In vivo characterization of the downfield part of1H MR spectra of human brain at 9.4 T: Magnetization exchange with water and relation to conventionally determined metabolite content

Quantification of NAD+ T1 and T2 Relaxation Times Using Downfield 1H MRS at 7 T in Human Brain In Vivo

The purpose of this study was to measure T1 and T2 relaxation times of NAD+ proton resonances in the downfield 1H MRS spectrum in human brain at 7 T in vivo and to assess the propagation of relaxation time uncertainty in NAD+ quantification. Downfield spectra from eight healthy volunteers were acquired at multiple echo times to measure T2 relaxation times, and saturation recovery data were acquired to measure T1 relaxation times. The downfield acquisition used a spectrally selective 90° sinc pulse for excitation centered at 9.1 ppm with a bandwidth of 2 ppm, followed by a 180° spatially selective Shinnar-Le Roux refocusing pulse for localization. Uncertainty propagation analysis on metabolite quantification was performed analytically and with Monte Carlo simulation. [NAD+] was quantified in five participants. The mean ± standard deviation of T1 relaxation times of the H2, H6, and H4 NAD+ protons were 205.6 ± 25.7, 211.6 ± 33.5, and 237.3 ± 42.4 ms, respectively. The mean ± standard deviation of T2 relaxation times of the H2, H6, and H4 protons were 33.6 ± 7.4, 29.1 ± 4.7, and 42.3 ± 11.6 ms, respectively. The relative uncertainty in NAD+ concentration due to relaxation time uncertainty was 8.4%-11.4%, and measured brain [NAD+] (N = 5) was 0.324 ± 0.050 mM. Using downfield spectrally selective spectroscopy with single-slice localization, we found T1 and T2 relaxation times averaged across all NAD+ resonances to be approximately 218 and 35 ms, respectively, in the human brain in vivo at 7 T.

Optimization of 1H-MRS methods for large-volume acquisition of low-concentration downfield resonances at 3 T and 7 T

PURPOSE

This goal of this study was to optimize spectrally selective 1H-MRS methods for large-volume acquisition of low-concentration metabolites with downfield resonances at 7 T and 3 T, with particular attention paid to detection of nicotinamide adenine dinucleotide (NAD+) and tryptophan.

METHODS

Spectrally selective excitation was used to avoid magnetization-transfer effects with water, and various sinc pulses were compared with a band-selective, uniform response, pure-phase (E-BURP) pulse. Localization using a single-slice selective pulse was compared with voxel-based localization that used three orthogonal refocusing pulses, and low bandwidth refocusing pulses were used to take advantage of the chemical shift displacement of water. A technique for water sideband removal was added, and a method of coil channel combination for large volumes was introduced.

RESULTS

Proposed methods were compared qualitatively with previously reported techniques at 7 T. Sinc pulses resulted in reduced water signal excitation and improved spectral quality, with a symmetric, low bandwidth-time product pulse performing best. Single-slice localization allowed shorter TEs with large volumes, enhancing signal, whereas low-bandwidth slice-selective localization greatly reduced the observed water signal. Gradient cycling helped remove water sidebands, and frequency aligning and pruning individual channels narrowed spectral linewidths. High-quality brain spectra of NAD+ and tryptophan are shown in 4 subjects at 3 T.

CONCLUSION

Improved spectral quality with higher downfield signal, shorter TE, lower nuisance signal, reduced artifacts, and narrower peaks was realized at 7 T. These methodological improvements allowed for previously unachievable detection of NAD+ and tryptophan in human brain at 3 T in under 5 min.

High-field downfield MR spectroscopic imaging in the human brain

PURPOSE

To investigate the feasibility of downfield MR spectroscopic imaging (DF-MRSI) in the human brain at 7T.

METHODS

A 7T DF-MRSI pulse sequence was implemented based on the previously described methodology at 3T, with 3D phase-encoding,1 3 ‾ 3 1 ‾ $$ 1\overline{3}3\overline{1} $$ spectral-spatial excitation, and frequency selective refocusing. Data were pre-processed followed by analysis using the "LCModel" software package, and metabolite maps created from the LCModel results. Total scan time, including brain MRI and a water-reference MRSI, was 24 min. The sequence was tested in 10 normal volunteers. Estimated metabolite levels and uncertainty values (Cramer Rao lower bounds, CRLBs) for nine downfield peaks were compared between seven different brain regions, anterior cingulate cortex (ACC), centrum semiovale (CSO), corpus callosum (CC), cerebellar vermis (CV), dorsolateral prefrontal cortex (DLPFC), posterior cingulate cortex (PCC), and thalamus (Thal).

