Lipid-suppressed single- and multisection proton spectroscopic imaging of the human brain

Emerging methods and applications of ultra-high field MR spectroscopic imaging in the human brain

Magnetic Resonance Spectroscopic Imaging (MRSI) of the brain enables insights into the metabolic changes and fluxes in diseases such as tumors, multiple sclerosis, epilepsy, or hepatic encephalopathy, as well as insights into general brain functionality. However, the routine application of MRSI is mostly hampered by very low signal-to-noise ratios (SNR) due to the low concentrations of metabolites, about 10000 times lower than water. Furthermore, MRSI spectra have a dense information content with many overlapping metabolite resonances, especially for proton MRSI. MRI scanners at ultra-high field strengths, like 7 T or above, offer the opportunity to increase SNR, as well as the separation between resonances, thus promising to solve both challenges. Yet, MRSI at ultra-high field strengths is challenged by decreased B0- and B1-homogeneity, shorter T2 relaxation times, stronger chemical shift displacement errors, and aggravated lipid contamination. Therefore, to capitalize on the advantages of ultra-high field strengths, these challenges must be overcome. This review focuses on the challenges MRSI of the human brain faces at ultra-high field strength, as well as the possible applications to this date.

Advanced magnetic resonance spectroscopic neuroimaging: Experts' consensus recommendations

Magnetic resonance spectroscopic imaging (MRSI) offers considerable promise for monitoring metabolic alterations associated with disease or injury; however, to date, these methods have not had a significant impact on clinical care, and their use remains largely confined to the research community and a limited number of clinical sites. The MRSI methods currently implemented on clinical MRI instruments have remained essentially unchanged for two decades, with only incremental improvements in sequence implementation. During this time, a number of technological developments have taken place that have already greatly benefited the quality of MRSI measurements within the research community and which promise to bring advanced MRSI studies to the point where the technique becomes a true imaging modality, while making the traditional review of individual spectra a secondary requirement. Furthermore, the increasing use of biomedical MR spectroscopy studies has indicated clinical areas where advanced MRSI methods can provide valuable information for clinical care. In light of this rapidly changing technological environment and growing understanding of the value of MRSI studies for biomedical studies, this article presents a consensus from a group of experts in the field that reviews the state-of-the-art for clinical proton MRSI studies of the human brain, recommends minimal standards for further development of vendor-provided MRSI implementations, and identifies areas which need further technical development.

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.

In vitro singlet state and zero-quantum encoded magnetic resonance spectroscopy: Illustration with N-acetyl-aspartate

Magnetic resonance spectroscopy (MRS) allows the analysis of biochemical processes non-invasively and in vivo. Still, its application in clinical diagnostics is rare. Routine MRS is limited to spatial, chemical and temporal resolutions of cubic centimetres, mM and minutes. In fact, the signal of many metabolites is strong enough for detection, but the resonances significantly overlap, exacerbating identification and quantification. Besides, the signals of water and lipids are much stronger and dominate the entire spectrum. To suppress the background and isolate selected signals, usually, relaxation times, J-coupling and chemical shifts are used. Here, we propose methods to isolate the signals of selected molecular groups within endogenous metabolites by using long-lived spin states (LLS). We exemplify the method by preparing the LLSs of coupled protons in the endogenous molecules N-acetyl-L-aspartic acid (NAA). First, we store polarization in long-lived, double spin states, followed by saturation pulses before the spin order is converted back to observable magnetization or double quantum filters to suppress background signals. We show that LLS and zero-quantum coherences can be used to selectively prepare and measure the signals of chosen metabolites or drugs in the presence of water, inhomogeneous field and highly concentrated fatty solutions. The strong suppression of unwanted signals achieved allowed us to measure pH as a function of chemical shift difference.

Reproducibility of whole-brain temperature mapping and metabolite quantification using proton magnetic resonance spectroscopy

Assessing brain temperature can provide important information about disease processes (e.g., stroke, trauma) and therapeutic effects (e.g., cerebral hypothermia treatment). Whole-brain magnetic resonance spectroscopic imaging (WB-MRSI) is increasingly used to quantify brain metabolites across the entire brain. However, its feasibility and reliability for estimating brain temperature needs further validation. Therefore, the present study evaluates the reproducibility of WB-MRSI for temperature mapping as well as metabolite quantification across the whole brain in healthy volunteers. Ten healthy adults were scanned on three occasions 1 week apart. Brain temperature, along with four commonly assessed brain metabolites-total N-acetyl-aspartate (tNAA), total creatine (tCr), total choline (tCho) and myo-inositol (mI)-were measured from WB-MRSI data. Reproducibility was evaluated using the coefficient of variation (CV). The measured mean (range) of the intra-subject CVs was 0.9% (0.6%-1.6%) for brain temperature mapping, and 4.7% (2.5%-15.7%), 6.4% (2.4%-18.9%) and 14.2% (4.4%-52.6%) for tNAA, tCho and mI, respectively, with reference to tCr. Consistently larger variability was found when using H₂ O as the reference for metabolite quantifications: 7.8% (3.3%-17.8%), 7.8% (3.1%-18.0%), 9.8% (3.7%-31.0%) and 17.0% (5.9%-54.0%) for tNAA, tCr, tCho and mI, respectively. Further, the larger the brain region (indicated by a greater number of voxels within that region), the better the reproducibility for both temperature and metabolite estimates. Our results demonstrate good reproducibility of whole-brain temperature and metabolite measurements using the WB-MRSI technique.

Reduction of lipid contamination in MR spectroscopy imaging using signal space projection

PURPOSE

Lipid contamination can complicate the metabolite quantification in MR spectroscopic imaging (MRSI). In addition to various experimental methods demonstrated to be feasible for lipid suppression, the postprocessing method is beneficial in the flexibility of applications. In this study, the signal space projection (SSP) algorithm is proposed to suppress the lipid signal in the MRSI.

METHODS

The performance of lipid suppression using SSP and SSP combined with the Papoulis-Gerchberg (PG) algorithm (PG+SSP) is examined in 2D MRSI data and the results were compared with outer volume saturation (OVS) methods. Up to 10 lipid spatial components were extracted by SSP from lipid signals in the range of 0.8~1.5 ppm.

RESULTS

Our results show that most lipid signals were found in the first 4 to 5 components and that lipid signals on the spectra can be suppressed using 4 to 5 components. Metabolites concentrations were quantified using LCModel. Two regions of interest (ROIs) were manually selected on the peripheral and inner brain regions. The quantification of metabolites in terms of fitting reliability (CRLB) and spatial variations within ROIs (SpaVar) is improved using SSP. When 5 to 6 components were used in SSP and PG+SSP, the metabolite concentrations and the associated SpaVar and CRLB are at the same level as those from the OVS.

CONCLUSION

We have demonstrated that the SSP method can be used to suppress the lipid signals of MRSI and SSP with 5 to 6 components is suggested to have a similar suppression performance as the OVS method.

