In vivo 31P magnetic resonance spectroscopy using a needle microcoil

Batch fabrication methods have been used to produce low‐cost microcoils for magnetic resonance spectroscopy (MRS) that could be discarded after applications such as insertion into tissue during interventional surgery. Needle‐shaped microcoils were constructed using electroplated conductors buried in shafts formed with different combinations of silicon and plastic and used to acquire in vivo ³¹P spectra of rat thigh muscle at 81 MHz. The designs in this study achieved a maximum signal‐to‐noise ratio (SNR) for phosphocreatine (PCr) of 10.4 in a 10‐min acquisition, with the three adenosine triphosphate (ATP) multiplets also clearly visible. An average 20% reduction in PCr occurred over a 60‐min period, and intracellular pH was estimated to be 6.6, which are both evidence of ischemia. A needle microcoil design could have applications in real‐time MRS of tumors or in evaluating pathology in general during surgical investigations. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Effect of temperature in focal ischemia of rat brain studied by 31P and 1H spectroscopic imaging

³¹P, ¹H and lactate spectroscopic imaging was used to evaluate the effects of hypothermia on focal cerebral ischemia produced by middle cerebral artery occlusion. The effects on high energy phosphate metabolism, pH, lactate and NAA were investigated in 24 spontaneously hypertensive rats subjected to either permanent or transient ischemia. Under either normothermic (37.5°C) or hypothermic (32°C) conditions, with permanent 6-h occlusion, there was little difference between groups in either the NMR measurements or the volume of infarction. In animals that underwent 3 h of ischemia followed by 12 h of reperfusion, the ischemic changes in lactate, pH, NAA, and high-energy phosphate returned toward control values, and there was a protective effect of hypothermia (infarct volume of 211 ± 26 and 40 ± 14 mm³ in normothermic and hypothermic groups, respectively). Thus, hypothermia did not ameliorate the changes in lactate, pH, NAA, or high energy phosphate levels occurring during ischemia, however, during reperfusion there was an improvement in both the recovery of these metabolites and pathological outcome in hypothermic compared with normothermic animals.     

A 31P NMR study of preconditioned isolated perfused rat heart exposed to intermittent ischemia

Exposure to a short ischemic period (ischemic preconditioning, IP) will protect the heart from damage following a subsequent longer ischemic episode. The aim of the study was to test whether IP is cardioprotective in the setting of repeated ischemia-reperfusion cycles. Thus, Langendorff-perfused hearts, exposed to IP, were subjected to three consecutive ischemia-reperfusion (10/15 min) cycles. Myocardial energetics, manifested by ³¹P NMR spectroscopy, was correlated with hemodynamics. ATP recovery was significantly higher for the IP group compared with control (P < 0.02) during reperfusions. However, there was no significant difference in ATP recovery during the three ischemic intervals. The supernormal recovery of phosphocreatine recorded during reperfusion was lower for the IP group (～120%) compared with control (～135%, P < 0.065). Better recovery of the left ventriculardeveloped pressure was noted during reperfusions for the IP group and became significant only during the last reperfusion (86% versus 68%, P < 0.025). In conclusion, the above results support prolonged IP cardioprotection.     

Ex vivo identification of atherosclerotic plaque calcification by a 31P solid-state magnetic resonance imaging technique.

Calcified tissue is a common component of atherosclerotic plaques, and occurs most often in mature plaques. The process of calcification is a poorly understood risk factor that may contribute to a plaque's vulnerability to sudden rupture. In this study a solid-state imaging sequence, termed single-point imaging (SPI), was used to observe calcification directly in ex vivo atherosclerotic plaques. Standards were used to validate the ability of (31)P SPI to detect and differentiate calcification from crystalline cholesterol, phospholipids, and other plaque components. After suitable experimental parameters were found, human carotid specimens obtained by endarterectomy were imaged ex vivo by (31)P solid-state imaging and standard (1)H methods. In contrast to (1)H imaging methods, (31)P imaging detected only the calcification in the plaque.     