RESULTS

DF peaks were relatively uniformly distributed throughout the brain, with only a small number of peaks showing any significant regional variations. Most DF peaks had average CRLB<25% in most brain regions. Average SNR values were higher for the brain regions ACC and DLPFC (˜7 ± 0.95, mean ± SD) while in a range of 3.4-6.0 for other brain regions. Average linewidth (FWHM) values were greater than 35 Hz in the ACC, CV, and Thal, and 22 Hz in CC, CSO, DLPFC, and PCC.

CONCLUSION

High-field DF-MRSI is able to spatially map exchangeable protons in the human brain at high resolution and with near whole-brain coverage in acceptable scan times, and in the future may be used to study metabolism of brain tumors or other neuropathological disorders.

Optimization of 1H MR spectroscopy methods for large volume acquisition of low concentration downfield resonances at 3T and 7T

Purpose

This goal of this study was to optimize spectrally selective 1H MRS methods for large volume acquisition of low concentration metabolites with downfield resonances at 7T and 3T, with particular attention paid to detection of nicotinamide adenine dinucleotide (NAD+) and tryptophan.

Methods

Spectrally selective excitation was used to avoid magnetization transfer effects with water, and various sinc pulses were compared to a pure-phase E-BURP pulse. Localization using a single slice selective pulse was compared to voxel-based localization that used three orthogonal refocusing pulses, and low bandwidth refocusing pulses were used to take advantage of the chemical shift displacement of water. A technique for water sideband removal was added, and a method of coil channel combination for large volumes was introduced.

Results

Proposed methods were compared qualitatively to previously-reported techniques at 7T. Sinc pulses resulted in reduced water signal excitation and improved spectral quality, with a symmetric, low bandwidth-time product pulse performing best. Single slice localization allowed shorter TEs with large volumes, enhancing signal, while low bandwidth slice selective localization greatly reduced the observed water signal. Gradient cycling helped remove water sidebands, and frequency aligning and pruning individual channels narrowed spectral linewidths. High quality brain spectra of NAD+ and tryptophan are shown in four subjects at 3T.

Conclusion

Improved spectral quality with higher downfield signal, shorter TE, lower nuisance signal, reduced artifacts, and narrower peaks was realized at 7T. These methodological improvements allowed for previously unachievable detection of NAD+ and tryptophan in human brain at 3T in under five minutes.

Quantification of NAD + T 1 and T 2 relaxation times using downfield 1 H MRS at 7 T in human brain in vivo

Introduction

The purpose of this study was to use a single-slice spectrally-selective sequence to measure T 1 and T 2 relaxation times of NAD + proton resonances in the downfield 1 H MRS spectrum in human brain at 7 T in vivo and assess the propagation of relaxation time uncertainty in NAD + quantification.

Methods

Downfield spectra from 7 healthy volunteers were acquired at multiple echo times in all subjects to measure T 2 relaxation, and saturation recovery data were to measure T 1 relaxation. The downfield acquisition used a spectrally-selective 90° sinc pulse for excitation centered at 9.1 ppm with a bandwidth of 2 ppm, followed by a 180° spatially-selective Shinnar-Le Roux refocusing pulse for localization. For the multiple echo experiment, spectra were collected with echo times ranging from 13 to 33 ms. For the saturation recovery experiment, saturation was performed prior to excitation using the same spectrally-selective sinc pulse as was used for excitation. Saturation delay times (TS) ranged from 100 to 600 ms. Uncertainty propagation analysis was performed analytically and with Monte Carlo simulation.