Comparison of reproducibility of single voxel spectroscopy and whole-brain magnetic resonance spectroscopy imaging at 3T

To date, single voxel spectroscopy (SVS) is the most commonly used MRS technique. SVS is relatively easy to use and provides automated and immediate access to the resulting spectra. However, it is also limited in spatial coverage. A new and very promising MRS technique allows for whole-brain MR spectroscopic imaging (WB-MRSI) with much improved spatial resolution. Establishing the reproducibility of data obtained using SVS and WB-MRSI is an important first step for using these techniques to evaluate longitudinal changes in metabolite concentration. The purpose of this study was to assess and directly compare the reproducibility of metabolite quantification at 3T using SVS and WB-MRSI in 'hand-knob' areas of motor cortices and hippocampi in healthy volunteers. Ten healthy adults were scanned using both SVS and WB-MRSI on three occasions one week apart. N-acetyl aspartate (NAA), creatine (Cr), choline (Cho) and myo-inositol (mI) were quantified using SVS and WB-MRSI with reference to both Cr and H₂ O. The reproducibility of each technique was evaluated using the coefficient of variation (CV), and the correspondence between the two techniques was assessed using Pearson correlation analysis. The measured mean (range) intra-subject CVs for SVS were 5.90 (2.65-10.66)% for metabolites (i.e. NAA, Cho, mI) relative to Cr, and 8.46 (4.21-21.07)% for metabolites (NAA, Cr, Cho, mI) relative to H₂ O. The mean (range) CVs for WB-MRSI were 7.56 (2.78-11.41)% for metabolites relative to Cr, and 7.79 (4.57-14.11)% for metabolites relative to H₂ O. Significant positive correlations were observed between metabolites quantified using SVS and WB-MRSI techniques when the Cr but not H₂ O reference was used. The results demonstrate that reproducibilities of SVS and WB-MRSI are similar for quantifying the four major metabolites (NAA, Cr, Cho, mI); both SVS and WB-MRSI exhibited good reproducibility. Our findings add reference information for choosing the appropriate ¹ H-MRS technique in future studies.

A minimum-phase Shinnar-Le Roux spectral-spatial excitation RF pulse for simultaneous water and lipid suppression in 1H-MRSI of body extremities

PURPOSE

To develop a spectral-spatial (SPSP) excitation RF pulse for simultaneous water and lipid suppression in proton (1H) magnetic resonance spectroscopic imaging (MRSI) of body extremities.

METHODS

An SPSP excitation pulse is designed to excite Creatine (Cr) and Choline (Cho) metabolite signals while suppressing the overwhelming water and lipid signals. The SPSP pulse is designed using a recently proposed multidimensional Shinnar-Le Roux (SLR) RF pulse design method. A minimum-phase spectral selectivity profile is used to minimize signal loss from T2⁎ decay.

RESULTS

The performance of the SPSP pulse is evaluated via Bloch equation simulations and phantom experiments. The feasibility of the proposed method is demonstrated using three-dimensional, short repetition-time, free induction decay-based 1H-MRSI in the thigh muscle at 3T.

CONCLUSION

The proposed SPSP excitation pulse is useful for simultaneous water and lipid suppression. The proposed method enables new applications of high-resolution 1H-MRSI in body extremities.

Prior-knowledge Fitting of Accelerated Five-dimensional Echo Planar J-resolved Spectroscopic Imaging: Effect of Nonlinear Reconstruction on Quantitation

¹H Magnetic Resonance Spectroscopic imaging (SI) is a powerful tool capable of investigating metabolism in vivo from mul- tiple regions. However, SI techniques are time consuming, and are therefore difficult to implement clinically. By applying non-uniform sampling (NUS) and compressed sensing (CS) reconstruction, it is possible to accelerate these scans while re- taining key spectral information. One recently developed method that utilizes this type of acceleration is the five-dimensional echo planar J-resolved spectroscopic imaging (5D EP-JRESI) sequence, which is capable of obtaining two-dimensional (2D) spectra from three spatial dimensions. The prior-knowledge fitting (ProFit) algorithm is typically used to quantify 2D spectra in vivo, however the effects of NUS and CS reconstruction on the quantitation results are unknown. This study utilized a simulated brain phantom to investigate the errors introduced through the acceleration methods. Errors (normalized root mean square error >15%) were found between metabolite concentrations after twelve-fold acceleration for several low concentra- tion (<2 mM) metabolites. The Cramér Rao lower bound% (CRLB%) values, which are typically used for quality control, were not reflective of the increased quantitation error arising from acceleration. Finally, occipital white (OWM) and gray (OGM) human brain matter were quantified in vivo using the 5D EP-JRESI sequence with eight-fold acceleration.

3D spatially encoded and accelerated TE-averaged echo planar spectroscopic imaging in healthy human brain

Several different pathologies, including many neurodegenerative disorders, affect the energy metabolism of the brain. Glutamate, a neurotransmitter in the brain, can be used as a biomarker to monitor these metabolic processes. One method that is capable of quantifying glutamate concentration reliably in several regions of the brain is TE-averaged (1) H spectroscopic imaging. However, this type of method requires the acquisition of multiple TE lines, resulting in long scan durations. The goal of this experiment was to use non-uniform sampling, compressed sensing reconstruction and an echo planar readout gradient to reduce the scan time by a factor of eight to acquire TE-averaged spectra in three spatial dimensions. Simulation of glutamate and glutamine showed that the 2.2-2.4 ppm spectral region contained 95% glutamate signal using the TE-averaged method. Peak integration of this spectral range and home-developed, prior-knowledge-based fitting were used for quantitation. Gray matter brain phantom measurements were acquired on a Siemens 3 T Trio scanner. Non-uniform sampling was applied retrospectively to these phantom measurements and quantitative results of glutamate with respect to creatine 3.0 (Glu/Cr) ratios showed a coefficient of variance of 16% for peak integration and 9% for peak fitting using eight-fold acceleration. In vivo scans of the human brain were acquired as well and five different brain regions were quantified using the prior-knowledge-based algorithm. Glu/Cr ratios from these regions agreed with previously reported results in the literature. The method described here, called accelerated TE-averaged echo planar spectroscopic imaging (TEA-EPSI), is a significant methodological advancement and may be a useful tool for categorizing glutamate changes in pathologies where affected brain regions are not known a priori. Copyright © 2016 John Wiley & Sons, Ltd.

Three-dimensional MR spectroscopic imaging using adiabatic spin echo and hypergeometric dual-band suppression for metabolic mapping over the entire brain

PURPOSE

Large lipid and water signals in MR spectroscopic imaging (MRSI) complicate brain metabolite quantification. In this study, we combined adiabatic hypergeometric dual-band (HGDB) lipid and water suppression with gradient offset independent adiabatic (GOIA) spin echo to improve three-dimensional (3D) MRSI of the entire brain.

