Very short echo time proton MR spectroscopy of human brain with a standard transmit/receive surface coil

Optimized in vivo brain glutamate measurement using long-echo-time semi-LASER at 7 T

A short echo time (T_E ) is commonly used for brain glutamate measurement by ¹ H MRS to minimize drawbacks of long T_E such as signal modulation due to J evolution and T₂ relaxation. However, J coupling causes the spectral patterns of glutamate to change with T_E , and the shortest achievable T_E may not produce the optimal glutamate measurement. The purpose of this study was to determine the optimal T_E for glutamate measurement at 7 T using semi-LASER (localization by adiabatic selective refocusing). Time-domain simulations were performed to model the T_E dependence of glutamate signal energy, a measure of glutamate signal strength, and were verified against measurements made in the human sensorimotor cortex (five subjects, 2 × 2 × 2 cm³ voxel, 16 averages) on a 7 T MRI scanner. Simulations showed a local maximum of glutamate signal energy at T_E  = 107 ms. In vivo, T_E  = 105 ms produced a low Cramér-Rao lower bound of 6.5 ± 2.0% across subjects, indicating high-quality fits of the prior knowledge model to in vivo data. T_E  = 105 ms also produced the greatest glutamate signal energy with the smallest inter-subject glutamate-to-creatine ratio (Glu/Cr) coefficient of variation (CV), 4.6%. Using these CVs, we performed sample size calculations to estimate the number of participants per group required to detect a 10% change in Glu/Cr between two groups with 95% confidence. 13 were required at T_E  = 45 ms, the shortest achievable echo time on our 7 T MRI scanner, while only 5 were required at T_E  = 105 ms, indicating greater statistical power. These results indicate that T_E  = 105 ms is optimum for in vivo glutamate measurement at 7 T with semi-LASER. Using long T_E decreases power deposition by allowing lower maximum RF pulse amplitudes in conjunction with longer RF pulses. Importantly, long T_E minimizes macromolecule contributions, eliminating the requirement for acquisition of separate macromolecule spectra or macromolecule fitting techniques, which add additional scan time or bias the estimated glutamate fit.

Designing adiabatic radio frequency pulses using the Shinnar-Le Roux algorithm

Adiabatic pulses are a special class of radio frequency (RF) pulses that may be used to achieve uniform flip angles in the presence of a nonuniform B(1) field. In this work, we present a new, systematic method for designing high-bandwidth (BW), low-peak-amplitude adiabatic RF pulses that utilizes the Shinnar-Le Roux (SLR) algorithm for pulse design. Currently, the SLR algorithm is extensively employed to design nonadiabatic pulses for use in magnetic resonance imaging and spectroscopy. We have adapted the SLR algorithm to create RF pulses that also satisfy the adiabatic condition. By overlaying sufficient quadratic phase across the spectral profile before the inverse SLR transform, we generate RF pulses that exhibit the required spectral characteristics and adiabatic behavior. Application of quadratic phase also distributes the RF energy more uniformly, making it possible to obtain the same spectral BW with lower RF peak amplitude. The method enables the pulse designer to specify spectral profile parameters and the degree of quadratic phase before pulse generation. Simulations and phantom experiments demonstrate that RF pulses designed using this new method behave adiabatically.

Short-TE localised 1H MRS of the human brain at 3 T: quantification of the metabolite signals using two approaches to account for macromolecular signal contributions

The goal of this study was to validate metabolite quantification at short TE, with particular focus on how to best account for the macromolecular signal contribution. A robust, short-TE PRESS protocol is presented, which allows reliable quantification, in vivo, of metabolite signals at 3 T in human brain. Water suppression was adapted to the experimental conditions at 3 T. Metabolite signal from the parietal white matter was quantified in the time domain using QUEST (jMRUI). The increased macromolecular signal contribution at short TE was dealt with by two approaches, based on either metabolite nulling or initial signal truncation. A detailed comparison of the two approaches was made. The first used a metabolite-nulled signal, measured either individually or averaged over different subjects. The second used the total signal, metabolites and macromolecules, from a single scan. The two approaches gave similar quantification results in terms of metabolite concentrations, but differed in their precision and the number of metabolites quantified reliably. With an average metabolite-nulled baseline, a set of seven metabolites could be reliably quantified in parietal white matter under these experimental conditions: N-acetylaspartate, myo-inositol, glucose, glutamate, glutathione, creatine and choline. When initial signal truncation was used, glucose was removed from this set. The short TE (10-11 ms) facilitated quantification of glutamate. The reliable quantification of N-acetylaspartyl glutamate at 3 T proved very difficult.