Results

The mean ± standard deviation of T 1 relaxation times of the H2, H6, and H4 protons were 152.7 ± 16.6, 163.6 ± 22.3, and 169.9 ± 11.2 ms, respectively. The mean ± standard deviation of T 2 relaxation times of the H2, H6, and H4 protons were 32.5 ± 7.0, 27.4 ± 5.2, and 38.1 ± 11.7 ms, respectively. The mean R 2 of the H2 and H6 T 1 fits were 0.98. The mean R 2 of the H4 proton T 1 fit was 0.96. The mean R 2 of the T 2 fits of the H2 and H4 proton resonances were 0.98, while the mean R 2 of the T 2 fits of the H4 proton was 0.93. The relative uncertainty in NAD + concentration due to relaxation time uncertainty was 8.5%-11%.

Conclusion

Using downfield spectrally-selective spectroscopy with single-slice localization, we found NAD + T 1 and T 2 relaxation times to be approximately 162 ms and 32 ms respectively in the human brain in vivo at 7 T.

Quantification of Cerebral Glucose Concentrations via Detection of the H1-α-Glucose Peak in 1 H MRS at 7 T

BACKGROUND

Sensitive detection and quantification of cerebral glucose is desired.

PURPOSE

To quantify cerebral glucose by detecting the H1-α-glucose peak at 5.23 ppm in 1 H magnetic resonance spectroscopy at 7 T.

STUDY TYPE

Prospective.

SUBJECTS

Twenty-eight non-fasted healthy subjects (aged 20-28 years).

FIELD STRENGTH/SEQUENCE

Short echo time stimulated echo acquisition mode (short-TE STEAM) and semi-localized by adiabatic selective refocusing (semi-LASER) at 7 T.

ASSESSMENT

Single voxel spectra were obtained from the posterior cingulate cortex (27-mL) using a 32-channel head coil. The H1-α-glucose peak in the spectrum with retrospective removal of the residual water peak was fitted using LCModel with a glucose basis set of only the H1-α-glucose peak. Conventional spectral analysis was performed with a glucose basis set of a full spectral pattern of glucose, also. Fitting precision was evaluated with Cramér-Rao lower bounds (CRLBs). The repeatability of glucose quantification via the semi-LASER sequence was tested.

STATISTICAL TESTS

Paired or Welch's t-test were used for normally distributed values. A P value of <0.05 was considered significant. The repeatability of measures was analyzed using coefficient of variation (CV).

RESULTS

Removal of the residual water peak improved the flatness and stability of baselines around the H1-α-glucose peak and reduced CRLBs for fitting the H1-α-glucose peak. The semi-LASER sequence was superior to the short-TE STEAM in the higher signal-to-noise ratio of the H1-α-glucose peak (mean ± SD 7.9 ± 2.5, P < 0.001). The conventional analysis overfitted the H1-α-glucose peak. The individual CVs of glucose quantification by detecting the H1-α-glucose peak were smaller than the corresponding CRLBs.

DATA CONCLUSION

Cerebral glucose concentration is quantitated to be 1.07 mM by detecting the H1-α-glucose peak in the semi-LASER spectra. Despite requiring long scan times, detecting the H1-α-glucose peak allows true glucose quantification free from the influence of overlapping taurine and macromolecule signals.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY STAGE: 1.

Downfield proton MRSI with whole-brain coverage at 3T

PURPOSE

To develop a 3D downfield (DF) MRSI protocol with whole brain coverage and post-processing pipeline for creation of metabolite maps.

METHODS

A 3D, circularly phase-encoded version of the previously developed 2D DF MRSI sequence with1 3 ‾ 3 1 ‾ $$ 1\overline{3}3\overline{1} $$ spectral-spatial excitation and frequency selective refocusing was implemented and tested in five healthy volunteers at 3T. The DF metabolite maps with a nominal spatial resolution of 0.7 cm3 were recorded in eight slices at 3T in a scan time of 22 m 40 s. An MRSI post-processing pipeline was developed to create DF metabolite maps. Metabolite concentrations and uncertainty estimates were compared between region differences for nine DF peaks.

