Dataset Information

Methodological consensus on clinical proton MRS of the brain: Review and recommendations.

ABSTRACT: Proton MRS (1 H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a consensus is presented on deficiencies in widely available MRS methodology and validated improvements that are currently in routine use at several clinical research institutions. In particular, the localization error for the PRESS localization sequence was found to be unacceptably high at 3 T, and use of the semi-adiabatic localization by adiabatic selective refocusing sequence is a recommended solution. Incorporation of simulated metabolite basis sets into analysis routines is recommended for reliably capturing the full spectral detail available from short TE acquisitions. In addition, the importance of achieving a highly homogenous static magnetic field (B0 ) in the acquisition region is emphasized, and the limitations of current methods and hardware are discussed. Most recommendations require only software improvements, greatly enhancing the capabilities of clinical MRS on existing hardware. Implementation of these recommendations should strengthen current clinical applications and advance progress toward developing and validating new MRS biomarkers for clinical use.

SUBMITTER: Wilson M

PROVIDER: S-EPMC7179569 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Methodological consensus on clinical proton MRS of the brain: Review and recommendations.

Wilson Martin M Andronesi Ovidiu O Barker Peter B PB Bartha Robert R Bizzi Alberto A Bolan Patrick J PJ Brindle Kevin M KM Choi In-Young IY Cudalbu Cristina C Dydak Ulrike U Emir Uzay E UE Gonzalez Ramon G RG Gruber Stephan S Gruetter Rolf R Gupta Rakesh K RK Heerschap Arend A Henning Anke A Hetherington Hoby P HP Huppi Petra S PS Hurd Ralph E RE Kantarci Kejal K Kauppinen Risto A RA Klomp Dennis W J DWJ Kreis Roland R Kruiskamp Marijn J MJ Leach Martin O MO Lin Alexander P AP Luijten Peter R PR Marjańska Małgorzata M Maudsley Andrew A AA Meyerhoff Dieter J DJ Mountford Carolyn E CE Mullins Paul G PG Murdoch James B JB Nelson Sarah J SJ Noeske Ralph R Öz Gülin G Pan Julie W JW Peet Andrew C AC Poptani Harish H Posse Stefan S Ratai Eva-Maria EM Salibi Nouha N Scheenen Tom W J TWJ Smith Ian C P ICP Soher Brian J BJ Tkáč Ivan I Vigneron Daniel B DB Howe Franklyn A FA

Magnetic resonance in medicine 20190328 2

Proton MRS (<sup>1</sup> H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contrib ...[more]

PMID: 30919510

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Project description:Diffusion-weighted (DW-) MRS investigates non-invasively microstructural properties of tissue by probing metabolite diffusion in vivo. Despite the growing interest in DW-MRS for clinical applications, little has been published on the reproducibility of this technique. In this study, we explored the optimization of a single-voxel DW-semi-LASER sequence for clinical applications at 3 T, and evaluated the reproducibility of the method under different experimental conditions. DW-MRS measurements were carried out in 10 healthy participants and repeated across three sessions. Metabolite apparent diffusion coefficients (ADCs) were calculated from mono-exponential fits (ADCexp ) up to b = 3300 s/mm2 , and from the diffusional kurtosis approach (ADCK ) up to b = 7300 s/mm2 . The inter-subject variabilities of ADCs of N-acetylaspartate + N-acetylaspartylglutamate (tNAA), creatine + phosphocreatine, choline containing compounds, and myo-inositol were calculated in the posterior cingulate cortex (PCC) and in the corona radiata (CR). We explored the effect of physiological motion on the DW-MRS signal and the importance of cardiac gating and peak thresholding to account for signal amplitude fluctuations. Additionally, we investigated the dependence of the intra-subject variability on the acquisition scheme using a bootstrapping resampling method. Coefficients of variation were lower in PCC than CR, likely due to the different sensitivities to motion artifacts of the two regions. Finally, we computed coefficients of repeatability for ADCexp and performed power calculations needed for designing clinical studies. The power calculation for ADCexp of tNAA showed that in the PCC seven subjects per group are sufficient to detect a difference of 5% between two groups with an acquisition time of 4 min, suggesting that ADCexp of tNAA is a suitable marker for disease-related intracellular alteration even in small case-control studies. In the CR, further work is needed to evaluate the voxel size and location that minimize the motion artifacts and variability of the ADC measurements.

Dataset Information

Methodological consensus on clinical proton MRS of the brain: Review and recommendations.

Publications

Methodological consensus on clinical proton MRS of the brain: Review and recommendations.

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