Characterization of hepatic and brain metabolism in young adults with glycogen storage disease type 1: a magnetic resonance spectroscopy study

In glycogen storage disease type 1 (GSD1), children present with severe hypoglycemia, whereas the propensity for hypoglycemia may decrease with age in these patients. It was the aim of this study to elucidate the mechanisms for milder hypoglycemia symptoms in young adult GSD1 patients. Four patients with GSD1 [body mass index (BMI) 23.2 +/- 6.3 kg/m, age 21.3 +/- 2.9 yr] and four healthy controls matched for BMI (23.1 +/- 3.0 kg/m) and age (24.0 +/- 3.1 yr) were studied. Combined (1)H/(31)P nuclear magnetic resonance spectroscopy (NMRS) was used to assess brain metabolism. Before and after administration of 1 mg glucagon, endogenous glucose production (EGP) was measured with d-[6,6-(2)H(2)]glucose and hepatic glucose metabolism was examined by (1)H/(13)C/(31)P NMRS. At baseline, GSD1 patients exhibited significantly lower rates of EGP (0.53 +/- 0.04 vs. 1.74 +/- 0.03 mg.kg(-1).min(-1); P < 0.01) but an increased intrahepatic glycogen (502 +/- 89 vs. 236 +/- 11 mmol/l; P = 0.05) and lipid content (16.3 +/- 1.1 vs. 1.4 +/- 0.4%; P < 0.001). After glucagon challenge, EGP did not change in GSD1 patients (0.53 +/- 0.04 vs. 0.59 +/- 0.24 mg.kg(-1).min(-1); P = not significant) but increased in healthy controls (1.74 +/- 0.03 vs. 3.95 +/- 1.34; P < 0.0001). In GSD1 patients, we found an exaggerated increase of intrahepatic phosphomonoesters (0.23 +/- 0.08 vs. 0.86 +/- 0.19 arbitrary units; P < 0.001), whereas inorganic phosphate decreased (0.36 +/- 0.08 vs. -0.43 +/- 0.17 arbitrary units; P < 0.01). Intracerebral ratios of glucose and lactate to creatine were higher in GSD1 patients (P < 0.05 vs. control). Therefore, hepatic defects of glucose metabolism persist in young adult GSD1 patients. Upregulation of the glucose and lactate transport at the blood-brain barrier could be responsible for the amelioration of hypoglycemic symptoms.

Localized short-echo-time proton MR spectroscopy with full signal-intensity acquisition

We developed a short-echo-time (TE) sequence for proton localized spectroscopy by combining a 1D add-subtract scheme with a doubly slice-selective spin-echo (SE) sequence. The sequence preserves the full magnetization available from the selected volume of interest (VOI). By reducing the number of radiofrequency (RF) pulses acting on transverse magnetization, we were able to minimize the TE to the level that is achievable with the stimulated echo acquisition mode (STEAM) technique, and also gained a twofold increase in sensitivity. The use of an adiabatic pulse in the add-subtract localization improved the efficiency of excitation in spatially inhomogeneous RF fields, which are frequently encountered at high magnetic fields. The localization performance and sensitivity gains of this method, which is termed SPin ECho, full Intensity Acquired Localized (SPECIAL) spectroscopy, were demonstrated in vivo in rat brains. In conjunction with spectroscopic imaging, a 2-microl spatial resolution was accomplished with a signal-to-noise ratio (SNR) above 30, which is usually sufficient for reliable quantification of a large number of metabolites (neurochemical profile).

Spatial localization in nuclear magnetic resonance spectroscopy

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

Cerebral glutamate metabolism during hypoglycaemia in healthy and type 1 diabetic humans

BACKGROUND

The mechanisms responsible for the progressive failure of hypoglycaemia counterregulation in long-standing type 1 diabetes are poorly understood. Increased brain glucose uptake during hypoglycaemia or alterations of brain energy metabolism could effect glucose sensing by the brain and thus contribute to hypoglycaemia-associated autonomic failure.

MATERIALS AND METHODS

Type 1 diabetic patients (T1DM) and healthy volunteers (CON) were studied before, during and after a hypoglycaemic (50 mg dL(-1)) hyperinsulinaemic (1.5 mU kg(-1) min(-1)) clamp test. The (1)H magnetic resonance spectroscopy of the occipital lobe of the brain was performed employing the STEAM localization technique. The water signal was suppressed by the modified SWAMP method. All spectra were acquired on a 3 Tesla scanner (80 cm MEDSPEC-DBX, Bruker Medical, Ettlingen, Germany) using a 10-cm diameter surface coil.

RESULTS

During hypoglycaemia, T1DM showed blunted endocrine counterregulation. At baseline the brain tissue glucose : creatine ratio was lower in CON than in T1DM (CON 0.13 +/- 0.05 vs. T1DM 0.19 0.11; P < 0.01). During hypoglycaemia glucose : creatine ratios decreased in both groups (CON 0.07 +/- 0.08, P < 0.05; T1DM 0.03 +/- 0.03, P < 0.001). A significant drop in the glutamate : creatine ratio could only be found in CON during hypoglycaemia (CON 1.36 +/- 0.08 vs. 1.26 +/- 0.11; P < 0.01; T1DM 1.32 +/- 0.13 vs. 1.28 +/- 0.15; P = NS). The ratios of glutamine, N-acetylaspartate, choline and myo-inositol : creatine were not different between both groups and did not change throughout the experiment.