RESULTS

LCModel analysis showed Cramer Rao lower bounds average values of 3%-4% for protein amide resonances in the three selected regions (anterior cingulate, dorsolateral prefrontal cortex, and centrum semiovale); Cramer Rao lower bounds were somewhat higher for individual peaks but for the most part were less than 20%. While DF concentration maps were visually quite homogeneous throughout the brain, general linear regression analysis corrected for multiple comparisons found significant differences between centrum semiovale and dorsolateral prefrontal cortex for peaks at 7.09 ppm (p = 0.014), 7.90 ppm (p = 0.009), 8.18 ppm (p = 0.009), combined amides (p = 0.009), and between anterior cingulate and dorsolateral prefrontal cortex for the 7.30 ppm peak (p = 0.020). Cramer Rao lower bounds values were not significantly different between brain regions for any of the DF peaks.

CONCLUSION

The 3D DF MRSI of the human brain at 3T with wide spatial coverage for the mapping of exchangeable amide and other resonances is feasible at a nominal spatial resolution of 0.7 cm3 .

Identification of new resonances in downfield 1 H MRS of human calf muscle in vivo: Potentially metabolite precursors for skeletal muscle NAD. Magn Reson Med 2023;90:1166-1171. [PMID: 37125620 PMCID: PMC10330283 DOI: 10.1002/mrm.29687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

PURPOSE

The purpose of this study was to identify and characterize newly discovered resonances appearing in the downfield proton MR spectrum (DF 1 H MRS) of the human calf muscle in vivo at 7T.

METHODS

Downfield 1 H MRS was performed on the calf muscle of five healthy volunteers at 7T. A spectrally selective 90° E-BURP RF pulse with an excitation center frequency at 10.3 ppm and an excitation bandwidth of 2 ppm was used for DF 1 H MRS acquisition.

RESULTS

In all participants, we observed new resonances at 9.7, 10.1, 10.3, and 10.9 ppm in the DF 1 H MRS. Phantom experiments at 37°C strongly suggest the new resonance at 9.7 ppm could be from H2-proton of the nicotinamide rings in nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) while the resonance at 10.1 ppm could be attributed to the indole -NH proton of L-tryptophan. We observed that the resonances at 10.1 and 10.9 ppm are significantly suppressed when the water resonance is saturated, indicating that these peaks have either 1 H chemical exchange or cross-relaxation with water. Conversely, the resonances at 9.7 and 10.3 ppm exhibit moderate signal reduction in the presence of water saturation.

CONCLUSION

We have identified new proton resonances in vivo in human calf muscle occurring at chemical shifts of 9.7, 10.1, 10.3, and 10.9 ppm. These preliminary results are promising for investigating the role of NR/NMN and L-tryptophan metabolism in understanding the de novo and salvage pathways of NAD+ synthesis in skeletal muscle.

Downfield Proton MRSI at 3 Tesla: A Pilot Study in Human Brain Tumors

PURPOSE

To investigate the use of 3D downfield proton magnetic resonance spectroscopic imaging (DF-MRSI) for evaluation of tumor recurrence in patients with glioblastoma (GBM).

METHODS

Seven patients (4F, age range 44-65 and mean ± standard deviation 59.3 ± 7.5 years) with previously treated GBM were scanned using a recently developed 3D DF-MRSI sequence at 3T. Short TE 3D DF-MRSI and water reference 3D-MRSI scans were collected with a nominal spatial resolution of 0.7 cm3. DF volume data in eight slices covered 12 cm of brain in the cranio-caudal axis. Data were analyzed using the 'LCModel' program and a basis set containing nine peaks ranging in frequency between 6.83 to 8.49 ppm. The DF8.18 (assigned to amides) and DF7.90 peaks were selected for the creation of metabolic images and statistical analysis. Longitudinal MR images and clinical history were used to classify brain lesions as either recurrent tumor or treatment effect, which may include necrosis. DF-MRSI data were compared between lesion groups (recurrent tumor, treatment effect) and normal-appearing brain.

RESULTS

Of the seven brain tumor patients, two were classified as having recurrent tumor and the rest were classified as treatment effect. Amide metabolite levels from recurrent tumor regions were significantly (p < 0.05) higher compared to both normal-appearing brain and treatment effect regions. Amide levels in lesion voxels classified as treatment effect were significantly lower than normal brain.

CONCLUSIONS

3D DF-MRSI in human brain tumors at 3T is feasible and was well tolerated by all patients enrolled in this preliminary study. Amide levels measured by 3D DF-MRSI were significantly different between treatment effect and tumor regrowth.

