A half-volume coil for efficient proton decoupling in humans at 4 tesla

Toward structure and metabolism of glycogen C1-C6 in humans at 7 T by localized 13C MRS using low-power bilevel broadband 1H decoupling

This work aims to develop and implement a pulse-acquire sequence for three-dimensional (3D) single-voxel localized 13C MRS in humans at 7 T, in conjunction with bilevel broadband 1H decoupling, and to test its feasibility in vitro and in vivo in human calf muscle with emphasis on the detection of glycogen C1-C6. A localization scheme suitable for measuring fast-relaxing 13C signals in humans at 7 T was developed and implemented using the outer volume suppression (OVS) and one-dimensional image selected in vivo spectroscopy (ISIS-1D) schemes, similar to that which was previously reported in humans at 4 T. The 3D 13C localization scheme was followed by uniform 13C adiabatic excitation, all complemented with an option for bilevel broadband 1H decoupling to improve both 13C sensitivity and spectral resolution at 7 T. The performance of the pulse-acquire sequence was investigated in vitro on phantoms and in vivo in the human calf muscle of three healthy volunteers, while measuring glycogen C1-C6. In addition, T1 and T2 of glycogen C1-C6 were measured in vitro at 7 T, as well as T1 of glycogen C1 in vivo. The glycerol C2 and C1,3 lipid resonances were efficiently suppressed in vitro at 7 T using the OVS and ISIS-1D schemes, allowing distinct detection of glycogen C2-C6. While some glycerol remained in calf muscle in vivo, the intense lipid at 130 ppm was efficiently suppressed. The 13C sensitivity and spectral resolution of glycogen C1-C6 in vitro and glycogen C1 in vivo were improved at 7 T using bilevel broadband 1H decoupling. The T1 and T2 of glycogen C1-C6 in vitro at 7 T were consistent compared with those at 8.5 T, while the T1 of glycogen C1 in vivo at 7 T resulted similar to that in vitro. Localized 13C MRS is feasible in human calf muscle in vivo at 7 T, and this will allow further extension of this method for 13C MRS measurements such as in the brain.

Development of a 31P magnetic resonance spectroscopy technique to quantify NADH and NAD+ at 3 T

NADH and NAD+ act as electron donors and acceptors and NAD+ was shown to stimulate mitochondrial biogenesis and metabolic health. We here develop a non-invasive Phosphorous Magnetic Resonance Spectroscopy (31P-MRS) method to quantify these metabolites in human skeletal muscle on a clinical 3 T MRI scanner. This new MR-sequence enables NADH and NAD+ quantification by suppressing α-ATP signal, normally overlapping with NADH and NAD+. The sequence is based on a double spin echo in combination with a modified z-Filter achieving strong α-ATP suppression with little effect on NAD+ and NADH. Here we test and validate it in phantoms and in humans by measuring reproducibility and detecting a physiological decrease in NAD+ and increase in NADH induced by ischemia. Furthermore, the 31P-MRS outcomes are compared to analysis in biopsies. Additionally, we show higher NAD+ and lower NADH content in physically active older adults compared to sedentary individuals, reflecting increased metabolic health.

Measurement of neuro-energetics and neurotransmission in the rat olfactory bulb using 1H and 1H-[13C] NMR spectroscopy

The olfactory bulb (OB) plays a fundamental role in the sense of smell and has been implicated in several pathologies, including Alzheimer's disease. Despite its importance, high metabolic activity and unique laminar architecture, the OB is not frequently studied using MRS methods, likely due to the small size and challenging location. Here we present a detailed metabolic characterization of OB metabolism, in terms of both static metabolite concentrations using 1H MRS and metabolic fluxes associated with neuro-energetics and neurotransmission by tracing the dynamic 13C flow from intravenously administered [1,6-13C2]-glucose, [2-13C]-glucose and [2-13C]-acetate to downstream metabolites, including [4-13C]-glutamate, [4-13C]-glutamine and [2-13C]-GABA. The unique laminar architecture and associated metabolism of the OB, distinctly different from that of the cerebral cortex, is characterized by elevated GABA and glutamine levels, as well as increased GABAergic and astroglial energy metabolism and neurotransmission. The results show that, despite the technical challenges, high-quality 1H and 1H-[13C] MR spectra can be obtained from the rat OB in vivo. The derived metabolite concentrations and metabolic rates demonstrate a unique metabolic profile for the OB. The metabolic model provides a solid basis for future OB studies on functional activation or pathological conditions.

Triple-tuned birdcage and single-tuned dipole array for quadri-nuclear head MRI at 7 T

PURPOSE

The purpose of this work was to design and build a coil for quadri-nuclear MRI of the human brain at 7 T.

METHODS

We built a transmit/receive triple-tuned (45.6 MHz for  2 $$ {}^2 $$ H, 78.6 MHz for  23 $$ {}^{23} $$ Na, and 120.3 MHz for  31 $$ {}^{31} $$ P) quadrature four-rod birdcage that was geometrically interleaved with a transmit/receive four-channel dipole array (297.2 MHz for  1 $$ {}^1 $$ H). The birdcage rods contained passive, two-pole resonant circuits that emulated capacitors required for single-tuning at three frequencies. The birdcage assembly also included triple-tuned matching networks, baluns, and transmit/receive switches. We assessed the performance of the coil with quality factor (Q) and signal-to-noise ratio (SNR) measurements, and performed in vivo multinuclear MRI and MR spectroscopic imaging (MRSI).

RESULTS

Q measurements showed that the triple-tuned birdcage efficiency was within 33% of that of single-tuned baseline birdcages at all three frequencies. The quadri-tuned coil SNR was 78%, 59%, 44%, and 48% lower than that of single or dual-tuned reference coils for  1 $$ {}^1 $$ H,  2 $$ {}^2 $$ H,  23 $$ {}^{23} $$ Na, and  31 $$ {}^{31} $$ P, respectively. Quadri-nuclear MRI and MRSI was demonstrated in brain in vivo in about 30 min.

CONCLUSION

While the SNR of the quadruple tuned coil was significantly lower than dual- and single-tuned reference coils, it represents a step toward truly simultaneous quadri-nuclear measurements.

Imaging ocular water inflow in the mouse with deuterium oxide MRI

Abnormal intraocular fluid flow or clearance is involved with a variety of eye diseases such as glaucoma and diabetic retinopathy, but measurement of water exchange dynamics in the vitreous and aqueous remain challenging. 2H MRI can be used to image deuterium oxide (D₂O) as a tracer, but the signal-to-noise ratio for deuterium is low due to its low concentration, which has hampered its application to imaging the eye. To overcome this challenge, we investigated the feasibility of direct D2O MRI to measure water dynamics in the mouse eye. The balanced steady-state free precession (bSSFP) sequence provided substantially higher signal-to-noise ratio for imaging D2O in fluid compared to standard gradient echo and spin echo sequences. bSSFP allowed dynamic imaging of intraocular water inflow in the mouse with 41 s temporal resolution. The inflow rate in the vitreous was found to be faster than in the aqueous. These studies demonstrate the feasibility of in vivo imaging of water inflow dynamics into the both the vitreous and aqueous in mice, which could be useful in studies of abnormal fluid exchange in rodent models of eye disease.

