtain a sevenfold increase in SNR of (31)P signals in the occipital lobe of the human brain compared with the birdcage alone. These signals can be further enhanced by 30 ± 9% using the nuclear Overhauser effect by B1-shimmed low-power irradiation of water protons. Together, these features enable acquisition of (31)P MRSI at high spatial resolutions (3.0 cm(3)  voxel) in the occipital lobe of the human brain in clinically acceptable scan times (~15 min).

Dynamic PCr and pH imaging of human calf muscles during exercise and recovery using (31) P gradient-Echo MRI at 7 Tesla

PURPOSE

Simultaneous acquisition of spatially resolved (31) P-MRI data for evaluation of muscle specific energy metabolism, i.e., PCr and pH kinetics.

METHODS

A three-dimensional (3D) gradient-echo sequence for multiple frequency-selective excitations of the PCr and Pi signals in an interleaved sampling scheme was developed and tested at 7 Tesla (T). The pH values were derived from the chemical shift-induced phase difference between the resonances. The achieved spatial resolution was ∼2 mL with image acquisition time below 6 s. Ten healthy volunteers were studied performing plantar flexions during the delay between (31) P-MRI acquisitions, yielding a temporal resolution of 9-10 s.

RESULTS

Signal from anatomically matched regions of interest had sufficient signal-to-noise ratio to allow single-acquisition PCr and pH quantification. The Pi signal was clearly detected in voxels of actively exercising muscles. The PCr depletions were in gastrocnemius 42 ± 14% (medialis), 48 ± 17% (lateralis) and in soleus 20 ± 11%. The end exercise pH values were 6.74 ± 0.18 and 6.65 ± 0.27 for gastrocnemius medialis and lateralis, respectively, and 6.96 ± 0.12 for soleus muscle.

CONCLUSION

Simultaneous acquisition of PCr and Pi images with high temporal resolution, suitable for measuring PCr and pH kinetics in exercise-recovery experiments, was demonstrated at 7T. This study presents a fast alternative to MRS for quantifying energy metabolism of posterior muscle groups of the lower leg. Magn Reson Med 75:2324-2331, 2016. © 2015 Wiley Periodicals, Inc.

Depth-resolved surface coil MRS (DRESS)-localized dynamic (31) P-MRS of the exercising human gastrocnemius muscle at 7 T

Dynamic (31) P-MRS with sufficiently high temporal resolution enables the non-invasive evaluation of oxidative muscle metabolism through the measurement of phosphocreatine (PCr) recovery after exercise. Recently, single-voxel localized (31) P-MRS was compared with surface coil localization in a dynamic fashion, and was shown to provide higher anatomical and physiological specificity. However, the relatively long TE needed for the single-voxel localization scheme with adiabatic pulses limits the quantification of J-coupled spin systems [e.g. adenosine triphosphate (ATP)]. Therefore, the aim of this study was to evaluate depth-resolved surface coil MRS (DRESS) as an alternative localization method capable of free induction decay (FID) acquisition for dynamic (31) P-MRS at 7 T. The localization performance of the DRESS sequence was tested in a phantom. Subsequently, two dynamic examinations of plantar flexions at 25% of maximum voluntary contraction were conducted in 10 volunteers, one examination with and one without spatial localization. The DRESS slab was positioned obliquely over the gastrocnemius medialis muscle, avoiding other calf muscles. Under the same load, significant differences in PCr signal drop (31.2 ± 16.0% versus 43.3 ± 23.4%), end exercise pH (7.06 ± 0.02 versus 6.96 ± 0.11), initial recovery rate (0.24 ± 0.13 mm/s versus 0.35 ± 0.18 mm/s) and maximum oxidative flux (0.41 ± 0.14 mm/s versus 0.54 ± 0.16 mm/s) were found between the non-localized and DRESS-localized data, respectively. Splitting of the inorganic phosphate (Pi) signal was observed in several non-localized datasets, but in none of the DRESS-localized datasets. Our results suggest that the application of the DRESS localization scheme yielded good spatial selection, and provided muscle-specific insight into oxidative metabolism, even at a relatively low exercise load. In addition, the non-echo-based FID acquisition allowed for reliable detection of ATP resonances, and therefore calculation of the specific maximum oxidative flux, in the gastrocnemius medialis using standard assumptions about resting ATP concentration in skeletal muscle.