Downfield Proton MRSI with whole-brain coverage at 3T

Purpose

To develop a 3D downfield magnetic resonance spectroscopic imaging (DF-MRSI) protocol with whole brain coverage and post-processing pipeline for creation of metabolite maps.

Methods

A 3D, circularly phase-encoded version of the previously developed 2D DF-MRSI sequence with spectral-spatial excitation and frequency selective refocusing was implemented and tested in 5 healthy volunteers at 3T. Downfield metabolite maps with a nominal spatial resolution of 0.7 cm 3 were recorded in 8 slices at 3T in a scan time of 22m 40s. An MRSI post-processing pipeline was developed to create DF metabolite maps. Metabolite concentrations and uncertainty estimates were compared between region differences for nine downfield peaks.

Results

LCModel analysis showed CRLB average values of 3-4% for protein amide resonances in the three selected regions (anterior cingulate (ACC), dorsolateral prefrontal cortex (DLPFC), and centrum semiovale (CSO)); CRLBs were somewhat higher for individual peaks but for the most part were less than 20%. While DF concentration maps were visually quite homogeneous throughout the brain, general linear regression analysis corrected for multiple comparisons found significant differences between CSO and DLPFC for peaks at 7.09 ppm (p= 0.014), 7.90 ppm (p=0.009), 8.18 ppm (p=0.009), combined amides (p=0.009), and between ACC and DLPFC for the 7.30 ppm peak (p=0.020). CRLB values were not significantly different between brain regions for any of the DF peaks.

Conclusion

3D DF-MRSI of the human brain at 3T with wide spatial coverage for the mapping of exchangeable amide and other resonances is feasible at a nominal spatial resolution of 0.7 cm 3 .

Identification of l-Tryptophan by down-field 1 H MRS: A precursor for brain NAD+ and serotonin syntheses

PURPOSE

To explore the presence of new resonances beyond 9.4 ppm from the human brain, down-field proton MRS was performed in vivo in the human brain on 6 healthy volunteers at 7 T.

METHODS

To maximize the SNR, a large voxel was placed within the brain to cover the maximal area in such a way that sinus cavities were avoided. A spectrally selective 90° E-BURP pulse with an excitation bandwidth of 2 ppm was used to probe the spectral chemical shift range between 9.1 and 10.5 ppm. The E-BURP pulse was integrated with PRESS spatial localization to obtain non-water-suppressed proton MR spectra from the desired spectral region.

RESULTS

In the down-field proton MRS obtained from all of the volunteers scanned, we identified a new peak consistently resonating at 10.1 ppm. Protons associated with this resonance are in cross-relaxation with the bulk water, as demonstrated by the water saturation and deuterium exchange experiments.

CONCLUSION

Based on the chemical shift, this new peak was identified as the indole (-NH) proton of l-tryptophan (l-TRP) and was further confirmed from phantom experiments on l-TRP. These promising preliminary results potentially pave the way to investigate the role of cerebral metabolism of l-TRP in healthy and disease conditions.

Short TE downfield magnetic resonance spectroscopy in a mouse model of brain glioma

PURPOSE

Enhanced cell proliferation in tumors can be associated with altered metabolic profiles and dramatic microenvironmental changes. Downfield magnetic resonance spectroscopy (MRS) has received increasing attention due to its ability to report on labile resonances of molecules not easily detected in upfield ¹ H MRS. Image-selected-in-vivo-spectroscopy-relaxation enhanced MRS (iRE-MRS) was recently introduced for acquiring short echo-time (TE) spectra. Here, iRE-MRS was used to investigate in-vivo downfield spectra in glioma-bearing mice.

METHODS

Experiments were performed in vivo in an immunocompetent glioma mouse model at 9.4 T using a cryogenic coil. iRE-MRS spectra were acquired in N = 6 glioma-bearing mice (voxel size = 2.2³  mm³ ) and N = 6 control mice. Spectra were modeled by a sum of Lorentzian peaks simulating known downfield resonances, and differences between controls and tumors were quantified using relative peak areas.