Scalable and modular 8-channel transmit and 8-channel flexible receive coil array for 19 F MRI of large animals

PURPOSE

To introduce an RF coil system consisting of an 8-channel transmit (Tx) and 8-channel receive (Rx) coil arrays for ¹⁹ F MRI of large animals.

METHODS

The Tx efficiency and homogeneity of the 8-element loop coil array (loop size: 6 × 15 cm² ) were simulated for two different pig models rendered from MR images. An 8-channel Rx coil array consisting of a flexible 6-channel posterior and a 2-channel planar anterior array was designed to fit on the abdomen of an average-sized pig in supine position. Measurements were performed in a grid phantom and ex vivo on a pig model with perfluoroctylbromide (PFOB)-filled tubes inserted in the thorax.

RESULTS

Measured and simulated Tx efficiency and homogeneity for the 8-channel and 5-channel arrays were in good agreement: 1.87 ± 0.22μT/√kW versus 1.96 ± 0.29μT/√kW, and 2.29 ± 0.39μT/√kW versus 2.41 ± 0.37μT/√kW. An isolation of 38 ± 8 dB is achieved between the ¹⁹ F Tx and Rx elements, and over 30 dB between the ¹ H and ¹⁹ F elements. The PFOB-filled vials could be clearly identified within the cadaver abdomen with an SNR of 275 ± 51 for a 3D gradient-echo sequence with 2-mm isotropic resolution and 12 averages, acquired in 9:52 min:s. Performance of the Tx array was robust against phase and amplitude mismatches at the input ports.

CONCLUSIONS

A modular and scalable Tx array offers improved Tx efficiency in ¹⁹ F MRI of large animals with various sizes. Although conventional birdcage coils have superior Tx efficiency within the target region of interest, scalability of the Tx array to animal size is a major benefit. The described ¹⁹ F coil provides homogeneous excitation and high sensitivity detection in large pig models.

Glucose fluxes in glycolytic and oxidative pathways detected in vivo by deuterium magnetic resonance spectroscopy reflect proliferation in mouse glioblastoma

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We performed dynamic glucose enhanced (DGE) ²H-MRS in mouse GBM tumors.

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Marchenko-Pastur PCA denoising of ²H-MRS spectra improved kinetic quantification.

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Metabolic kinetics revealed differential glucose pathway fluxes in non-necrotic tumors.

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Modulation of glucose metabolism reflected tumor heterogeneity (proliferation).

Objectives

Glioblastoma multiforme (GBM), the most aggressive glial brain tumors, can metabolize glucose through glycolysis and mitochondrial oxidation pathways. While specific dependencies on those pathways are increasingly associated with treatment response, detecting such GBM subtypes in vivo remains elusive. Here, we develop a dynamic glucose-enhanced deuterium spectroscopy (DGE ²H-MRS) approach for differentially assessing glucose turnover rates through glycolysis and mitochondrial oxidation in mouse GBM and explore their association with histologic features of the tumor and its microenvironment.

Materials and methods

GL261 and CT2A glioma allografts were induced in immunocompetent mice and scanned in vivo at 9.4 Tesla, harnessing DGE ²H-MRS with volume selection and Marchenko-Pastur PCA (MP-PCA) denoising to achieve high temporal resolution. Each tumor was also classified by histopathologic analysis and assessed for cell proliferation (Ki67 immunostaining), while the respective cell lines underwent in situ extracellular flux analysis to assess mitochondrial function.

Results

MP-PCA denoising of in vivo DGE ²H-MRS data significantly improved the time-course detection (~2-fold increased Signal-to-Noise Ratio) and fitting precision (−19 ± 1 % Cramér-Rao Lower Bounds) of ²H-labelled glucose, and glucose-derived glutamate-glutamine (Glx) and lactate pools in GL261 and CT2A orthotopic tumors. Kinetic modeling further indicated inter-tumor heterogeneity of glucose consumption rate for glycolysis and oxidation during a defined epoch of active proliferation in both cohorts (19 ± 1 days post-induction), with consistent volumes (38.3 ± 3.4 mm³) and perfusion properties prior to marked necrosis. Histopathologic analysis of these tumors revealed clear differences in tumor heterogeneity between the two GBM models, aligned with metabolic differences of the respective cell lines monitored in situ. Importantly, glucose oxidation (i.e. Glx synthesis and elimination rates: 0.40 ± 0.08 and 0.12 ± 0.03 mM min⁻¹, respectively) strongly correlated with cell proliferation across the pooled cohorts (R = 0.82, p = 0.001; and R = 0.80, p = 0.002, respectively), regardless of tumor morphologic features or in situ metabolic characteristics of each GBM model.

Conclusions

Our fast DGE ²H-MRS enables the quantification of glucose consumption rates through glycolysis and mitochondrial oxidation in mouse GBM, which is relevant for assessing their modulation in vivo according to tumor microenvironment features such as cell proliferation. This novel application augurs well for non-invasive metabolic characterization of glioma or other cancers with mitochondrial oxidation dependencies.

Design and Construction of a PET-Compatible Double-Tuned 1H/31P MR Head Coil

Simultaneous MR-PET is an increasingly popular multimodal imaging technique that is able to combine metabolic information obtained from PET with anatomical/functional information from MRI. One of the key technological challenges of the technique is the integration of a PET-transparent MR coil system, a solution to which is demonstrated here for a double-tuned ¹H/³¹P head coil at 3 T. Two single-resonant birdcage coils tuned to the ¹H and ³¹P resonances were arranged in an interleaved fashion and electrically decoupled with the use of trap circuits. All high 511 keV quanta absorbing components were arranged outside the PET field-of-view in order to minimize count rate reduction. The materials inside the PET field-of-view were carefully evaluated and chosen for minimum impact on the PET image quality. As far as possible, the coil case was geometrically optimized to avoid sharp transitions in attenuation, which may potentially result in streaking artefacts during PET image reconstruction. The coil caused a count rate loss of just above 5% when inserted into the PET detector ring. Except for the anterior region, which was designed to maintain free openings for increased patient comfort, an almost uniform distribution of 511 keV attenuation was maintained around the circumference of the coil. MR-related performance for both nuclei was similar or slightly better than that of a commercial double-tuned coil, despite the MR-PET coil having a close-fitting RF screen to shield the PET and MR electronics from possible electromagnetic interferences.