CONCLUSIONS

Only in CON does moderate hypoglycaemia reduce intracerebral glutamate concentrations, possibly owing to a slower substrate flux through the tricarboxylic acid cycle in neurones. The maintenance of normal energy metabolism in T1DM during hypoglycaemia might effect glucose sensing in the brain and contribute to hypoglycaemia-associated autonomic failure.

Localized in vivo human 1H MRS at very short echo times

A new point-resolved spectroscopy (PRESS) sequence was developed that allows localized human proton MR spectra to be acquired at echo times (TEs) of 10 ms or less. The method was implemented on a 4 Tesla Varian research console and a clinical 3 Tesla Siemens Trio scanner. Human brain spectra acquired in vivo from the prefrontal cortex at TE=8 ms showed improved signals from coupled resonances (such as glutamate, glutamine, and myo-inositol) compared to spectra acquired at TE=30 ms. These improvements should result in more accurate quantitation of these metabolites.

Relaxation times of 31P-metabolites in human calf muscle at 3 T

Localized (31)P-STEAM experiments were performed at 3 T to estimate relaxation times of phosphorus-containing metabolites in the human calf muscle in vivo. T(1) and T(2) times of PCr, P(i), and NTPs were measured in the resting calf muscle of healthy subjects by varying TR and TE. The localization performance of the (31)P-STEAM sequence was evaluated on a test object, resulting in a relative selection efficiency of 78 +/- 1% and contamination from outside the voxel of 0 +/- 2% under fully relaxed conditions. T(1) relaxation times (+/-SD, n = 5) of P(i), PCr, gamma-NTP, alpha-NTP, and beta-NTP obtained at 3 T are 5.2 +/- 1.0 s, 6.4 +/- 0.2 s, 4.5 +/- 0.3 s, 2.6 +/- 0.9 s, and 3.5 +/- 1.1 s, respectively. T(2) relaxation times (+/-SD, n = 6) of these metabolites are 148 +/- 17 ms, 334 +/- 30 ms, 78 +/- 13 ms, 55 +/- 7 ms, and 55 +/- 10 ms, respectively. Spin-lattice relaxation times established at 3 T are consistent with literature data at lower field strengths, whereas spin-spin relaxation times are lower. Several methodological considerations are discussed which may help improve quantification of metabolite concentrations in the human (calf) muscle in vivo by using localized noninvasive (31)P-MRS at 3 T, which is currently being tested for routine clinical applications.

Low-power water suppression by hyperbolic secant pulses with controlled offsets and delays (WASHCODE)

A class of chemical-shift-selective (CHESS) water suppression (WS) schemes is presented in which the characteristic frequency-domain excitation profiles of "adiabatic" full-passage (AFP) RF pulses are utilized for frequency-selective excitation of the water resonance. In the proposed WS schemes, dubbed WASHCODE, hyperbolic secant (HS) pulses were used as the AFP pulses. Besides the high immunity of WS efficiency toward B(1) inhomogeneity, these sequences also exhibit extraordinary insensitivity to the dispersion of the water T(1) relaxation times. The actual performance of the proposed WS schemes was achieved in particular by optimizing the frequency offsets of WS HS pulses and the time intervals between them. To reduce the RF power requirements of these WS sequences for in vivo applications, HS pulses with the minimum possible frequency bandwidths were employed, which also substantially reduced the adverse effects on the observed proton MR spectra. The proposed WS schemes were evaluated by simulations based on the Bloch equations. Several WS sequences which looked particularly promising were verified experimentally on the human brain on a 3 T MR scanner using very short echo-time STEAM for volume selection and a standard single-loop surface coil for both signal transmission and reception. Routinely, water-suppression factors ranging from 2000 to 4000 were achieved in vivo without additional adjustment of parameters for individual subjects and without violating legal safety limits.

Proton T (1) and T (2) relaxation times of human brain metabolites at 3 Tesla

Longitudinal and transverse relaxation times were measured for proton MRS signals from human brain metabolites at 3 T using a short-echo STEAM protocol and a surface coil as a transmitter/receiver. Volumes of interest containing mostly grey or mostly white matter were selected in occipital lobes of healthy subjects and relaxation times for the following resonances were obtained: N-acetylaspartate at 2.01 ppm (T(1) and T(2)), glutamate at 2.35 ppm (T(1)), creatine at 3.03 and 3.92 ppm (T(1) and T(2)), choline-containing substances at 3.22 ppm (T(1) and T(2)), myo-inositol at 3.57 and 3.65 ppm (T(1)) and the overlapping signals of glutamate and glutamine at 3.75 ppm (T(1)). The T(1) relaxation times obtained range from 0.97 to 1.47 s for grey matter and from 0.87 to 1.35 s for white matter. On the other hand, T(2) relaxation times range from 116 to 247 ms and from 141 to 295 ms in grey and white matter, respectively. Generally, the T(1) values measured at 3 T are close to the previously published data found at 1.5, 2 and 4.1 T. Also, the T(2) values confirm the previously observed decrease in transverse relaxation times with increasing static magnetic field. The proton relaxation times obtained will allow improved sequence design and spectra quantitation at 3 T, currently tested for enhanced clinical applications.