Application of localized ³¹P MRS saturation transfer at 7 T for measurement of ATP metabolism in the liver: reproducibility and initial clinical application in patients with non-alcoholic fatty liver disease

OBJECTIVES

Saturation transfer (ST) phosphorus MR spectroscopy ((31)P MRS) enables in vivo insight into energy metabolism and thus could identify liver conditions currently diagnosed only by biopsy. This study assesses the reproducibility of the localized (31)P MRS ST in liver at 7 T and tests its potential for noninvasive differentiation of non-alcoholic fatty liver (NAFL) and steatohepatitis (NASH).

METHODS

After the ethics committee approval, reproducibility of the localized (31)P MRS ST at 7 T and the biological variation of acquired hepato-metabolic parameters were assessed in healthy volunteers. Subsequently, 16 suspected NAFL/NASH patients underwent MRS measurements and diagnostic liver biopsy. The Pi-to-ATP exchange parameters were compared between the groups by a Mann-Whitney U test and related to the liver fat content estimated by a single-voxel proton ((1)H) MRS, measured at 3 T.

RESULTS

The mean exchange rate constant (k) in healthy volunteers was 0.31 ± 0.03 s(-1) with a coefficient of variation of 9.0 %. Significantly lower exchange rates (p < 0.01) were found in NASH patients (k = 0.17 ± 0.04 s(-1)) when compared to healthy volunteers, and NAFL patients (k = 0.30 ± 0.05 s(-1)). Significant correlation was found between the k value and the liver fat content (r = 0.824, p < 0.01).

CONCLUSIONS

Our data suggest that the (31)P MRS ST technique provides a tool for gaining insight into hepatic ATP metabolism and could contribute to the differentiation of NAFL and NASH.

KEY POINTS

• 1D localized (31) P MRS saturation transfer in the liver is reproducible at 7 T • NASH patients have decreased hepatic Pi-to-ATP exchange rate • In this study, hepatic metabolic activity correlates with liver fat content.

MRI at 7 Tesla and above: demonstrated and potential capabilities

With more than 40 installed MR systems worldwide operating at 7 Tesla or higher, ultra-high-field (UHF) imaging has been established as a platform for clinically oriented research in recent years. Along with technical developments that, in part, have also been successfully transferred to lower field strengths, MR imaging and spectroscopy at UHF have demonstrated capabilities and potentials for clinical diagnostics in a variety of studies. In terms of applications, this overview article focuses on already achieved advantages for in vivo imaging, i.e., in imaging the brain and joints of the musculoskeletal system, but also considers developments in body imaging, which is particularly challenging. Furthermore, new applications for clinical diagnostics such as X-nuclei imaging and spectroscopy, which only really become feasible at ultra-high magnetic fields, will be presented.

One-dimensional image-selected in vivo spectroscopy localized phosphorus saturation transfer at 7T

PURPOSE

To evaluate the feasibility of a one-dimensional image-selected in vivo spectroscopy (1D-ISIS) saturation transfer (ST) sequence at 7T for localized in vivo measurements of energy metabolism in different tissues in clinically reasonable examination times.

METHODS

The performance of a gradient offset independent adiabacity-based 1D-ISIS localization was tested on phantom and the localized ST sequence was compared with the nonlocalized version in vivo. We performed localized measurements of basal metabolism of human liver and different muscle groups of the calf. Localized ST experiments took 15-25 minutes.