Excitatory/inhibitory neuronal metabolic balance in mouse hippocampus upon infusion of [U-13C6]glucose

Hippocampus plays a critical role in linking brain energetics and behavior typically associated to stress exposure. In this study, we aimed to simultaneously assess excitatory and inhibitory neuronal metabolism in mouse hippocampus in vivo by applying ¹⁸FDG-PET and indirect ¹³C magnetic resonance spectroscopy (¹H-[¹³C]-MRS) at 14.1 T upon infusion of uniformly ¹³C-labeled glucose ([U-¹³C₆]Glc). Improving the spectral fitting by taking into account variable decoupling efficiencies of [U-¹³C₆]Glc and refining the compartmentalized model by including two γ-aminobutyric acid (GABA) pools permit us to evaluate the relative contributions of glutamatergic and GABAergic metabolism to total hippocampal neuroenergetics. We report that GABAergic activity accounts for ∼13% of total neurotransmission (V_NT) and ∼27% of total neuronal TCA cycle (V_TCA) in mouse hippocampus suggesting a higher V_TCA/V_NT ratio for inhibitory neurons compared to excitatory neurons. Finally, our results provide new strategies and tools for bringing forward the developments and applications of ¹³C-MRS in specific brain regions of small animals.

Magnetic resonance spectroscopy in the rodent brain: Experts' consensus recommendations

In vivo MRS is a non-invasive measurement technique used not only in humans, but also in animal models using high-field magnets. MRS enables the measurement of metabolite concentrations as well as metabolic rates and their modifications in healthy animals and disease models. Such data open the way to a deeper understanding of the underlying biochemistry, related disturbances and mechanisms taking place during or prior to symptoms and tissue changes. In this work, we focus on the main preclinical 1H, 31P and 13C MRS approaches to study brain metabolism in rodent models, with the aim of providing general experts' consensus recommendations (animal models, anesthesia, data acquisition protocols). An overview of the main practical differences in preclinical compared with clinical MRS studies is presented, as well as the additional biochemical information that can be obtained in animal models in terms of metabolite concentrations and metabolic flux measurements. The properties of high-field preclinical MRS and the technical limitations are also described.

Optimization of a transmit/receive surface coil for squirrel monkey spinal cord imaging

MR Imaging the spinal cord of non-human primates (NHP), such as squirrel monkey, is important since the injuries in NHP resemble those that afflict human spinal cords. Our previous studies have reported a multi-parametric MRI protocol, including functional MRI, diffusion tensor imaging, quantitative magnetization transfer and chemical exchange saturation transfer, which allows non-invasive detection and monitoring of injury-associated structural, functional and molecular changes over time. High signal-to-noise ratio (SNR) is critical for obtaining high-resolution images and robust estimates of MRI parameters. In this work, we describe our construction and use of a single channel coil designed to maximize the SNR for imaging the squirrel monkey cervical spinal cord in a 21 cm bore magnet at 9.4 T. We first numerically optimized the coil dimension of a single loop coil and then evaluated the benefits of a quadrature design. We then built an optimized coil based on the simulation results and compared its SNR performance with a non-optimized single coil in both phantoms and in vivo.

Design of Distributed Spiral Resonators for the Decoupling of MRI Double-Tuned RF Coils

OBJECTIVE

A systematic analytical approach to design Spiral Resonators (SRs), acting as distributed magnetic traps (DMTs), for the decoupling of concentric Double-Tuned (DT) RF coils suitable for Ultra-High Field (7 T) MRI is presented.

METHODS

The design is based on small planar SRs placed in between the two RF loops (used for signal detection of the two nuclei of interest). We developed a general framework based on a fully analytical approach to estimate the mutual coupling between the RF coils and to provide design guidelines for the geometry and number of SRs to be employed. Starting from the full-analytical estimations of the SRs geometry, electromagnetic simulations for improving and validating the performance can be carried out.

RESULTS AND CONCLUSION

We applied the method to a test case of a DT RF coil consisting of two concentric and coplanar loops used for 7 T MRI, tuned at the Larmor frequencies of the proton (¹H, 298 MHz) and sodium (²³Na, 79 MHz) nuclei, respectively. We performed numerical simulations and experimental measurements on fabricated prototypes, which both demonstrated the effectiveness of the proposed design procedure.

SIGNIFICANCE

The decoupling is achieved by printing the SRs on the same dielectric substrate of the RF coils thus allowing a drastic simplification of the fabrication procedure. It is worth noting that there are no physical connections between the decoupling SRs and the ¹H/²³Na RF coils, thus providing a mechanically robust experimental set-up, and improving the transceiver design with respect to other traditional decoupling techniques.

Improved off-resonance phase behavior using a phase-inverted adiabatic half-passage pulse for 13 C MRS in humans at 7 T

In vivo ¹³ C MRS at high field benefits from an improved SNR and spectral resolution especially when using surface coils in combination with adiabatic pulses, such as the adiabatic half-passage (AHP) pulse for ¹³ C excitation. However, the excitation profile of the AHP pulse is asymmetric relative to the carrier frequency, which could lead to asymmetric excitation of the spectral lines relative to the center of the spectrum. In this study, a pulse-acquire sequence was designed for adiabatic ¹³ C excitation with a symmetric bandwidth, utilizing a combination of two AHP pulses with inverted phases in alternate scans. Magnetization and phase behavior as a function of frequency offset and RF amplitude of the B₁ field, as well as the steady-state transverse magnetization response to off-resonance, were simulated. Excitation properties of the combined pulse sequence were studied by ²³ Na imaging and ¹³ C spectroscopy in vitro on a phantom and in vivo on the human calf at 7 T. Simulations demonstrated symmetric transverse magnetization and phase with respect to positive and negative frequency offsets when using two AHP pulses with inverted phases in alternate scans, thereby minimizing baseline distortion and achieving symmetric T₁ weighting, as confirmed by in vitro measurements. The intensities of the lipid peaks at 15, 30, 62, 73, and 130 ppm were in agreement with those theoretically predicted using two AHP pulses with inverted phases in alternate scans. We conclude that using two phase-inverted AHP pulses improves the symmetry of the ¹³ C excitation profile and phase response to off-resonance effects at 7 T in comparison with using a single AHP pulse.

Design and evaluation of a 1H/31P double-resonant helmet coil for 3T MRI of the brain

Proton magnetic resonance imaging (MRI) can be combined with signals from non-proton nuclei (X-nuclei) to provide metabolic information. Double-resonant coils are often used for X-nuclei MR studies where the proton element is employed for scout imaging and B ₀ shimming. This work describes the development of a new double-resonant coil capable of operating at both proton and X-nuclei frequencies. The proposed design extends the wheel-and-spoke coil, which allows for quadrature drive, by adding an extra ring outside the coil to achieve double-resonance. Furthermore, in order to maximise SNR by increasing the filling factor, the shape of the coil has been modified to a helmet style making it suitable for brain applications. The performance of the double-resonant helmet coil was evaluated by simulation and MR measurements. The helmet coil was successfully tuned to the ¹H/³¹P resonance frequencies of a 3T MR scanner, with high isolation between the two quadrature ports. MR measurements of a phantom were carried out, and the averaged sensitivity of the double-resonant helmet coil over the whole phantom was found to be higher than that of the conventional double-tuned birdcage coil at both frequencies.