METHODS

3D MRSI was acquired at 3T with a 32-channel coil. HGDB pulses were used before excitation and during echo time. A brain slab was selected with GOIA-W(16,4) pulses, weighted phase encoded stack of spirals, and real-time motion/shim correction. HGDB alone or in combination with OVS and MEGA (MEscher-GArwood) was compared with OVS only and no suppression.

RESULTS

The combined HGDB pulses suppressed lipids to 2%-3% of their full unsuppressed signal. The HGDB lipid suppression was on average 5 times better than OVS suppression. HGDB+MEGA provided 30% more suppression compared with a previously described HGDB+OVS scheme. The number of voxels with good metabolic fits was significantly larger in the HGDB data (91%-94%) compared with the OVS data (59%-80%).

CONCLUSION

HGDB pulses provided efficient lipid and water suppression for full brain 3D MRSI. The HGDB suppression is superior to traditional OVS, and it can be combined with adiabatic spin echo to provide a sequence that is robust to B₁ inhomogeneity. Magn Reson Med 77:490-497, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Correlated spectroscopic imaging of calf muscle in three spatial dimensions using group sparse reconstruction of undersampled single and multichannel data

PURPOSE

To implement a 5D (three spatial + two spectral) correlated spectroscopic imaging sequence for application to human calf.

THEORY AND METHODS

Nonuniform sampling was applied across the two phase encoded dimensions and the indirect spectral dimension of an echo planar-correlated spectroscopic imaging sequence. Reconstruction was applied that minimized the group sparse mixed ℓ2,1-norm of the data. Multichannel data were compressed using a sensitivity map-based approach with a spatially dependent transform matrix and utilized the self-sparsity of the individual coil images to simplify the reconstruction.

RESULTS

Single channel data with 8× and 16× undersampling are shown in the calf of a diabetic patient. A 15-channel scan with 12× undersampling of a healthy volunteer was reconstructed using 5 virtual channels and compared to a fully sampled single slice scan. Group sparse reconstruction faithfully reconstructs the lipid cross peaks much better than ℓ1 minimization.

CONCLUSION

COSY spectra can be acquired over a 3D spatial volume with scan time under 15 min using echo planar readout with highly undersampled data and group sparse reconstruction.

Removal of nuisance signals from limited and sparse 1H MRSI data using a union-of-subspaces model

PURPOSE

To remove nuisance signals (e.g., water and lipid signals) for (1) H MRSI data collected from the brain with limited and/or sparse (k, t)-space coverage.

METHODS

A union-of-subspace model is proposed for removing nuisance signals. The model exploits the partial separability of both the nuisance signals and the metabolite signal, and decomposes an MRSI dataset into several sets of generalized voxels that share the same spectral distributions. This model enables the estimation of the nuisance signals from an MRSI dataset that has limited and/or sparse (k, t)-space coverage.

RESULTS

The proposed method has been evaluated using in vivo MRSI data. For conventional chemical shift imaging data with limited k-space coverage, the proposed method produced "lipid-free" spectra without lipid suppression during data acquisition at 130 ms echo time. For sparse (k, t)-space data acquired with conventional pulses for water and lipid suppression, the proposed method was also able to remove the remaining water and lipid signals with negligible residuals.

CONCLUSION

Nuisance signals in (1) H MRSI data reside in low-dimensional subspaces. This property can be utilized for estimation and removal of nuisance signals from (1) H MRSI data even when they have limited and/or sparse coverage of (k, t)-space. The proposed method should prove useful especially for accelerated high-resolution (1) H MRSI of the brain.

Accelerated five-dimensional echo planar J-resolved spectroscopic imaging: Implementation and pilot validation in human brain

PURPOSE

To implement an accelerated five-dimensional (5D) echo-planar J-resolved spectroscopic imaging sequence combining 3 spatial and 2 spectral encoding dimensions and to apply the sequence in human brain.

METHODS

An echo planar readout was used to acquire a single spatial and a single spectral dimension during one readout. Nonuniform sampling was applied to the two phase-encoded spatial directions and the indirect spectral dimension. Nonlinear reconstruction was used to minimize the ℓ1-norm or the total variation and included a spectral mask to enhance sparsity. Retrospective reconstructions at multiple undersamplings were performed in phantom. Ten healthy volunteers were scanned with 8× undersampling and compared to a fully sampled single slice scan.

RESULTS

Retrospective reconstruction of fully sampled phantom data showed excellent quality at 4×, 8×, 12×, and 16× undersampling using either reconstruction method. Reconstruction of prospectively acquired in vivo scans with 8× undersampling showed excellent quality in the occipito-parietal lobes and good quality in the frontal lobe, consistent with the fully sampled single slice scan.

CONCLUSION

By utilizing nonuniform sampling with nonlinear reconstruction, 2D J-resolved spectra can be acquired over a 3D spatial volume with a total scan time of 20 min, which is reasonable for in vivo studies.

Multivendor implementation and comparison of volumetric whole-brain echo-planar MR spectroscopic imaging

PURPOSE

To assess volumetric proton MR spectroscopic imaging (MRSI) of the human brain on multivendor MRI instruments.

METHODS

Echo-planar spectroscopic imaging was developed on instruments from three manufacturers, with matched specifications and acquisition protocols that accounted for differences in sampling performance, radiofrequency (RF) power, and data formats. Intersite reproducibility was evaluated for signal-normalized maps of N-acetylaspartate (NAA), creatine (Cre), and choline using phantom and human subject measurements. Comparative analyses included metrics for spectral quality, spatial coverage, and mean values in atlas-registered brain regions.

RESULTS

Intersite differences for phantom measurements were less than 1.7% for individual metabolites and less than 0.2% for ratio measurements. Spatial uniformity ranged from 79% to 91%. The human studies found differences of mean values in the temporal lobe, but good agreement in other white matter regions, with maximum differences relative to their mean of under 3.2%. For NAA/Cre, the maximum difference was 1.8%. In gray matter, a significant difference was observed for frontal lobe NAA. Primary causes of intersite differences were attributed to shim quality, B0 drift, and accuracy of RF excitation. Correlation coefficients for measurements at each site were over 0.60, indicating good reliability.

CONCLUSION

A volumetric intensity-normalized MRSI acquisition can be implemented in a comparable manner across multivendor MR instruments.

Accelerated 1 H MRSI using randomly undersampled spiral-based k-space trajectories

PURPOSE

To develop and evaluate the performance of an acquisition and reconstruction method for accelerated MR spectroscopic imaging (MRSI) through undersampling of spiral trajectories.

THEORY AND METHODS

A randomly undersampled spiral acquisition and sensitivity encoding (SENSE) with total variation (TV) regularization, random SENSE+TV, is developed and evaluated on single-slice numerical phantom, in vivo single-slice MRSI, and in vivo three-dimensional (3D)-MRSI at 3 Tesla. Random SENSE+TV was compared with five alternative methods for accelerated MRSI.