In vivo 31P MR spectroscopic imaging of the human prostate at 7 T: Safety and feasibility

³¹P MR spectroscopic imaging of the human prostate provides information about phosphorylated metabolites that could be used for prostate cancer characterization. The sensitivity of a magnetic field strength of 7 T might enable 3D ³¹P MR spectroscopic imaging with relevant spatial resolution in a clinically acceptable measurement time. To this end, a ³¹P endorectal coil was developed and combined with an eight‐channel ¹H body‐array coil to relate metabolic information to anatomical location. An extensive safety validation was performed to evaluate the specific absorption rate, the radiofrequency field distribution, and the temperature distribution of both coils. This validation consisted of detailed Finite Integration Technique simulations, confirmed by MR thermometry and B measurements in a phantom and in vivo temperature measurements. The safety studies demonstrated that the presence of the ³¹P endorectal coil had no influence on the specific absorption rate levels and temperature distribution of the external eight‐channel ¹H array coil. To stay within a 10 g averaged local specific absorption rate of 10 W/kg, a maximum time‐averaged input power of 33 W for the ¹H array coil was allowed. For transmitting with the ³¹P endorectal coil, our safety limit of less than 1°C temperature increase in vivo during a 15‐min MR spectroscopic imaging experiment was reached at a time‐averaged input power of 1.9 W. With this power setting, a second in vivo measurement was performed on a healthy volunteer. Using adiabatic excitation, 3D ³¹P MR spectroscopic imaging produced spectra from the entire prostate in 18 min with a spatial resolution of 4 cm³. The spectral resolution enabled the separate detection of phosphocholine, phosphoethanolamine, inorganic phosphate, and other metabolites that could play an important role in the characterization of prostate cancer. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Surface coil cardiac tagging and 31P spectroscopic localization with B1-insensitive adiabatic pulses

A technique is presented for MRI tagging in the presence of inhomogeneous B₁ fields. A rectangular tagging grid is produced with B₁-insensitive adiabatic pulses in a magnetization preparation period that precedes image acquisition. Phantom results demonstrate that the method is well-suited to surface coil experiments. The technique is applied to a canine model of myocardial ischemia to track the spatially dependent wall motion of the left ventricle during the cardiac cycle. Transmural ³¹P spectra are acquired from the same double-tuned surface coil, with tagging and spectroscopy performed for the first time, during normal, ischemic, and recovery conditions for the same animal.     

Primary heart angiosarcoma detected by magnetic resonance imaging

We present a case of primary heart angiosarcoma in a 38-year-old male. The patient presented with severe dyspnoe and arrhythmia. Echocardiography showed multiple solid masses in the pericardium and pericardial effusion. Chest radiography revealed left-sided pleural effusion and suspicion of a mass projected on the right atrium. Non-enhanced chest computed tomography raised the suspicion of a pericardial neoplasm projected on the right atrium adjacent to ascending aorta with markedly thickened pericardium and multiple round-shaped masses around the heart. Cardiac-gated magnetic resonance imaging demonstrated an inhomogeneous mass in the free wall of the right atrium adjacent to ascending aorta and multiple pericardial masses. Biopsy performed through thoracoscopy confirmed the diagnosis of a primary heart angiosarcoma.     

Scan time reduction in proton magnetic resonance spectroscopic imaging of the human brain.

A simple technique is described for scan time reductions in proton magnetic resonance spectroscopic imaging (MRSI) of the human brain. Scan time is reduced by approximately 35% while preserving spatial resolution by reducing the field of view (FOV) and number of phase-encoding steps in the transverse direction of the brain. A multislice MRSI of the brain is demonstrated which takes approximately 20 min with a square FOV, and 13 min with a reduced FOV. The signal-to-noise ratio (SNR) in the reduced FOV scan was measured to be 15% lower than that of the full FOV scan, which is close to the expected theoretical value of 19% based on the square root of the scan time. The method can be applied with any sequence, and requires minimal software and no hardware modifications. Scan time in MRSI is minimized in this method by using FOVs no larger than the dimensions of the object to be imaged. The method may also be combined with other fast MRSI techniques to provide further scan time reductions.     