RESULTS

Short TE tumor spectra exhibited large qualitative differences compared to control spectra. Most peaks appeared modulated, with strong attenuation of NAA (∼7.82, 7.86 ppm) and changes in relative peak areas between 6.75 and 8.49 ppm. Peak areas tended to be smaller for DF_6.83 , DF_7.60 , DF_8.18 and NAA; and larger for DF_7.95 and DF_8.24 . Differences were also detected in signals resonating above 8.5 ppm, assumed to arise from NAD+.

CONCLUSIONS

In-vivo downfield ¹ H iRE-MRS of mouse glioma revealed differences between controls and tumor bearing mice, including in metabolites which are not easily detectable in the more commonly investigated upfield spectrum. These findings motivate future downfield MRS investigations exploring pH and exchange contributions to these differences.

Respiratory-triggered quantitative MR spectroscopy of the human cervical spinal cord at 7 T

PURPOSE

Ultra-high field 1 H MR spectroscopy (MRS) is of great interest to help characterizing human spinal cord pathologies. However, very few studies have been reported so far in this small size structure at these fields due to challenging experimental difficulties caused by static and radiofrequency field heterogeneities, as well as physiological motion. In this work, in line with the recent developments proposed to strengthen spinal cord MRS feasibility at 7 T, a respiratory-triggered acquisition approach was optimized to compensate for dynamic B 0 field heterogeneities and to provide robust cervical spinal cord MRS data.

METHODS

A semi-LASER sequence was purposely used, and a dedicated raw data processing algorithm was developed to enhance MR spectral quality by discarding corrupted scans. To legitimate the choices done during the optimization stage, additional tests were carried out to determine the impact of breathing, voluntary motion, body mass index, and fitting algorithm. An in-house quantification tool was concomitantly designed for accurate estimation of the metabolite concentration ratios for choline, N-acetyl-aspartate (NAA), myo-inositol and glutathione. The method was tested on a cohort of 14 healthy volunteers.

RESULTS

Average water linewidth and NAA signal-to-noise ratio reached 0.04 ppm and 11.01, respectively. The group-average metabolic ratios were in good agreement with previous studies and showed intersession reproducibility variations below 30%.

CONCLUSION

The developed approach allows a rise of the acquired MRS signal quality and of the quantification robustness as compared to previous studies hence offering strengthened possibilities to probe the metabolism of degenerative and traumatic spinal cord pathologies.

Magnetic resonance spectroscopic imaging of downfield proton resonances in the human brain at 3 T

PURPOSE

To develop an MRSI technique capable of mapping downfield proton resonances in the human brain.

METHODS

A spectral-spatial excitation and frequency-selective refocusing scheme, in combination with 2D phase encoding, was developed for mapping of downfield resonances without any perturbation of the water magnetization. An alternative scheme using spectral-spatial refocusing was also investigated for simultaneous detection of both downfield and upfield resonances. The method was tested in 5 healthy human volunteers.

RESULTS

Downfield metabolite maps with a nominal spatial resolution of 1.5 cm³ were recorded at 3 T in a scan time of 12 minutes. Cramer-Rao lower bounds for nine different downfield peaks were 20% or less over a single supraventricular slice. Downfield spectral profiles were similar to those in the literature recorded previously using single-voxel localization methods. The same approach was also used for upfield MRSI, and simultaneous upfield and downfield acquisitions.

CONCLUSION

The developed MRSI pulse sequence was shown to be an efficient way of rapidly mapping downfield resonances in the human brain at 3 T, maximizing sensitivity through the relaxation enhancement effect. Because the MRSI approach is efficient in terms of data collection and can be readily implemented at short TE, somewhat higher spatial resolution can be achieved than has been reported in previous single-voxel downfield MRS studies. With this approach, nine downfield resonances could be mapped in a single slice for the first time using MRSI at 3 T.