Deuterium metabolic imaging (DMI) for MRI-based 3D mapping of metabolism in vivo

Currently, the only widely available metabolic imaging technique in the clinic is positron emission tomography (PET) detection of the radioactive glucose analog 2-¹⁸F-fluoro-2-deoxy-d-glucose (¹⁸FDG). However, ¹⁸FDG-PET does not inform on metabolism downstream of glucose uptake and often provides ambiguous results in organs with intrinsic high glucose uptake, such as the brain. Deuterium metabolic imaging (DMI) is a novel, noninvasive approach that combines deuterium magnetic resonance spectroscopic imaging with oral intake or intravenous infusion of nonradioactive ²H-labeled substrates to generate three-dimensional metabolic maps. DMI can reveal glucose metabolism beyond mere uptake and can be used with other ²H-labeled substrates as well. We demonstrate DMI by mapping metabolism in the brain and liver of animal models and human subjects using [6,6'-²H₂]glucose or [²H₃]acetate. In a rat glioma model, DMI revealed pronounced metabolic differences between normal brain and tumor tissue, with high-contrast metabolic maps depicting the Warburg effect. We observed similar metabolic patterns and image contrast in two patients with a high-grade brain tumor after oral intake of ²H-labeled glucose. Further, DMI used in rat and human livers showed [6,6'-²H₂]glucose stored as labeled glycogen. DMI is a versatile, robust, and easy-to-implement technique that requires minimal modifications to existing clinical magnetic resonance imaging scanners. DMI has great potential to become a widespread method for metabolic imaging in both (pre)clinical research and the clinic.

Development and Implementation of a PIN-Diode Controlled, Quadrature-Enhanced, Double-Tuned RF Coil for Sodium MRI

Sodium (²³Na) MRI provides complementary cellular and metabolic information. However, the intrinsic MR sensitivity of ²³Na is considerably lower compared with that of the proton, making it difficult to measure MR-detectable sodium signals. It is therefore important to maintain the signal-to-noise ratio (SNR) of the sodium signal as high as possible. Double-tuned coils are often employed in combinationwith a ¹H coil, providing structural images and B₀ shimming capability. The double-tuned coil design can be achieved with the use of two geometrically decoupled coils whose B₁ field directions are perpendicular to each other. This can be used to design quadrature-driven, single-nucleus coils to improve SNR, and additionally, this coil can also be utilized as a linear-driven double-resonant mode. Here, we have developed and evaluateda quadrature-enhanced, double-tuned coil. The novel coil uses PIN-diode switches, inserted only in the loop coil, to shift the resonance frequency between ¹H and ²³Na so that ²³Na signals can be acquired in quadrature and the capability of using ¹H function remains. Consequently, the ²³Na SNR values obtained with the double-tuned coil are nearly 33% and 17% higher in comparison with geometrically identical single-tuned coils. SNR plots also show the superiority of double-tuned coil in ²³Na.

Proton-decoupled carbon magnetic resonance spectroscopy in human calf muscles at 7 T using a multi-channel radiofrequency coil

¹³C magnetic resonance spectroscopy is a viable, non-invasive method to study cell metabolism in skeletal muscles. However, MR sensitivity of ¹³C is inherently low, which can be overcome by applying a higher static magnetic field strength together with radiofrequency coil arrays instead of single loop coils or large volume coils, and ¹H decoupling, which leads to a simplified spectral pattern. ¹H-decoupled ¹³C-MRS requires RF coils which support both, ¹H and ¹³C, Larmor frequencies with sufficient electromagnetic isolation between the pathways of the two frequencies. We present the development, evaluation, and first in vivo measurement with a 7 T 3-channel ¹³C and 4-channel ¹H transceiver array optimized for ¹H-decoupled ¹³C-MRS in the posterior human calf muscles. To ensure minimal cross-coupling between ¹³C and ¹H arrays, several strategies were combined: mutual magnetic flux was minimized by coil geometry, two LCC traps were inserted into each ¹³C element, and band-pass and low-pass filters were integrated along the signal pathways. The developed coil array was successfully tested in phantom and in vivo MR experiments, showing a simplified spectral pattern and increase in signal-to-noise ratio of approximately a factor 2 between non-decoupled and ¹H-decoupled spectra in a glucose phantom and the human calf muscle.

Maximizing sensitivity for fast GABA edited spectroscopy in the visual cortex at 7 T

The combination of functional MRI (fMRI) and MRS is a promising approach to relate BOLD imaging to neuronal metabolism, especially at high field strength. However, typical scan times for GABA edited spectroscopy are of the order of 6-30 min, which is long compared with functional changes observed with fMRI. The aim of this study is to reduce scan time and increase GABA sensitivity for edited spectroscopy in the human visual cortex, by enlarging the volume of activated tissue in the primary visual cortex. A dedicated setup at 7 T for combined fMRI and GABA MRS is developed. This setup consists of a half volume multi-transmit coil with a large screen for visual cortex activation, two high density receive arrays and an optimized single-voxel MEGA-sLASER sequence with macromolecular suppression for signal acquisition. The coil setup performance as well as the GABA measurement speed, SNR, and stability were evaluated. A 2.2-fold gain of the average SNR for GABA detection was obtained, as compared with a conventional 7 T setup. This was achieved by increasing the viewing angle of the participant with respect to the visual stimulus, thereby activating almost the entire primary visual cortex, allowing larger spectroscopy measurement volumes and resulting in an improved GABA SNR. Fewer than 16 signal averages, lasting 1 min 23 s in total, were needed for the GABA fit method to become stable, as demonstrated in three participants. The stability of the measurement setup was sufficient to detect GABA with an accuracy of 5%, as determined with a GABA phantom. In vivo, larger variations in GABA concentration are found: 14-25%. Overall, the results bring functional GABA detections at a temporal resolution closer to the physiological time scale of BOLD cortex activation.

In Vivo Heteronuclear Magnetic Resonance Spectroscopy

Magnetic Resonance Spectroscopy is a technique that has the capability of measuring metabolites in vivo and, in appropriate conditions, to infer its metabolic rates. The success of MRS depends a lot on its sensitivity, which limits the usage of X-nuclei MRS. However, technological developments and refinements in methods have made in vivo heteronuclear MRS possible in humans and in small animals. This chapter provides detailed descriptions of the main procedures needed to perform successful in vivo heteronuclear MRS experiments, with a particular focus on experimental setup in ¹³C MRS experiments in rodents.