Temporal and regional changes during focal ischemia in rat brain studied by proton spectroscopic imaging and quantitative diffusion NMR imaging

The early development of focal ischemia after permanent occlusion of the right middle cerebral artery (MCA) was studied in six rats using interleaved measurements by diffusion-weighted NMR imaging (DWI) of water and two variants of proton spectroscopic imaging (SI), multiecho SI (TE: 136, 272, 408 ms) and short TE SI (TE: 20 ms). Measurements on a 4.7-T NMR imaging system were performed between the control phase and approximately 6 h postocclusion. In the center of the ischemic lesion of all rats, the apparent diffusion coefficient (ADC) decreased rapidly to 84.4 ± 4.2% (mean ± SD) of the control values approximately 2 min postocclusion. Approximately 6 h postocclusion, the ADC was reduced to 67.1 ± 5.9%. In contrast, large differences between the animals were observed for the temporal increase of lactate (Lac) in the ipsilateral hemisphere. The maximum Lac signal was reached in four rats after 0.5-1.5 h, and in two rats was not reached even after 6 h postocclusion. Six h postocclusion, SI spectra measured at a TE of 136 ms revealed a decrease in the CH³ signal of N-acetylaspartate (NAA) to 67 ± 13% of the control values. Differences were observed between the spatial regions of decreased NAA and increased Lac. In the lesions, a T2 relaxation time of Lac of 292 ± 40 ms, considering a J-cou-pling constant of 6.9 Hz, was measured. Furthermore, a prolongation of the T₂ of the CH₃ signal of creatine/phosphocre-atine (Cr/PCr) was observed in the lesion, from 163 ± 22 ms during control to 211 ± 41 ms approximately 6 h postocclusion. The experiments proved that DWI and proton SI are valuable tools to provide complementary information on processes associated with brain infarcts.     

Early detection of cerebral infarction by31P spectroscopic imaging

Summary Recent advances in magnetic resonance spectroscopy permit noninvasive study of brain metabolism in vivo,³¹P spectroscopic imaging being the method for evaluation of localized phosphorous metabolism. Experimentally, an ischemic-hypoxic brain insult is characterized by depletion of high energy metabolites. These changes are seen immediately after an ischemic insult. We had the opportunity of carrying out³¹P spectroscopic imaging of hyperacute cerebral infarction, while MRI and CT were negative. Cerebral infarction of the middle cerebral artery territory was suggested by³¹P spectroscopic imaging, which was closely consistent with a later-developing region of low density on CT. In cerebral infarction, early detection of the lesion is a useful pointer to the patient's prognosis, making³¹P spectroscopic imaging a potential tool.     

Feasibility of dobutamine stress cardiovascular magnetic resonance imaging in children

Purpose

To evaluate the feasibility of dobutamine stress magnetic resonance (DSMR) in pediatric patients.

Materials and Methods

The medical records of all DSMR studies performed on patients ≤22 years old at a single institution were retrospectively reviewed. The DSMR protocol included dobutamine doses up to 40 μg/kg/minute and atropine to attain the target heart rate [0.85 · (220 – age)].

Results

Thirty‐two DSMR studies were performed in 28 patients (median age = 7.3 years; range = 0.8–22 years). Twenty of the studies were performed under general anesthesia. The protocol was completed in 26 studies, technical problems and interruptions were few, and image quality scores ( 1 - 5 ) for all ventricular wall segments were high (mean = 4.2). A heart rate ≥160 bpm was attained in 84% of the studies, a rate pressure product ≥20,000 beats · mm Hg in 87%, and a heart rate greater than or equal to the target heart rate in 19%. No serious adverse events occurred. One patient had an inducible wall motion abnormality. Interobserver agreement was 100% (kappa = 1.0) for test positivity and 92% (kappa = 0.72) for wall motion scores.

Conclusion

DSMR in pediatric patients is feasible and provides high‐quality imaging of all ventricular wall segments with low interobserver variability. Further exploration of DSMR in pediatric patients is warranted, particularly for those children who are unable to cooperate sufficiently for exercise stress or have poor acoustic windows. J. Magn. Reson. Imaging 2009;29:313–319. © 2009 Wiley‐Liss, Inc.     