Water and lipid suppression techniques for advanced 1 H MRS and MRSI of the human brain: Experts' consensus recommendations

The neurochemical information provided by proton magnetic resonance spectroscopy (MRS) or MR spectroscopic imaging (MRSI) can be severely compromised if strong signals originating from brain water and extracranial lipids are not properly suppressed. The authors of this paper present an overview of advanced water/lipid-suppression techniques and describe their advantages and disadvantages. Moreover, they provide recommendations for choosing the most appropriate techniques for proper use. Methods of water signal handling are primarily focused on the VAPOR technique and on MRS without water suppression (metabolite cycling). The section on lipid-suppression methods in MRSI is divided into three parts. First, lipid-suppression techniques that can be implemented on most clinical MR scanners (volume preselection, outer-volume suppression, selective lipid suppression) are described. Second, lipid-suppression techniques utilizing the combination of k-space filtering, high spatial resolutions and lipid regularization are presented. Finally, three promising new lipid-suppression techniques, which require special hardware (a multi-channel transmit system for dynamic B₁⁺ shimming, a dedicated second-order gradient system or an outer volume crusher coil) are introduced.

Combining chemical exchange saturation transfer and 1 H magnetic resonance spectroscopy for simultaneous determination of metabolite concentrations and effects of magnetization exchange

Purpose

A new sequence combining chemical‐exchange saturation‐transfer (CEST) with traditional MRS is used to simultaneously determine metabolite content and effects of magnetization exchange.

Methods

A CEST saturation block consisting of a train of RF‐pulses is placed before a metabolite‐cycled semi‐LASER single‐voxel spectroscopy sequence. The saturation parameters are adjustable to allow optimization of the saturation for a specific target. Data were collected in brain from 20 subjects in experiments with different B₁‐settings (0.4‐2.0 µT) on a 3T MR scanner. CEST Z‐spectra were calculated from water intensities and fitted with a multi‐pool Lorentzian model. Interrelated metabolite spectra were fitted in fitting tool for arrays of interrelated datasets (FiTAID).

Results

Evaluation of traditional Z‐spectra from water revealed exchange effects from amides, amines, and hydroxyls as well as an upfield nuclear Overhauser effect. The magnetization transfer effect was evaluated on metabolites and macromolecules for the whole spectral range and for the different B₁ levels. A correction scheme for direct saturation on metabolites is proposed. Both magnetization‐transfer and direct saturation proved to differ for individual metabolites.

Conclusion

Using non‐water‐suppressed spectroscopy offers time‐saving simultaneous recording of the traditional CEST Z‐spectrum from water and the metabolite spectrum under frequency‐selective saturation. In addition, exchange and magnetization‐transfer effects on metabolites and macromolecules can be detected, which might offer additional possibilities for quantification or give further insight into the composition of the traditional CEST Z‐spectrum. Apparent magnetization‐transfer effects on macromolecular signals in the ¹H‐MR spectrum have been found. Detailed knowledge of magnetization‐transfer effects is also relevant for judging the influence of water‐suppression on the quantification of metabolite signals.

Pulse sequences for measuring exchange rates between proton species: From unlocalised NMR spectroscopy to chemical exchange saturation transfer imaging

Within the field of NMR spectroscopy, the study of chemical exchange processes through saturation transfer techniques has a long history. In the context of MRI, chemical exchange techniques have been adapted to increase the sensitivity of imaging to small fractions of exchangeable protons, including the labile protons of amines, amides and hydroxyls. The MR contrast is generated by frequency-selective irradiation of the labile protons, which results in a reduction of the water signal associated with transfer of the labile protons' saturated magnetization to the protons of the surrounding free water. The signal intensity depends on the rate of chemical exchange and the concentration of labile protons as well as on the properties of the irradiation field. This methodology is referred to as CEST (chemical exchange saturation transfer) imaging. Applications of CEST include imaging of molecules with short transverse relaxation times and mapping of physiological parameters such as pH, temperature, buffer concentration and chemical composition due to the dependency of this chemical exchange effect on all these parameters. This article aims to describe these effects both theoretically and experimentally. In depth analysis and mathematical modelling are provided for all pulse sequences designed to date to measure the chemical exchange rate. Importantly, it has become clear that the background signal from semi-solid protons and the presence of the Nuclear Overhauser Effect (NOE), either through direct dipole-dipole mechanisms or through exchange-relayed signals, complicates the analysis of CEST effects. Therefore, advanced methods to suppress these confounding factors have been developed, and these are also reviewed. Finally, the experimental work conducted both in vitro and in vivo is discussed and the progress of CEST imaging towards clinical practice is presented.