Cerebral glycogen in humans following acute and recurrent hypoglycemia: Implications on a role in hypoglycemia unawareness

Supercompensated brain glycogen levels may contribute to the development of hypoglycemia-associated autonomic failure (HAAF) following recurrent hypoglycemia (RH) by providing energy for the brain during subsequent periods of hypoglycemia. To assess the role of glycogen supercompensation in the generation of HAAF, we estimated the level of brain glycogen following RH and acute hypoglycemia (AH). After undergoing 3 hyperinsulinemic, euglycemic and 3 hyperinsulinemic, hypoglycemic clamps (RH) on separate occasions at least 1 month apart, five healthy volunteers received [1-¹³C]glucose intravenously over 80+ h while maintaining euglycemia. ¹³C-glycogen levels in the occipital lobe were measured by ¹³C magnetic resonance spectroscopy at ∼8, 20, 32, 44, 56, 68 and 80 h at 4 T and glycogen levels estimated by fitting the data with a biophysical model that takes into account the tiered glycogen structure. Similarly, prior ¹³C-glycogen data obtained following a single hypoglycemic episode (AH) were fitted with the same model. Glycogen levels did not significantly increase after RH relative to after euglycemia, while they increased by ∼16% after AH relative to after euglycemia. These data suggest that glycogen supercompensation may be blunted with repeated hypoglycemic episodes. A causal relationship between glycogen supercompensation and generation of HAAF remains to be established.

High Field In vivo13C Magnetic Resonance Spectroscopy of Brain by Random Radiofrequency Heteronuclear Decoupling and Data Undersampling

In vivo¹³C magnetic resonance spectroscopy (MRS) is a unique and effective tool for studying dynamic human brain metabolism and the cycling of neurotransmitters. One of the major technical challenges for in vivo¹³C-MRS is the high radio frequency (RF) power necessary for heteronuclear decoupling. In the common practice of in vivo¹³C-MRS, alkanyl carbons are detected in the spectra range of 10-65 ppm. The amplitude of decoupling pulses has to be significantly greater than the large one-bond ¹H-¹³C scalar coupling (¹J_CH = 125-145 Hz). Two main proton decoupling methods have been developed: broadband stochastic decoupling and coherent composite or adiabatic pulse decoupling (e.g., WALTZ); the latter is widely used because of its efficiency and superb performance under inhomogeneous B₁ field. Because the RF power required for proton decoupling increases quadratically with field strength, in vivo¹³C-MRS using coherent decoupling is often limited to lowmagnetic fields [<=4 Tesla (T)] to keep the local and averaged specific absorption rate (SAR) under the safety guidelines established by the International Electrotechnical Commission (IEC) and the US Food and Drug Administration (FDA). Alternately, carboxylic/amide carbons are coupled to protons via weak long-range ¹H-¹³C scalar couplings, which can be decoupled using low RF power broadband stochastic decoupling. Recently, the carboxylic/amide ¹³C-MRS technique using low power random RF heteronuclear decoupling was safely applied to human brain studies at 7T. Here, we review the two major decoupling methods and the carboxylic/amide ¹³C-MRS with low power decoupling strategy. Further decreases in RF power deposition by frequency-domain windowing and time-domain random under-sampling are also discussed. Low RF power decoupling opens the possibility of performing in vivo¹³C experiments of human brain at very high magnetic fields (such as 11.7T), where signal-to-noise ratio as well as spatial and temporal spectral resolution are more favorable than lower fields.

Progress towards in vivo brain 13C-MRS in mice: Metabolic flux analysis in small tissue volumes

The combination of dynamic ¹³C MRS data under infusion of ¹³C-labelled substrates and compartmental models of cerebral metabolism enabled in vivo measurement of metabolic fluxes with a quantitative and distinct determination of cellular-specific activities. The non-invasive nature and the chemical specificity of the ¹³C dynamic data obtained in those tracer experiments makes it an attractive approach offering unique insights into cerebral metabolism. Genetically engineered mice present a wealth of disease models particularly interesting for the neuroscience community. Nevertheless, in vivo¹³C NMR studies of the mouse brain are only recently appearing in the field due to the numerous challenges linked to the small mouse brain volume and the difficulty to follow the mouse physiological parameters within the NMR system during the infusion experiment. This review will present the progresses in the quest for a higher in vivo¹³C signal-to-noise ratio up to the present state of the art techniques, which made it feasible to assess glucose metabolism in different regions of the mouse brain. We describe how experimental results were integrated into suitable compartmental models and how a deep understanding of cerebral metabolism depends on the reliable detection of ¹³C in the different molecules and carbon positions.

Trap Design and Construction for High-Power Multinuclear Magnetic Resonance Experiments

Performing multinuclear experiments requires one or more radiofrequency (RF) coils operating at both the proton and second-nucleus frequencies; however, inductive coupling between coils must be mitigated to retain proton sensitivity and coil tuning stability. The inclusion of trap circuits simplifies placement of multinuclear RF coils while maintaining inter-element isolation. Of the commonly investigated non-proton nuclei, perhaps the most technically demanding is carbon-13, particularly when applying a proton decoupling scheme to improve the resulting spectra. This work presents experimental data for trap circuits withstanding high-power broadband proton decoupling of carbon-13 at 7 T. The advantages and challenges of building trap circuits with various inductor and capacitor components are discussed. Multiple trap designs are evaluated on the bench and utilized on an RF coil at 7 T to detect broadband proton-decoupled carbon-13 spectra from a lipid phantom. A particular trap design, built from a coaxial stub inductor and high-voltage ceramic chip capacitors, is highlighted owing to both its performance and adaptability for planar array coil elements with diverse spatial orientations.

Detection of cerebral NAD+ in humans at 7T

PURPOSE

To develop ¹ H-based MR detection of nicotinamide adenine dinucleotide (NAD⁺ ) in the human brain at 7T and validate the ¹ H results with NAD⁺ detection based on ³¹ P-MRS.

METHODS

¹ H-MR detection of NAD⁺ was achieved with a one-dimensional double-spin-echo method on a slice parallel to the surface coil transceiver. Perturbation of the water resonance was avoided through the use of frequency-selective excitation. ³¹ P-MR detection of NAD⁺ was performed with an unlocalized pulse-acquire sequence.

RESULTS

Both ¹ H- and ³¹ P-MRS allowed the detection of NAD⁺ signals on every subject in 16 min. Spectral fitting provided an NAD⁺ concentration of 107 ± 28 μM for ¹ H-MRS and 367 ± 78 μM and 312 ± 65 μM for ³¹ P-MRS when uridine diphosphate glucose (UDPG) was excluded and included, respectively, as an overlapping signal.

CONCLUSIONS

NAD⁺ detection by ¹ H-MRS is a simple method that comes at the price of reduced NMR visibility. NAD⁺ detection by ³¹ P-MRS has near-complete NMR visibility, but it is complicated by spectral overlap with NADH and UDPG. Overall, the ¹ H- and ³¹ P-MR methods both provide exciting opportunities to study NAD⁺ metabolism on human brain in vivo. © 2016 International Society for Magnetic Resonance in Medicine. Magn Reson Med 78:828-835, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Experimental strategies for in vivo13C NMR spectroscopy

In vivo carbon-13 (¹³C) MRS opens unique insights into the metabolism of intact organisms, and has led to major advancements in the understanding of cellular metabolism under normal and pathological conditions in various organs such as skeletal muscles, the heart, the liver and the brain. However, the technique comes at the expense of significant experimental difficulties. In this review we focus on the experimental aspects of non-hyperpolarized ¹³C MRS in vivo. Some of the enrichment strategies which have been proposed so far are described; the various MRS acquisition paradigms to measure ¹³C labeling are then presented. Finally, practical aspects of ¹³C spectral quantification are discussed.