1H and31P magnetic resonance spectroscopic imaging of white matter signal hyperintensity areas in elderly subjects

White matter signal hyperintensities (WMSH) are commonly seen on MRI of elderly subjects. The purpose of this study was to characterize metabolic changes in the white matter of elderly subjects with extensive WMSH. We used water-suppressed proton (¹H) magnetic resonance spectroscopic imaging (MRSI) to compare six subjects with extensive WMSH with eight age-matched elderly subjects with minimal or absent WMSH, and phosphorus (³¹P) MRSI to compare nine subjects with extensive WMSH and seven age-matched elderly subjects without extensive WMSH. Relative to region-matched tissue in elderly controls, extensive WMSH were associated with increased signal from choline-containing metabolites, no significant change of signal fromN-acetylaspartate, and a trend to a decreased phosphomonoester (PME) resonance. These findings suggest that WMSH may be associated with an alteration of brain myelin phospholipids in the absence of axonal damage. There were no differences in energy phosphates, consistent with lack of ongoing brain ischemia. Within the group with extensive WMSH, PME resonance measures were significantly lower in WMSH than in contralateral normal-appearing white matter. These results provide information on pathophysiology of WMSH and a basis for comparison with WMSH in Alzheimer's disease, vascular dementia, multiple sclerosis, and other diseases.     

In vivo measurement of regional brain metabolic response to hyperventilation using magnetic resonance: Proton echo planar spectroscopic imaging (PEPSI)

A new rapid spectroscopic imaging technique with improved sensitivity and lipid suppression, referred to as Proton Echo Planar Spectroscopic Imaging (PEPSI), has been developed to measure the 2-dimensional distribution of brain lactate increases during hyperventilation on a conventional clincal scanner equipped with a head surface coil phased array. PEPSI images (nominal voxel size: 1.125 cm³) in five healthy subjects from an axial section approximately 20 mm inferior to the intercommissural line were obtained during an 8.5-min baseline period of normocapnia and during the final 8.5 min of a 10-min period of capnometry-controlled hyperventilation (end-tidal PCO₂ of 20 mmHg). The lactate/N-acetyl aspartate signal increased significantly from baseline during hyperventilation for the insular cortex, temporal cortex, and occipital regions of both the right and left hemispheres, but not in the basal ganglia. Regional or hemispheric right-to-left differences were not found. The study extends previous work using single-voxel MR spectroscopy to dynamically study hyperventilation effects on brain metabolism.     

Importance of perfusion in myocardial viability studies using delayed contrast-enhanced magnetic resonance imaging

PURPOSE: To investigate whether an extracellular gadolinium-(Gd)-based contrast agent (CA) enters nonperfused myocardium during acute coronary occlusion, and whether nonperfused myocardium presents as hyperintense in delayed contrast-enhanced (DE) MR images in the absence of CA in that region. MATERIALS AND METHODS: The left anterior descending coronary artery (LAD) was occluded for 200 minutes in six pigs. The longitudinal relaxation rate (R(1)) in blood, perfused myocardium, and nonperfused myocardium was repeatedly measured using a Look-Locker sequence before and during the first hour after administration of Gd-DTPA-BMA. RESULTS: While blood and perfused myocardium showed a major increase in R(1) after CA administration, nonperfused myocardium did not. R(1) in nonperfused myocardium was significantly lower than in blood and perfused myocardium during the first hour after CA administration. When the signal from perfused myocardium was nulled, demarcation of the hyperintense nonperfused myocardium was achieved in all of the study animals. CONCLUSION: Gd-DTPA-BMA does not enter ischemic myocardium within one hour after administration during acute coronary occlusion. The ischemic region with complete absence of CA still appears bright when the signal from perfused myocardium is nulled using inversion-recovery DE-MRI. This finding is important for understanding the basic pathophysiology of inversion-recovery viability imaging, as well as for imaging of acute coronary syndromes.     