Terminology and concepts for the characterization of in vivo MR spectroscopy methods and MR spectra: Background and experts' consensus recommendations

With a 40-year history of use for in vivo studies, the terminology used to describe the methodology and results of magnetic resonance spectroscopy (MRS) has grown substantially and is not consistent in many aspects. Given the platform offered by this special issue on advanced MRS methodology, the authors decided to describe many of the implicated terms, to pinpoint differences in their meanings and to suggest specific uses or definitions. This work covers terms used to describe all aspects of MRS, starting from the description of the MR signal and its theoretical basis to acquisition methods, processing and to quantification procedures, as well as terms involved in describing results, for example, those used with regard to aspects of quality, reproducibility or indications of error. The descriptions of the meanings of such terms emerge from the descriptions of the basic concepts involved in MRS methods and examinations. This paper also includes specific suggestions for future use of terms where multiple conventions have emerged or coexisted in the past.

In vivo characterization of downfield peaks at 9.4 T: T2 relaxation times, quantification, pH estimation, and assignments

PURPOSE

Relaxation times are a valuable asset when determining spectral assignments. In this study, apparent T₂ relaxation times ( T 2 app ) of downfield peaks are reported in the human brain at 9.4 T and are used to guide spectral assignments of some downfield metabolite peaks.

METHODS

Echo time series of downfield metabolite spectra were acquired at 9.4 T using a metabolite-cycled semi-LASER sequence. Metabolite spectral fitting was performed using LCModel V6.3-1L while fitting a pH sweep to estimate the pH of the homocarnosine (hCs) imidazole ring. T 2 app were calculated by fitting the resulting relative amplitudes of the peaks to a mono-exponential decay across the TE series. Furthermore, estimated tissue concentrations of molecules were calculated using the relaxation times and internal water as a reference.

RESULTS

T 2 app of downfield metabolites are reported within a range from 16 to 32 ms except for homocarnosine with T 2 app of 50 ms. Correcting T 2 app for exchange rates ( T 2 c o r r ) resulted in relaxation times between 20 and 33 ms. The estimated pH values based on hCs imidazole range from 7.07 to 7.12 between subjects. Furthermore, analyzing the linewidths of the downfield peaks and their T 2 app contribution led to possible peak assignments.

CONCLUSION

T 2 app relaxation times were longer for the assigned metabolite peaks compared to the unassigned peaks. Tissue pH estimation in vivo with proton MRS and simultaneous quantification of amide protons at 8.30 ± 0.15 ppm is likely possible. Based on concentration, linewidth, and exchange rates measurements, tentative peak assignments are discussed for adenosine triphosphate (ATP), N-acetylaspartylglutamate (NAAG), and urea.

Non-water-excitation MR spectroscopy techniques to explore exchanging protons in human brain at 3 T

PURPOSE

To develop localization sequences for in vivo MR spectroscopy (MRS) on clinical scanners of 3 T to record spectra that are not influenced by magnetization transfer from water.

METHODS

Image-selected in vivo spectroscopy (ISIS) localization and chemical-shift-selective excitation (termed I-CSE) was combined in two ways: first, full ISIS localization plus a frequency-selective spin-echo and second, two-dimensional (2D) ISIS plus a frequency-selective excitation and slice-selective refocusing. The techniques were evaluated at 3 T in phantoms and human subjects in comparison to standard techniques with water presaturation or metabolite-cycling. ISIS included gradient-modulated offset-independent adiabatic (GOIA)-type adiabatic inversion pulses; echo times were 8-10 ms.

RESULTS

The novel 2D and 3D I-CSE methods yield upfield spectra that are comparable to those from standard MRS, except for shorter echo times and a limited frequency range. On the downfield/high-frequency side, they yield much more signal for exchangeable protons when compared to MRS with water presaturation or metabolite-cycling and longer echo times.

CONCLUSION

Novel non-water-excitation MRS sequences offer substantial benefits for the detection of metabolite signals that are otherwise suppressed by saturation transfer from water. Avoiding water saturation and using very short echo times allows direct observation of faster exchanging moieties than was previously possible at 3 T and additionally makes the methods less susceptible to fast T₂ relaxation.