High-performance radiofrequency coils for (23)Na MRI: brain and musculoskeletal applications

(23)Na RF coil design for brain and MSK applications presents a number of challenges, including poor coil loading for arrays of small coils and SNR penalties associated with providing (1)H capability with the same coil. The basics of RF coil design are described, as well as a review of historical approaches to dual tuning. There follows a review of published high performance coil designs for MSK and brain imaging. Several coil designs have been demonstrated at 7T and 3T which incorporate close-fitting receive arrays and in some cases design features which provide (1)H imaging with little penalty to (23)Na sensitivity. The "nested coplanar loop" approach is examined, in which small transmit-receive (1)H elements are placed within each (23)Na loop, presenting only a small perturbation to (23)Na performance and minimizing RF shielding issues. Other designs incorporating transmit-receive arrays for (23)Na and (1)H are discussed including a 9.4 T (23)Na/(1)H brain coil. Great gains in (23)Na SNR have been made with many of these designs, but simultaneously achieving high performance for 1H remains elusive.

Sodium MRI radiofrequency coils for body imaging

The proliferation of high-field whole-body systems, advances in gradient performance and refinement of signal-to-noise ratio (SNR)-efficient short-TE sequences suitable for sodium imaging have led to a resurgence of interest in sodium imaging for body applications. With this renewed interest has come increased demand for SNR-efficient sodium coils. Efficient coils can significantly increase SNR in sodium imaging, allowing higher resolutions and/or shorter scan times. In this work, we focus on body imaging applications of sodium MRI, and review developments in MRI radiofrequency (RF) coil topologies for sodium imaging. We first provide a brief discussion of RF coil design considerations in sodium imaging. This is followed by an overview of common coil topologies, their advantages and disadvantages, and examples of each.

A nested phosphorus and proton coil array for brain magnetic resonance imaging and spectroscopy

A dual-nuclei radiofrequency coil array was constructed for phosphorus and proton magnetic resonance imaging and spectroscopy of the human brain at 7T. An eight-channel transceive degenerate birdcage phosphorus module was implemented to provide whole-brain coverage and significant sensitivity improvement over a standard dual-tuned loop coil. A nested eight-channel proton module provided adequate sensitivity for anatomical localization without substantially sacrificing performance on the phosphorus module. The developed array enabled phosphorus spectroscopy, a saturation transfer technique to calculate the global creatine kinase forward reaction rate, and single-metabolite whole-brain imaging with 1.4cm nominal isotropic resolution in 15min (2.3cm actual resolution), while additionally enabling 1mm isotropic proton imaging. This study demonstrates that a multi-channel array can be utilized for phosphorus and proton applications with improved coverage and/or sensitivity over traditional single-channel coils. The efficient multi-channel coil array, time-efficient pulse sequences, and the enhanced signal strength available at ultra-high fields can be combined to allow volumetric assessment of the brain and could provide new insights into the underlying energy metabolism impairment in several neurodegenerative conditions, such as Alzheimer's and Parkinson's diseases, as well as mental disorders such as schizophrenia.

1 H-13 C independently tuned radiofrequency surface coil applied for in vivo hyperpolarized MRI

PURPOSE

To develop a lump-element double-tuned common-mode-differential-mode (CMDM) radiofrequency (RF) surface coil with independent frequency tuning capacity for MRS and MRI applications.

METHODS

The presented design has two modes that can operate with different current paths, allowing independent frequency adjustment. The coil prototype was tested on the bench and then examined in phantom and in vivo experiments.

RESULTS

Standard deviations of frequency and impedance fluctuations measured in one resonator, while changing the tuning capacitor of another resonator, were less than 13 kHz and 0.55 Ω. The unloaded S21 was -36 dB and -41 dB, while the unloaded Q factor was 260 and 287, for ¹³ C and ¹ H, respectively. In vivo hyperpolarized ¹³ C MR spectroscopy data demonstrated the feasibility of using the CMDM coil to measure the dynamics of lactate, alanine, pyruvate and bicarbonate signal in a normal rat head along with acquiring ¹ H anatomical reference images.

CONCLUSION

Independent frequency tuning capacity was demonstrated in the presented lump-element double-tuned CMDM coil. This CMDM coil maintained intrinsically decoupled magnetic fields, which provided sufficient isolation between the two resonators. The results from in vivo experiments demonstrated high sensitivity of both the ¹ H and ¹³ C resonators. Magn Reson Med 76:1612-1620, 2016. © 2015 International Society for Magnetic Resonance in Medicine.

A flexible nested sodium and proton coil array with wideband matching for knee cartilage MRI at 3T

PURPOSE

We describe a 2 × 6 channel sodium/proton array for knee MRI at 3T. Multielement coil arrays are desirable because of well-known signal-to-noise ratio advantages over volume and single-element coils. However, low tissue-coil coupling that is characteristic of coils operating at low frequency can make the potential gains from a phased array difficult to realize.

METHODS

The issue of low tissue-coil coupling in the developed six-channel sodium receive array was addressed by implementing 1) a mechanically flexible former to minimize the coil-to-tissue distance and reduce the overall diameter of the array and 2) a wideband matching scheme that counteracts preamplifier noise degradation caused by coil coupling and a high-quality factor. The sodium array was complemented with a nested proton array to enable standard MRI.

RESULTS

The wideband matching scheme and tight-fitting mechanical design contributed to >30% central signal-to-noise ratio gain on the sodium module over a mononuclear sodium birdcage coil, and the performance of the proton module was sufficient for clinical imaging.

CONCLUSION

We expect the strategies presented in this study to be generally relevant in high-density receive arrays, particularly in x-nuclei or small animal applications. Magn Reson Med 76:1325-1334, 2016. © 2015 Wiley Periodicals, Inc.

High-sensitivity, broadband-decoupled (13) C MR spectroscopy in humans at 7T using two-dimensional heteronuclear single-quantum coherence

PURPOSE

Carbon-13 ((13) C) magnetic resonance spectroscopy (MRS) has an intrinsically low NMR sensitivity that often leads to large acquisition volumes or long scan times. While the use of higher magnetic fields can overcome the sensitivity limitations, high radiofrequency (RF) power deposition associated with proton-decoupling limits the achievable gain. Two-dimensional (2D) heteronuclear single quantum coherence (HSQC) MRS is a method that uses the high chemical specificity of (13) C MRS while retaining the high sensitivity of (1) H detection. Due to the 2D nature of the method, proton-decoupled (13) C MR spectra can be obtained without the use of high-powered decoupling pulses.

METHODS

A novel three-dimensional (3D) localized 2D HSQC method based on 3D STEAM localization is presented and implemented at 7T. The low RF power deposition of the method allows TR variation along the indirect dimension which, in combination with controlled aliasing, leads to an acceleration of 11.8 relative to a standard 2D NMR acquisition.