RESULTS

The selectivity of the 1D-ISIS sequence was 81.63% and the outer volume suppression was 97.57%. The ST parameters acquired with the 1D-ISIS sequence and with the nonlocalized acquisition in the muscle were not statistically different. The forward rate constants for phosphocreatine (PCr)-adenosine triphosphate (ATP) and inorganic phosphate (Pi)-ATP exchange reactions were measured in the soleus (kCK  = 0.30 ± 0.06 s(-1) and kATP  = 0.11 ± 0.02 s(-1) , respectively) and in the medial gastrocnemius (kCK  = 0.27 ± 0.06 s(-1) and kATP  = 0.09 ± 0.03s(-1) , respectively) in 15 minutes per muscle group. The corresponding fluxes were FCK  = 6.26 ± 1.28 μmol/g/s, FATP  = 0.22 ± 0.05 μmol/g/s and FCK  = 6.29 ± 1.66 μmol/g/s, FATP  = 0.21 ± 0.07 μmol/g/s, for soleus and gastrocnemius, respectively. The hepatic ATP synthesis measurement was feasible in 24 minutes.

CONCLUSION

The fast assessment of PCr-ATP and Pi-ATP exchange rates at 7T makes the 1D-ISIS ST sequence a promising tool for examining local resting-state metabolism in clinically acceptable measurement times.

In vivo relaxation behavior of liver compounds at 7 Tesla, measured by single-voxel proton MR spectroscopy

PURPOSE

To assess the proton T1 and T2 relaxation of in vivo hepatic water, choline and lipid resonances with possible J-coupling behavior of lipids in healthy volunteers at 7 Tesla (T).

MATERIALS AND METHODS

Relaxation measurements were conducted on corn oil phantoms and on the hepatic tissue of 11 healthy volunteers at 7 T using a surface coil and a STEAM sequence. T1 's were determined by monoexponential fitting, and T2 's by both monoexponential and enhanced-exponential fitting (empirically designed to consider J-coupling of lipid resonances).

RESULTS

In vivo T1 's at 7 T were estimated as follows: water (4.70 ppm), 1362 ± 83 ms; methyl- (0.90 ppm), 1026 ± 162 ms; methylene- (1.30 ppm), 514 ± 25 ms; α-olefinic- (2.02 ppm), 488 ± 220 ms; α-carboxyl- (2.24 ppm), 476 ± 89 ms; diacyl- (2.77 ppm), 479 ± 260 ms group of lipid chains; and choline compounds (3.22 ppm), 1084 ± 52 ms. The T2 's calculated with enhanced fitting were as follows: water, 15 ± 2 ms; methyl-, 34 ± 10 ms; methylene-, 41 ± 8 ms; α-olefinic-, 44 ± 19 ms; α-carboxyl-, 39 ± 15 ms; diacyl-, 44 ± 5 ms group of lipid chains; and choline compounds, 32 ± 9 ms.

CONCLUSION

An accurate knowledge of in vivo relaxation and J-coupling behavior will significantly improve the quantification of an extended number of resolved liver metabolites at 7 T.

Flip-angle mapping of 31P coils by steady-state MR spectroscopic imaging

PURPOSE

Phosphorus ((31)P) MR spectroscopic imaging (MRSI) is primarily applied with sensitive, surface radiofrequency (RF) coils that provide inhomogeneous excitation RF field (B1(+)) and rough localization due to their B1(+) and sensitivity (B1(-)) profiles. A careful and time-consuming pulse adjustment and an accurate knowledge of flip angle (FA) are mandatory for quantification corrections.

MATERIALS AND METHODS

In this study, a simple, fast, and universal (31)P B1(+) mapping method is proposed, which requires fast steady-state MRSI (typically one sixth of normal measurement time) in addition to the typical MRSI acquired within the examination protocol. The FA maps are calculated from the ratio of the signal intensities acquired by these two measurements and were used to correct for the influence of B1(+) on the metabolite maps.

RESULTS

In vitro tests were performed on two scanners (3 and 7 Tesla) using a surface and a volume coil. The calculated FA maps were in good agreement with adjusted nominal FAs and the theoretical calculation using the Biot-Savart law. The method was successfully tested in vivo in the calf muscle and the brain of healthy volunteers (n = 4). The corrected metabolite maps show higher homogeneity compared with their noncorrected versions.

CONCLUSION

The calculated FA maps helped with B1(+) inhomogeneity corrections of acquired in vivo data, and should also be useful with optimization and testing of pulse performances, or with the construction quality tests of new dual-channel (1)H/(31)P coils.