RESULTS

For the in vivo single-slice MRSI, random SENSE+TV yields up to 2.7 and 2 times reduction in root-mean-square error (RMSE) of reconstructed N-acetyl aspartate (NAA), creatine, and choline maps, compared with the denoised fully sampled and uniformly undersampled SENSE+TV methods with the same acquisition time, respectively. For the in vivo 3D-MRSI, random SENSE+TV yields up to 1.6 times reduction in RMSE, compared with uniform SENSE+TV. Furthermore, by using random SENSE+TV, we have demonstrated on the in vivo single-slice and 3D-MRSI that acceleration factors of 4.5 and 4 are achievable with the same quality as the fully sampled data, as measured by RMSE of reconstructed NAA map, respectively.

CONCLUSION

With the same scan time, random SENSE+TV yields lower RMSEs of metabolite maps than other methods evaluated. Random SENSE+TV achieves up to 4.5-fold acceleration with comparable data quality as the fully sampled acquisition. Magn Reson Med 74:13-24, 2015. © 2014 Wiley Periodicals, Inc.

Reproducibility and reliability of short-TE whole-brain MR spectroscopic imaging of human brain at 3T

PURPOSE

A feasibility study of an echo-planar spectroscopic imaging (EPSI) using a short echo time (TE) that trades off sensitivity, compared with other short-TE methods, to achieve whole brain coverage using inversion recovery and spatial oversampling to control lipid bleeding.

METHODS

Twenty subjects were scanned to examine intersubject variance. One subject was scanned five times to examine intrasubject reproducibility. Data were analyzed to determine coefficients of variance (COV) and intraclass correlation coefficient (ICC) for N-acetylaspartate (NAA), total creatine (tCr), total choline (tCho), glutamine/glutamate (Glx), and myo-inositol (mI). Regional metabolite concentrations were derived by using multi-voxel analysis based on lobar-level anatomic regions.

RESULTS

For whole-brain mean values, the intrasubject COVs were 14%, 15%, and 20% for NAA, tCr, and tCho, respectively, and 31% for Glx and mI. The intersubject COVs were up to 6% higher. For regional distributions, the intrasubject COVs were ≤ 5% for NAA, tCr, and tCho; ≤ 9% for Glx; and ≤15% for mI, with about 6% higher intersubject COVs. The ICCs of 5 metabolites were ≥ 0.7, indicating the reliability of the measurements.

CONCLUSION

The present EPSI method enables estimation of the whole-brain metabolite distributions, including Glx and mI with small voxel size, and a reasonable scan time and reproducibility.

Improved slice-selective adiabatic excitation

PURPOSE

The purpose of this work is to design an improved Slice-selective Tunable-flip AdiaBatic Low peak-power Excitation (STABLE) pulse with shorter duration and increased off-resonance immunity to make it suitable for use in a greater range of applications and at higher field strengths. An additional aim is to design a variant of this pulse to achieve B1 -insensitive, fat-suppressed excitation.

METHODS

The adiabatic SLR algorithm was used to generate a more uniform spectral pulse envelope for this improved radiofrequency pulse for adiabatic slice-selective excitation, called STABLE-2. Pulse parameters were adjusted to design a version of STABLE-2 with a spectral null centered on lipids.

RESULTS

In vivo images obtained of the human brain at 3 and 7 T demonstrate that STABLE-2 provides robust, uniform, slice-selective excitation over a range of B1 values. Phantom and in vivo knee images obtained at 3 T demonstrate the effectiveness of STABLE-2 for fat suppression.

CONCLUSIONS

STABLE-2 achieves B1 -insensitive slice-selective excitation while providing greater off-resonance immunity and a shorter pulse duration, when compared to the original STABLE pulse. In particular, the 9.8-ms STABLE-2 pulse provides slice selectivity over 120 Hz whereas the 21-ms STABLE pulse is limited to 80 Hz off-resonance. B1 -Insensitive fat-suppressed excitation may also be achieved by using a variant of this pulse.

Non-spin-echo 3D transverse hadamard encoded proton spectroscopic imaging in the human brain

A non-spin-echo multivoxel proton MR localization method based on three-dimensional transverse Hadamard spectroscopic imaging is introduced and demonstrated in a phantom and the human brain. Spatial encoding is achieved with three selective 90° radiofrequency pulses along perpendicular axes: The first two create a longitudinal ±M(Z) Hadamard order in the volume of interest. The third pulse spatially Hadamard-encodes the ±M(Z)s in the volume of interest in the third direction while bringing them to the transverse plane to be acquired immediately. The approaching-ideal point spread function of Hadamard encoding and very short acquisition delay yield signal-to-noise-ratios of 20 ± 8, 23 ± 9, and 31 ± 10 for choline, creatine, and N-acetylaspartate in the human brain at 1.5 T from 1 cm(3) voxels in 21 min. The advantages of transverse Hadamard spectroscopic imaging are that unlike gradient (Fourier) phase-encoding: (i) the volume of interest does not need to be smaller than the field of view to prevent aliasing; (ii) the number of partitions in each direction can be small, 8, 4, or even 2 at no cost in point spread function; (iii) the volume of interest does not have to be contiguous; and (iv) the voxel profile depends on the available B1 and pulse synthesis paradigm and can, therefore, at least theoretically, approach "ideal" "1" inside and "0" elsewhere.

Lipid suppression in CSI with spatial priors and highly undersampled peripheral k-space

Mapping 1H brain metabolites using chemical shift imaging is hampered by the presence of subcutaneous lipid signals, which contaminate the metabolites by ringing due to limited spatial resolution. Even though chemical shift imaging at spatial resolution high enough to mitigate the lipid artifacts is infeasible due to signal-to-noise constraints on the metabolites, the lipid signals have orders of magnitude of higher concentration, which enables the collection of high-resolution lipid maps with adequate signal-to-noise. The previously proposed dual-density approach exploits this high signal-to-noise property of the lipid layer to suppress truncation artifacts using high-resolution lipid maps. Another recent approach for lipid suppression makes use of the fact that metabolite and lipid spectra are approximately orthogonal, and seeks sparse metabolite spectra when projected onto lipid-basis functions. This work combines and extends the dual-density approach and the lipid-basis penalty, while estimating the high-resolution lipid image from 2-average k-space data to incur minimal increase on the scan time. Further, we exploit the spectral-spatial sparsity of the lipid ring and propose to estimate it from substantially undersampled (acceleration R=10 in the peripheral k-space) 2-average in vivo data using compressed sensing and still obtain improved lipid suppression relative to using dual-density or lipid-basis penalty alone.

Improved spatial coverage for brain 3D PRESS MRSI by automatic placement of outer-volume suppression saturation bands

PURPOSE

To develop a technique for optimizing coverage of brain 3D (1) H magnetic resonance spectroscopic imaging (MRSI) by automatic placement of outer-volume suppression (OVS) saturation bands (sat bands) and to compare the performance for point-resolved spectroscopic sequence (PRESS) MRSI protocols with manual and automatic placement of sat bands.