RESULTS

Artifact-free, high-quality and high-sensitivity 2D HSQC spectra were obtained for all subjects in 19 min from a small (9 mL) volume placed in the leg adipose tissue. Complete proton decoupling was achieved along the indirect (13) C dimension despite the absence of broadband proton-decoupling pulses. The high chemical specificity along the indirect (13) C dimension allowed the detection of 19 unique resonances from which the lipids could be characterized in terms of saturation and omega-6/omega-3 fatty acid ratio.

CONCLUSION

It has been demonstrated that high-quality 2D HSQC NMR spectra can be acquired from human adipose tissue at 7T. The HSQC method is methodologically simple and robust and is flexible regarding trade-offs between temporal and spectral resolution. 2D HSQC has a strong potential to become a default method in natural-abundance or (13) C-enriched studies of human metabolism in vivo.

Revisiting Glycogen Content in the Human Brain

Glycogen provides an important glucose reservoir in the brain since the concentration of glucosyl units stored in glycogen is several fold higher than free glucose available in brain tissue. We have previously reported 3-4 µmol/g brain glycogen content using in vivo (13)C magnetic resonance spectroscopy (MRS) in conjunction with [1-(13)C]glucose administration in healthy humans, while higher levels were reported in the rodent brain. Due to the slow turnover of bulk brain glycogen in humans, complete turnover of the glycogen pool, estimated to take 3-5 days, was not observed in these prior studies. In an attempt to reach complete turnover and thereby steady state (13)C labeling in glycogen, here we administered [1-(13)C]glucose to healthy volunteers for 80 h. To eliminate any net glycogen synthesis during this period and thereby achieve an accurate estimate of glycogen concentration, volunteers were maintained at euglycemic blood glucose levels during [1-(13)C]glucose administration and (13)C-glycogen levels in the occipital lobe were measured by (13)C MRS approximately every 12 h. Finally, we fitted the data with a biophysical model that was recently developed to take into account the tiered structure of the glycogen molecule and additionally incorporated blood glucose levels and isotopic enrichments as input function in the model. We obtained excellent fits of the model to the (13)C-glycogen data, and glycogen content in the healthy human brain tissue was found to be 7.8 ± 0.3 µmol/g, a value substantially higher than previous estimates of glycogen content in the human brain.

A monopole/loop dual-tuned RF coil for ultrahigh field MRI

Proton and heteronuclear MRI/MRS using dual-tuned (DT) coils could provide both anatomical and metabolic images without repositioning the subject. However, it is technologically challenging to attain sufficiently electromagnetic (EM) decoupling between the heteronuclear channel and proton channel, and keep the imaging areas and profiles of two nuclear channels highly matched. In this study, a hybrid monopole/loop technique was proposed for DT coil design and this technique was validated by implementing and testing a DT (1)H/(23)Na coil for MR imaging at 7T. The RF fields of the monopole ((1)H channel) and regular L/C loop ((23)Na channel) were orthogonal and intrinsically EM decoupled. Bench measurement results demonstrated the isolation between the two nuclear channels was better than -28 dB at both nuclear frequencies. Compared with the conventional DT coil using trap circuits, the monopole/loop DT coil had higher MR sensitivity for sodium imaging. The experimental results indicated that the monopole/loop technique might be a simple and efficient design for multinuclear imaging at ultrahigh fields. Additionally, the proposed DT coils based on the monopole/loop technique can be used as building blocks in designing multichannel DT coil arrays.

What have novel imaging techniques revealed about metabolism in the aging brain?

Brain metabolism declines with age and do so in an accelerated manner in neurodegenerative disorders. Noninvasive neuroimaging techniques have played an important role to identify the metabolic biomarkers in aging brain. Particularly, PET with fluorine-18 (¹⁸F)-labeled 2-fluoro-2-deoxy-d-glucose tracer and proton magnetic resonance spectroscopy (MRS) have been widely used to monitor changes in brain metabolism over time, identify the risk for Alzheimer's disease (AD) and predict the conversion from mild cognitive impairment to AD. Novel techniques, including PET carbon-11 Pittsburgh compound B, carbon-13 and phosphorus-31 MRS, have also been introduced to determine Aβ plaques deposition, mitochondrial functions and brain bioenergetics in aging brain and neurodegenerative disorders. Here, we introduce the basic principle of the imaging techniques, review the findings from 2-fluoro-2-deoxy-d-glucose-PET, Pittsburgh compound B PET, proton, carbon-13 and phosphorus-31 MRS on changes in metabolism in normal aging brain, mild cognitive impairment and AD, and discuss the potential of neuroimaging to identify effective interventions and treatment efficacy for neurodegenerative disorders.

Faster metabolite (1)H transverse relaxation in the elder human brain

¹H magnetic resonance spectroscopy (MRS) is unique among imaging modalities because signals from several metabolites are measured during a single examination period. Each metabolite reflects a distinct intracellular process. Furthermore transverse (T₂) relaxation times probe the viability of the cell microenvironment, e.g., the viscosity of the cellular fluids, the microscopic susceptibility distribution within the cells, and the iron content. In this study, T₂s of brain metabolites were measured in the occipital lobe of eighteen young and fourteen elderly subjects at a field strength of 4 tesla. The T₂s of N-acetylaspartate, total creatine, and total choline were 23%, 16% and 10% shorter in elderly than in young subjects. The findings of this study suggest that noninvasive detection of T₂ provides useful biological information on changes in the cellular microenvironment that take place during aging.

A 3 T sodium and proton composite array breast coil

PURPOSE

The objective of this study was to determine whether a sodium phased array would improve sodium breast MRI at 3 T. The secondary objective was to create acceptable proton images with the sodium phased array in place.

METHODS

A novel composite array for combined proton/sodium 3 T breast MRI is compared with a coil with a single proton and sodium channel. The composite array consists of a 7-channel sodium receive array, a larger sodium transmit coil, and a 4-channel proton transceive array. The new composite array design utilizes smaller sodium receive loops than typically used in sodium imaging, uses novel decoupling methods between the receive loops and transmit loops, and uses a novel multichannel proton transceive coil. The proton transceive coil reduces coupling between proton and sodium elements by intersecting the constituent loops to reduce their mutual inductance. The coil used for comparison consists of a concentric sodium and proton loop with passive decoupling traps.

RESULTS

The composite array coil demonstrates a 2-5× improvement in signal-to-noise ratio for sodium imaging and similar signal-to-noise ratio for proton imaging when compared with a simple single-loop dual resonant design.

CONCLUSION

The improved signal-to-noise ratio of the composite array gives breast sodium images of unprecedented quality in reasonable scan times.