MATERIALS AND METHODS

The automated OVS procedure includes the acquisition of anatomic images from the head, obtaining brain and lipid tissue maps, calculating optimal sat band placement, and then using those optimized parameters during the MRSI acquisition. The data were analyzed to quantify brain coverage volume and data quality.

RESULTS

3D PRESS MRSI data were acquired from three healthy volunteers and 29 patients using protocols that included either manual or automatic sat band placement. On average, the automatic sat band placement allowed the acquisition of PRESS MRSI data from 2.7 times larger brain volumes than the conventional method while maintaining data quality.

CONCLUSION

The technique developed helps solve two of the most significant problems with brain PRESS MRSI acquisitions: limited brain coverage and difficulty in prescription. This new method will facilitate routine clinical brain 3D MRSI exams and will be important for performing serial evaluation of response to therapy in patients with brain tumors and other neurological diseases.

MR spectroscopy and spectroscopic imaging of the brain

Magnetic resonance spectroscopy (MRS) and the related technique of magnetic resonance spectroscopic imaging (MRSI) are widely used in both clinical and preclinical research for the non-invasive evaluation of brain metabolism. They are also used in medical practice, although their ultimate clinical value continues to be a source of discussion. This chapter reviews the general information content of brain spectra and commonly used protocols for both MRS and MRSI and also touches on data analysis methods and quantitation. The main focus is on proton MRS for application in humans, but many of the methods are also applicable to other nuclei and studies of animal models as well.

Automatic placement of outer volume suppression slices in MR spectroscopic imaging of the human brain

Spatial suppression of peripheral regions (outer volume suppression) is used in MR spectroscopic imaging to reduce contamination from strong lipid and water signals. The manual placement of outer volume suppression slices requires significant operator interaction, which is time consuming and introduces variability in volume coverage. Placing a large number of outer volume saturation bands for volumetric MR spectroscopic imaging studies is particularly challenging and time consuming and becomes unmanageable as the number of suppression bands increases. In this study, a method is presented that automatically segments a high-resolution MR image in order to identify the peripheral lipid-containing regions. This method computes an optimized placement of suppression bands in three dimensions and is based on the maximization of a criterion function. This criterion function maximizes coverage of peripheral lipid-containing areas and minimizes suppression of cortical brain regions and regions outside of the head. Computer simulation demonstrates automatic placement of 16 suppression slices to form a convex hull that covers peripheral lipid-containing regions above the base of the brain. In vivo metabolite mapping obtained with short echo time proton-echo-planar spectroscopic imaging shows that the automatic method yields a placement of suppression slices that is very similar to that of a skilled human operator in terms of lipid suppression and usable brain voxels.

Whole-brain N-acetylaspartate MR spectroscopic quantification: performance comparison of metabolite versus lipid nulling

BACKGROUND AND PURPOSE

Despite the prominent peak of N-acetylaspartate (NAA) in proton MR spectroscopy ((1)H-MR spectroscopy) of the adult brain and its almost exclusive presence in neuronal cells, the total amount of NAA, regarded as their marker, is difficult to obtain due to signal contamination from the skull lipids. This article compares the performance of 2 methods that overcome this difficulty to yield the whole-brain NAA signal, important for the assessment of the total disease load in diffuse neurologic disorders.

MATERIALS AND METHODS

The heads of 12 healthy volunteers, 3 women and 9 men, 31.0 +/- 7.1 years of age, were scanned at 3T by using 2 nonlocalizing (1)H-MR spectroscopy sequences: One nulls the NAA (TI = 940 ms) every second acquisition by inversion-recovery to cancel the signals of the lipids (T1 << TI) in an add-subtract scheme. The other nulls the signal of the lipids (TI = 155 ms) directly after each acquisition, requiring half as many averages for the same signal-to-noise ratio. Each sequence was repeated 3 times back-to-back on 3 occasions, and the comparison criteria were intrasubject precision (reproducibility) and total measurement duration.

RESULTS

NAA nulling is nearly twice as precise in its intrinsic back-to-back (5.8% versus 8.6%) as well as longitudinal (10.6% versus 19.7%) coefficients of variation compared with lipid nulling, but at the cost of double the acquisition time.

CONCLUSION

When speed is a more stringent requirement than precision, the new lipid-nulling sequence is a viable alternative. For precision in cross-sectional or longitudinal global NAA quantification, however, NAA nulling is still the approach of choice despite its x2 ( approximately 5 minutes) time penalty compared with the lipid-nulling approach.

Fat suppression for 1H MRSI at 7T using spectrally selective adiabatic inversion recovery

Proton magnetic resonance spectroscopic imaging ((1)H MRSI) at 7T offers many advantages, including increased SNR and spectral resolution. However, technical difficulties associated with operating at high fields, such as increased B(1) and B(0) inhomogeneity, severe chemical shift localization error, and converging T(1) values, make the suppression of the broad lipid peaks which can obscure targeted metabolite signals, particularly challenging. Conventional short tau inversion recovery can successfully suppress fat without restricting the selected volume, but only with significant metabolite signal loss. In this work, we have designed two new pulses for frequency-selective inversion recovery that achieve B(1)-insensitive fat suppression without degrading the signal from the major metabolites of interest. The first is a spectrally selective adiabatic pulse to be used in a volumetric (1)H MRSI sequence and the second is a spatial-spectral adiabatic pulse geared toward multi-slice (1)H MRSI. Partial interior volume selection may be used in addition to the pulses, to exclude areas with severe B(0) inhomogeneity. Some differences in the spectral profile as well as degree of suppression make each pulse valuable for different applications. 7T phantom and in vivo data show that both pulses significantly suppress fat, while leaving most of the metabolite signal intact.

Unaliasing lipid contamination for MR spectroscopic imaging of gliomas at 3T using sensitivity encoding (SENSE)

3D magnetic resonance spectroscopic imaging (MRSI) has been successfully employed to extract information about brain tumor metabolism, such as cell membrane breakdown, cellular energetics, and neuronal integrity, through its ability to differentiate signals coming from choline (Cho), creatine (Cr), and N-acetyl aspartate (NAA) molecules. The additional presence of lipids within subregions of the tumor may indicate cellular membrane breakdown due to cell death. Another potential source of lipids is subcutaneous fat, which may be excited with point-resolved spectroscopy (PRESS) volume selection and aliased into the spectral field of view (FOV) due to the chemical shift artifact and the low bandwidth of the selection pulses. The purpose of our study was to employ a postprocessing method for unaliasing lipid resonances originating from in-slice subcutaneous lipids from the 3D MRSI of gliomas at 3T, using an eight-channel phased-array coil and sensitivity encoding (SENSE).

Lipid signal extraction by SLIM: Application to1H MR spectroscopic imaging of human calf muscles

The measurement of intramyocellular lipid (IMCL) using in vivo (1)H MRS is important for better understanding muscle physiology. However, the accurate measurement of IMCL in muscle adjacent to subcutaneous fat (SF) and bone marrow (BM) is often hampered by contaminations from the fat. In this article a new postacquisition processing method is proposed that selectively removes unwanted lipid signals based on the spectral localization by imaging (SLIM) technique, which can localize spectra from arbitrarily shaped regions. The effectiveness of this lipid extraction method is demonstrated by both computer simulation and in vivo experiments in the human calf. The advantage of this method is that unwanted lipid signal, such as SF signal, can be selectively and completely removed. After the contaminating fat signals are removed, the quality of muscle spectra adjacent to SF improves such that it becomes comparable to that in uncontaminated muscle regions in (1)H MRSI of the calf.

Simultaneous water and lipid suppression for in vivo brain spectroscopy in humans

A method to achieve simultaneous water and lipid suppression is described. The key feature of the new dual suppression technique is the use of the well-known hyperbolic secant (HS) waveform as a 90 degrees saturation pulse. Two HS pulses with opposite frequency offsets are employed either sequentially or simultaneously to saturate resonance frequencies corresponding to water and lipid, while leaving the target spins untouched. The excitation bandwidth is controlled by the frequency sweep and offset of each pulse, while varying the pulse length controls the transition bandwidth. An example of the use of the dual saturation method in in vivo magnetic resonance spectroscopic imaging of the human brain is presented.

Multi-slice echo-planar spectroscopic MR imaging provides both global and local metabolite measures in multiple sclerosis

MR spectroscopy (MRS) provides information about neuronal loss or dysfunction by measuring decreases in N-acetyl aspartate (NAA), a metabolite widely believed to be a marker of neuronal viability. In multiple sclerosis (MS), whole-brain NAA (WBNAA) has been suggested as a marker of disease progression and treatment efficacy in treatment trials, and the ability to measure NAA loss in specific brain regions early in the evolution of this disease may have prognostic value. Most spectroscopic studies to date have been limited to single voxels or nonlocalized measurements of WBNAA only, and longitudinal studies have often been hampered by standardization and reproducibility problems. Multi-slice echo-planar spectroscopic imaging (EPSI) is presented as a promising alternative to single-voxel or nonlocalized spectroscopy for obtaining global metabolite estimates in MS. In the same session, measurements of metabolites in specific brain areas chosen after image acquisition (e.g., normal-appearing white matter (NAWM), gray matter (GM), and lesions) can be obtained. The identification and exclusion of regions that are inadequate for spectroscopic evaluation in global assessments can significantly improve quality and reproducibility, as demonstrated by a low within-subject variance in healthy controls. The reproducibility of the technique makes it a promising tool for future longitudinal spectroscopic studies of MS.

Proton magnetic resonance spectroscopic evaluation of brain tumor metabolism

Magnetic resonance imaging (MRI) is the neuroimaging method of choice for the noninvasive monitoring of patients with brain tumors due to the enormous amount of information it yields regarding the morphologic features of the lesion and surrounding parenchyma. Over the past decade, proton magnetic resonance spectroscopy (1H-MRS), which uses the same technology as MRI and can be performed during a routine clinical imaging examination, has been used to glean information about the metabolic status of the brain. Accurate interpretation of 1H-MRS data from individual patients requires an understanding of the various techniques for acquiring the data, the physiologic basis of the metabolic signatures obtained from different types of tumors, and the specificity of the technique. This review covers the basic physics of 1H-MRS, the spectral and physiological characteristics of the metabolites that are typically measured in various types of brain tumors, and the clinical utility of 1H-MRS with respect to diagnosis, therapeutic planning, and the assessment of response to treatment.

[Fast 1H-NR spectroscopic imaging of the human brain]

Techniques allowing the reduction of the measurement time of MR spectroscopic imaging of protons (1H SI) were studied in a 1.5-T whole-body MR tomograph. The purpose was to facilitate the inclusion of the modality into an MRT routine protocol for examination of the human brain. The techniques were evaluated in a study with 6 healthy volunteers. Shortening of the measurement times can be achieved by reducing the number of phase-encoding steps with spherical k-space sampling, or by using delay times during TR periods for excitation and detection of several slices or echos. Since the tomograph enables echo-planar imaging, multi-gradiennt-echo techniques were implemented, thus sparing one phase-encoding gradient and shortening the measurement time by a factor of N. Due to signal loss, however, this technique is applicable only when the concentration of the metabolites of interest is sufficiently high to obtain a signal-to-noise ratio of at least 2 with a single acquisition.

Comparison of inversion recovery preparation schemes for lipid suppression in 1H MRSI of human brain

To reduce contamination from subcutaneous lipid regions in MR spectroscopic imaging (MRSI) of whole brain, lipid signals are often suppressed using T(1) nulling methods. If a range of lipid T(1) values is present, the suppression efficiency will be improved using multiple inversion recovery (MIR) preparation. This study compared single IR (SIR) and double IR (DIR) applied with a volumetric MRSI sequence at 1.5 T based on experimental measurement of lipid T(1) and T(2) relaxation rates. At short and medium echo times (TEs), an approximately 28-47% improvement in lipid suppression was achieved with DIR compared to SIR. However, it also led to a loss of 37-43% in signal-to-noise ratio (SNR) for metabolites. Thus, SIR appears to be the better choice for suppressing lipid signals and maintaining metabolite sensitivity.

Truncation artifact reduction in spectroscopic imaging using a dual-density spiral k-space trajectory

Truncation artifacts arise in magnetic resonance spectroscopic imaging (MRSI) of the human brain due to limited coverage of k-space necessitated by low SNR of metabolite signal and limited scanning time. In proton MRSI of the head, intense extra-cranial lipid signals "bleed" into brain regions, thereby contaminating signals of metabolites therein. This work presents a data acquisition strategy for reducing truncation artifact based on extended k-space coverage achieved with a dual-SNR strategy. Using the fact that the SNR in k-space increases monotonically with sampling density, dual-SNR is achieved in an efficient manner with a dual-density spiral k-space trajectory that permits a smooth transition from high density to low density. The technique is demonstrated to be effective in reducing "bleeding" of extra-cranial lipid signals while preserving the SNR of metabolites in the brain.

Characterization of untreated gliomas by magnetic resonance spectroscopic imaging

Although there are trends in the morphologic, metabolic, hemodynamic, and structural properties of untreated gliomas that are reflected in MR measurements, there is considerable heterogeneity both within and between lesions of the same histologic grade. The spatial extent of the abnormality in ADC and RA images is similar to the T2 lesion, but there is no obvious difference in intensity between grades. The rCBV is significantly increased in the enhancing volume of grade 4 lesions but is similar or reduced in intensity for most grade 3 lesions. There are clear differences between the enhancing volumes and the regions with increased Cho that may be highly significant for planning focal therapy. The location and intensity of the Lac/Lip peaks are consistent with those representing regions of necrosis for grade 4 lesions. The fact that small Lac/Lip peaks can also be seen in grade 2 and grade 3 lesions suggests that their presence may be indicative of regions that are likely to progress to a higher grade. If this were the case, it would be valuable for directing biopsies. The correlations between rCBV, Cho, and ADC suggest that cellularity, membrane turnover, and vascularity are linked in grade 4 lesions. It is not clear whether there is any relationship between these parameters regions in grade 2 or grade 3 gliomas. While further work is required to optimize the methodology associated with these MR parameters, it seems likely that combining the information from such measurements may be valuable for predicting outcome and tailoring therapy to individual patients.