A dual-tuned transceive resonator for (13) C{(1) H} MRS: two open coils in one

Proton-decoupled, (13) C nuclear MRS experiments require a RF coil that operates at the Larmor frequencies of both (13) C and (1) H. In this work, we designed, built and tested a single-unit, dual-tuned coil based on a half-birdcage open coil design. It was constructed as a low-pass network with a resonant trap in series with each leg. Traps are tuned in alternate legs such that the two resonant modes arise from currents on alternate legs. The coil performance was compared with that of a dual-tuned coil consisting of two proton surface coils operating in quadrature and a single surface coil for (13) C transmission and reception. The half-birdcage coil was shown to produce a more homogeneous RF field at each frequency and was more sensitive to a (13) C signal arising from regions further from the coil surface. The applicability of the coil in vivo was demonstrated by acquiring a proton decoupled, natural abundance (13) C glycogen signal from the calf of a normal volunteer.

Measurement of Arterial Input Function in Hyperpolarized 13C Studies

Recently, hyperpolarized substrates generated through dynamic nuclear polarization have been introduced to study in vivo metabolism. Injection of hyperpolarized [1-13C]pyruvate, the most widely used substrate, allows detection of time courses of [1-13C]pyruvate and its metabolic products, such as [1-13C]lactate and 13C-bicarbonate, in various organs. However, quantitative metabolic modeling of in vivo data to measure specific metabolic rates remains challenging without measuring the input function. In this study, we demonstrate that the input function of [1-13C]pyruvate can be measured in vivo in the rat carotid artery using an implantable coil.

Brain glycogen content and metabolism in subjects with type 1 diabetes and hypoglycemia unawareness

Supercompensated brain glycogen may contribute to the development of hypoglycemia unawareness in patients with type 1 diabetes by providing energy for the brain during periods of hypoglycemia. Our goal was to determine if brain glycogen content is elevated in patients with type 1 diabetes and hypoglycemia unawareness. We used in vivo (13)C nuclear magnetic resonance spectroscopy in conjunction with [1-(13)C]glucose administration in five patients with type 1 diabetes and hypoglycemia unawareness and five age-, gender-, and body mass index-matched healthy volunteers to measure brain glycogen content and metabolism. Glucose and insulin were administered intravenously over ∼51 hours at a rate titrated to maintain a blood glucose concentration of 7 mmol/L. (13)C-glycogen levels in the occipital lobe were measured at ∼5, 8, 13, 23, 32, 37, and 50 hours, during label wash-in and wash-out. Newly synthesized glycogen levels were higher in controls than in patients (P<0.0001) for matched average blood glucose and insulin levels, which may be due to higher brain glycogen content or faster turnover in controls. Metabolic modeling indicated lower brain glycogen content in patients than in controls (P=0.07), implying that glycogen supercompensation does not contribute to the development of hypoglycemia unawareness in humans with type 1 diabetes.

Localized in vivo hyperpolarization transfer sequences

In vivo localized and fully adiabatic homonuclear and heteronuclear polarization transfer experiments were designed and performed in the rat brain at 9.4 T after infusion of hyperpolarized sodium [1,2-(13)C(2)] and sodium [1-(13)C] acetate. The method presented herein leads to highly enhanced in vivo detection of short-T(1) (13)C as well as attached protons. This indirect detection scheme allows for probing additional molecular sites in hyperpolarized substrates and their metabolites and can thus lead to improved spectral resolution such as in the case of (13)C-acetate metabolism.

Simultaneous measurement of glucose transport and utilization in the human brain

Glucose is the primary fuel for brain function, and determining the kinetics of cerebral glucose transport and utilization is critical for quantifying cerebral energy metabolism. The kinetic parameters of cerebral glucose transport, K(M)(t) and V(max)(t), in humans have so far been obtained by measuring steady-state brain glucose levels by proton ((1)H) NMR as a function of plasma glucose levels and fitting steady-state models to these data. Extraction of the kinetic parameters for cerebral glucose transport necessitated assuming a constant cerebral metabolic rate of glucose (CMR(glc)) obtained from other tracer studies, such as (13)C NMR. Here we present new methodology to simultaneously obtain kinetic parameters for glucose transport and utilization in the human brain by fitting both dynamic and steady-state (1)H NMR data with a reversible, non-steady-state Michaelis-Menten model. Dynamic data were obtained by measuring brain and plasma glucose time courses during glucose infusions to raise and maintain plasma concentration at ∼17 mmol/l for ∼2 h in five healthy volunteers. Steady-state brain vs. plasma glucose concentrations were taken from literature and the steady-state portions of data from the five volunteers. In addition to providing simultaneous measurements of glucose transport and utilization and obviating assumptions for constant CMR(glc), this methodology does not necessitate infusions of expensive or radioactive tracers. Using this new methodology, we found that the maximum transport capacity for glucose through the blood-brain barrier was nearly twofold higher than maximum cerebral glucose utilization. The glucose transport and utilization parameters were consistent with previously published values for human brain.

State of the art direct 13C and indirect 1H-[13C] NMR spectroscopy in vivo. A practical guide

Carbon-13 NMR spectroscopy in combination with (13)C-labeled substrate infusion is a powerful technique for measuring a large number of metabolic fluxes noninvasively in vivo. It has been used to quantify glycogen synthesis rates, establish quantitative relationships between energy metabolism and neurotransmission, and evaluate the importance of different substrates. Measurements can, in principle, be performed through direct (13)C NMR detection or via indirect (1)H-[(13)C] NMR detection of the protons attached to (13)C nuclei. The choice of detection scheme and pulse sequence depends on the magnetic field strength, whereas substrate selection depends on metabolic pathways. (13)C NMR spectroscopy remains a challenging technique that requires several nonstandard hardware modifications, infusion of (13)C-labeled substrates, and sophisticated processing and metabolic modeling. In this study, the various aspects of direct (13)C and indirect (1)H-[(13)C] NMR are reviewed with the aim of providing a practical guide.

13C MRS studies of neuroenergetics and neurotransmitter cycling in humans

In the last 25 years, (13)C MRS has been established as the only noninvasive method for the measurement of glutamate neurotransmission and cell-specific neuroenergetics. Although technically and experimentally challenging, (13)C MRS has already provided important new information on the relationship between neuroenergetics and neuronal function, the energy cost of brain function, the high neuronal activity in the resting brain state and how neuroenergetics and neurotransmitter cycling are altered in neurological and psychiatric disease. In this article, the current state of (13)C MRS as it is applied to the study of neuroenergetics and neurotransmitter cycling in humans is reviewed. The focus is predominantly on recent findings in humans regarding metabolic pathways, applications to clinical research and the technical status of the method. Results from in vivo (13)C MRS studies in animals are discussed from the standpoint of the validation of MRS measurements of neuroenergetics and neurotransmitter cycling, and where they have helped to identify key questions to address in human research. Controversies concerning the relationship between neuroenergetics and neurotransmitter cycling and factors having an impact on the accurate determination of fluxes through mathematical modeling are addressed. We further touch upon different (13)C-labeled substrates used to study brain metabolism, before reviewing a number of human brain diseases investigated using (13)C MRS. Future technological developments are discussed that will help to overcome the limitations of (13)C MRS, with special attention given to recent developments in hyperpolarized (13)C MRS.