Regional cerebral blood flow and magnetic resonance spectroscopic imaging findings in diaschisis from stroke

BACKGROUND AND PURPOSE

This study evaluated blood flow and metabolite changes in cerebral diaschisis from internal capsule region infarction using regional cerebral blood flow (rCBF) single-photon emission computed tomography (SPECT) and 1H magnetic resonance spectroscopic imaging (MRSI). We hypothesized that complementary measures of diaschisis effects in white matter (characterized by 1H MRSI) and gray matter (characterized by changes in rCBF) can be measured and exhibit parallel changes.

METHODS

Five stroke patients and 16 normal controls underwent Tc-99m hexamethylpropyleneamine-oxime brain SPECT and 1H MRSI at 4.1 T. The metabolites N-acetyl aspartate (NAA) and creatine (Cr) were measured using 1H MRSI. The tissue content was expressed as the percent of gray or white matter in each MRSI voxel to allow comparison of the differential effects of diaschisis in gray and white matter tissue types. The blood flow and metabolite changes were evaluated at superior cerebral regions distant from the stroke to allow a measure of diaschisis relatively unconfounded by their expected changes in the infarction region.

RESULTS

The rCBF SPECT data in stroke patients showed a perfusion defect, with size ranging from 1.23 cc to 10.23 cc, in the region of cortical diaschisis. 1H MRSI showed increased Cr/NAA ratios in regions of white matter diaschisis. There was a tendency for larger rCBF defect size to be associated with greater increases in Cr/NAA values in the same diaschitic cerebral hemisphere, ipsilateral to the infarction.

CONCLUSION

Diaschisis ipsilateral to stroke in white matter can be characterized by 1H MRSI, and diaschisis ipsilateral to stroke in cortical gray matter regions can be characterized by changes in rCBF. The tendency for greater reductions in cortical rCBF values to be associated with increased Cr/NAA values in the same diaschitic cerebral hemisphere implies that a relationship exists between rCBF reductions in gray matter and abnormal changes in white matter subservient to it.

Zero-quantum filter offering single-shot lipid suppression and simultaneous detection of lactate, choline, and creatine resonances

A zero-quantum (ZQ) filter offering single-shot lipid suppression and providing for simultaneous detection of the lactate methyl doublet (1.3 ppm) and nonoverlapping singlets including choline (Cho, 3.2 ppm) and creatine (Cr, 3.0 ppm) is described. Filtering is provided by soft mixing and reading pulses (RF(mix), RF(rd)) that are selective for the lactate methine quartet (4.1 ppm), Cho, and Cr resonances but exclude the 1.3 ppm lactate component and overlapping lipids. Surrounding RF(mix) and RF(rd) are magnetic field gradient pulses of equal magnitude but opposite signs to enable the rephasing of the zero-quantum lactate coherence and the creation of a stimulated echo for singlets within the pulse passbands. The sequence is designed to retain half the original lactate and singlet signal intensities. Theoretical predictions were confirmed experimentally at 1.5T using phantom acquisitions. The lipid suppression factor was measured to be over 10(3).

Comparison of methods for reduction of lipid contamination for in vivo proton MR spectroscopic imaging of the brain

In vivo proton MR spectroscopic imaging (MRSI) of human brain is complicated by the presence of a strong signal from subcutaneous lipids, which may result in signal contamination in metabolite images obtained following Fourier-transform reconstruction. In this study, two approaches for reduction of lipid contamination--using postprocessing and additional data acquisition--are compared. The first uses extrapolation of k-space information for subcutaneous lipid, which has been applied to data obtained using conventional fully phase-encoded MRSI with circularly sampled k-space or echo-planar spectroscopic imaging (EPSI). The second uses a dual EPSI technique that combines multiple-averaged central k-space data with a single EPSI acquisition of additional information that is used for improved lipid reconstruction. Comparisons are carried out with data obtained from human brain in vivo at 1.5 T with short and medium TEs. Results demonstrate that the performance of both methods for reducing the effects of lipid contamination is similar, and that both are limited by the effects of instrumental instabilities and subject motion, which also depend on the acquisition method used.

Reliable detection of macromolecules in single-volume 1H NMR spectra of the human brain

In short echo time proton MR spectra of the brain, resonances from macromolecules are visible. The macromolecular resonances in the 0.5-2.0 ppm region can be affected by lipid contamination arising from fat-containing regions outside the selected volume of interest (VOI). This study demonstrates that considerable lipid contamination may remain in stimulated echo acquisition mode (STEAM) spectra even if the spoiling of unwanted coherences is sufficient and the VOI is placed 2 cm or more away from fat-containing regions. The observed contamination was attributed to residual remote out-of-volume excitation, although only very small out-of-slice ripples of less than 0.2% of the in-slice excitation were found in the calculated excitation profile of the RF pulses. Spatial presaturation of fat-containing regions led to a sufficient suppression of the contamination and enabled the detection of highly reproducible macromolecular resonances. Thus, in single-volume spectroscopy as well as in spectroscopic imaging (SI or CSI), the combination of volume selection and outer volume presaturation, each in three dimensions, is highly recommended to ensure accurate detection and reliable evaluation of even small pathological alterations in macromolecules, e.g., proteins or lipids, or other resonances in the 0.5-2.0 ppm region.

Lactate discrimination incorporated into echo-planar spectroscopic imaging

A technique for discriminating a lactate signal from overlapping lipid signals in (1)H spectroscopic imaging is presented. It is based on J-coupling between lactate protons and on the broad spectral bandwidth of lipid signal. Measurement parameters used in the technique are determined so that TE is separated from n/J (n: a natural number, J: J-coupling constant) enough to suppress the lipid signal at the time when the lactate signal is strongest. Data processing is used to calculate the lactate signal intensity from the reconstructed spectra. This technique enables lactate to be discriminated in a single measurement and enables spectra of other metabolites to be acquired simultaneously. However, it necessitates a homogeneous magnetic field, long TE, and supplementary lipid suppression. Discrimination of the lactate signal is demonstrated by applying lactate-discriminating echo-planar spectroscopic imaging (EPSI), which combines this discrimination technique with the standard EPSI, to rat focal cerebral ischemia models. Magn Reson Med 45:568-574, 2001.

Short TE in vivo (1)H MR spectroscopic imaging at 1.5 T: acquisition and automated spectral analysis

Spectral analysis of short TE in vivo proton magnetic resonance spectroscopic imaging (MRSI) data are complicated by the presence of spectral overlap, low signal to noise and uncharacterized signal contributions. In this study, it is shown that an automated data analysis method can be used to generate metabolite images from MRSI data obtained from human brain at TE = 25 ms and 1.5 T when optimized pulse sequences and a priori metabolite knowledge are used. The analysis approach made use of computer simulation methods to obtain a priori spectral information of the metabolites of interest and utilized a combination of parametric spectral modeling and non-parametric signal characterization for baseline fitting. This approach was applied to data from optimized PRESS-SI and multi-slice spin-echo SI acquisitions, for which sample spectra and metabolite images are shown.

Musculoskeletal radiology: then and now

Musculoskeletal radiologists, owing to recent advances in imaging technologies and techniques, are playing an increasingly important role in documenting, diagnosing, and treating an increasing variety of bone and soft-tissue lesions. However, improved visualization of anatomic aberrations-"seeing better"-must be paired with "knowing more," on the basis of complete familiarity with all aspects of the biology, physiology, pathophysiology, and static anatomy of the musculoskeletal system. Only with foreknowledge of the latter can the musculoskeletal radiologist fully maximize the benefits of the former.

Measurements of human brain ethanol T(2) by spectroscopic imaging at 4 T

Previous MRS measurements of ethanol in human brain have yielded a range of transverse relaxation times for ethanol methyl resonance at 1.5 T (200-380 ms). To determine the T(2) of the methyl proton resonance of ethanol in human brain, 8 x 8 spectroscopic images were acquired at 16 different TE values. A frequency-selective refocusing pulse was used to suppress J-modulation of the ethanol triplet, permitting nonintegral multiples of 1/J to be used for TE values. The measured T(2) values for the methyl resonances of ethanol, creatine, and N-acetyl aspartate in mixed tissues were 82 +/- 12, 148 +/- 20, and 227 +/- 25 ms, respectively. Regression analysis of the measured T(2) as a function of gray matter content indicates a shorter T(2) value for ethanol in pure white matter compared to that in pure gray matter. Magn Reson Med 44:35-40, 2000.

Optimal voxel size for measuring global gray and white matter proton metabolite concentrations using chemical shift imaging

Quantification of gray and white matter levels of spectroscopically visible metabolites can provide important insights into brain development and pathological conditions. Chemical shift imaging offers a gain in efficiency for estimation of global gray and white matter metabolite concentrations compared to single voxel methods. In the present study, the optimal voxel size is calculated from segmented human brain data and accompanying field maps. The optimal voxel size is found to be approximately 8 cc, but a wide range of values, 4-64 cc, can be chosen with little increase in estimated concentration error (<15%). Magn Reson Med 44:10-18, 2000.

Three-dimensional magnetic resonance spectroscopic imaging of brain and prostate cancer

Clinical applications of magnetic resonance spectroscopic imaging (MRSI) for the study of brain and prostate cancer have expanded significantly over the past 10 years. Proton MRSI studies of the brain and prostate have demonstrated the feasibility of noninvasively assessing human cancers based on metabolite levels before and after therapy in a clinically reasonable amount of time. MRSI provides a unique biochemical "window" to study cellular metabolism noninvasively. MRSI studies have demonstrated dramatic spectral differences between normal brain tissue (low choline and high N-acetyl aspartate, NAA) and prostate (low choline and high citrate) compared to brain (low NAA, high choline) and prostate (low citrate, high choline) tumors. The presence of edema and necrosis in both the prostate and brain was reflected by a reduction of the intensity of all resonances due to reduced cell density. MRSI was able to discriminate necrosis (absence of all metabolites, except lipids and lactate) from viable normal tissue and cancer following therapy. The results of current MRSI studies also provide evidence that the magnitude of metabolic changes in regions of cancer before therapy as well as the magnitude and time course of metabolic changes after therapy can improve our understanding of cancer aggressiveness and mechanisms of therapeutic response. Clinically, combined MRI/MRSI has already demonstrated the potential for improved diagnosis, staging and treatment planning of brain and prostate cancer. Additionally, studies are under way to determine the accuracy of anatomic and metabolic parameters in providing an objective quantitative basis for assessing disease progression and response to therapy.

Human prostate: multisection proton MR spectroscopic imaging with a single spin-echo sequence--preliminary experience

The authors investigated the feasibility of a multisection proton magnetic resonance (MR) spectroscopic imaging technique for the acquisition of metabolic information in the human prostate. Multisection MR spectroscopic imaging was performed of a citrate phantom and of the prostates of eight adult volunteers. High-quality proton MR spectra and citrate metabolite maps of the prostate were obtained with this method.

Elimination of residual lipid contamination in single volume proton MR spectra of human brain

Short echo time 1H NMR spectra of the human brain reveal signals from various metabolites. In addition, resonances from macromolecules are present that may provide further useful information in several brain diseases. The detection of all these signals is possible if excellent volume selection is obtained; even small lipid contamination from surrounding fat tissue leads to strong spectral contamination. It affects the macromolecule resonances in the 0.5 to 2.0 ppm region and some adjacent metabolite signals and jeopardizes their quantitative analysis. This paper demonstrates how spatial contamination from insufficiently dephased signals can be recognized, analysed, and removed in localized STEAM spectroscopy of the brain.

Serial evaluation of patients with brain tumors using volume MRI and 3D 1H MRSI

Patients with brain tumors are routinely monitored for tumor progression and response to therapy using magnetic resonance imaging (MRI). Although serial changes in gadolinium enhancing lesions provide valuable information for making treatment decisions, they do not address the fate of non-enhancing lesions and are unable to distinguish treatment induced necrosis from residual or recurrent tumor. The introduction of a non-invasive methodology, which could identify an active tumor more reliably, would have a major impact upon patient care and evaluation of new therapies. There is now compelling evidence that magnetic resonance spectroscopic imaging (MRSI) can provide such information as an add-on to a conventional MRI examination. We discuss data acquisition and analysis procedures which are required to perform such serial MRI-MRSI examinations and compare their results with data from histology, contrast enhanced MRI, MR cerebral blood volume imaging and FDG-PET. Applications to the serial assessment of response to therapy are illustrated by considering populations of patients being treated with brachytherapy and gamma knife radiosurgery.

Optimal gradient waveform design for projection imaging and projection reconstruction echoplanar spectroscopic imaging

The use of modulated B0 projection gradient waveforms is proposed for magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) to shape the k-space sampling density function to match the profile of an applied reconstruction window function. This allows for a time-efficient means of maximizing the signal-to-noise ratio when, for example, a low-pass spatial filter, designed to reduce k-space truncation artifacts and corresponding point-spread function sidelobe energies, is implemented. Both the two-dimensional (2D) and 3D cases are investigated. To create the projection gradient waveforms, a design method is developed that uses nonlinear constrained optimization (NLCO) to minimize the variance of the reconstruction noise. The design is subject to both equality and inequality constraints, which include the maximum gradient magnitude and slew rate. It is shown that NLCO can also be applied to twisting the projection trajectories for purposes of reducing the data acquisition time while still maintaining the desired sampling density. Applications to 1H MRSI are investigated via simulations. Advantages and limitations of the new sampling schemes are discussed.