3D 31P Spectroscopic Imaging of the Human Heart at 4.1 T

High field (4 Tesla) spectroscopic imaging offers the advantages of increased signal-to-noise ratio and the possibility of acquiring high resolution metabolite images. We have applied a three dimensional spectroscopic imaging sequence using a sparse Gaussian sampling method to acquire phosphocreatine (PCr) images of the human heart with 8-cc voxels. PCr images enabled observation of the septum, left ventricular free wall, apex, and skeletal muscle. Quantitative evaluation of the 50 myocardial voxels acquired from 10 studies of healthy adults revealed a PCr/adenosine triphosphate (ATP) ratio of 1.80 ± 0.32 after correction for saturation effects. Due to the small size of the voxels and the ability to choose the location of the volumes to minimize inclusion of blood, no correction for blood pool ATP was required. The calculated PCr/ATP ratio is in agreement with other studies at 1.5 and 4.0 T.     

Single‐shot magnetic resonance spectroscopic imaging with partial parallel imaging

A magnetic resonance spectroscopic imaging (MRSI) pulse sequence based on proton–echo‐planar‐spectroscopic‐imaging (PEPSI) is introduced that measures two‐dimensional metabolite maps in a single excitation. Echo‐planar spatial–spectral encoding was combined with interleaved phase encoding and parallel imaging using SENSE to reconstruct absorption mode spectra. The symmetrical k‐space trajectory compensates phase errors due to convolution of spatial and spectral encoding. Single‐shot MRSI at short TE was evaluated in phantoms and in vivo on a 3‐T whole‐body scanner equipped with a 12‐channel array coil. Four‐step interleaved phase encoding and fourfold SENSE acceleration were used to encode a 16 × 16 spatial matrix with a 390‐Hz spectral width. Comparison with conventional PEPSI and PEPSI with fourfold SENSE acceleration demonstrated comparable sensitivity per unit time when taking into account g‐factor–related noise increases and differences in sampling efficiency. LCModel fitting enabled quantification of inositol, choline, creatine, and N‐acetyl‐aspartate (NAA) in vivo with concentration values in the ranges measured with conventional PEPSI and SENSE‐accelerated PEPSI. Cramer–Rao lower bounds were comparable to those obtained with conventional SENSE‐accelerated PEPSI at the same voxel size and measurement time. This single‐shot MRSI method is therefore suitable for applications that require high temporal resolution to monitor temporal dynamics or to reduce sensitivity to tissue movement. Magn Reson Med, 2009. © 2008 Wiley‐Liss, Inc.     

ATP production and mechanical work in exercising skeletal muscle: A theoretical analysis applied to 31P magnetic resonance spectroscopic studies of dialyzed uremic patients

³¹P magnetic resonance spectroscopy (³¹P MRS) can yield much information about bioenergetics in skeletal muscle. During mixed aerobic/glycolytic exercise, changes in phos-phocreatine (PCr) concentration and pH may be abnormal because of reduced muscle mass or reduced efficiency (which the authors combine here as “effective muscle mass”) or because of reduced oxidative capacity. The authors show how these can be distinguished by calculating the nonoxidative and oxidative costs of mechanical work, and also of work per unit of effective muscle mass (measured using the initial rate of ATP turnover). These quantities are substantially time-independent during incremental exercise, and so can be used to compare exercise studies of differing duration. The authors illustrate this analysis by showing that in dialyzed patients with chronic renal failure, the substantial exercise abnormalities seen by ³¹P MRS are due mainly to a decrease in effective muscle mass, which outweighs the oxidative defect implied by the abnormal PCr recovery kinetics.     

Automated estimation of tumor probability in prostate magnetic resonance spectroscopic imaging: pattern recognition vs quantification.

Despite its diagnostic value and technological availability, (1)H NMR spectroscopic imaging (MRSI) has not found its way into clinical routine yet. Prerequisite for the clinical application is an automated and reliable method for the diagnostic evaluation of MRS images. In the present paper, different approaches to the estimation of tumor probability from MRSI in the prostate are assessed. Two approaches to feature extraction are compared: quantification (VARPRO, AMARES, QUEST) and subspace methods on spectral patterns (principal components, independent components, nonnegative matrix factorization, partial least squares). Linear as well as nonlinear classifiers (support vector machines, Gaussian processes, random forests) are applied and discussed. Quantification-based approaches are much more sensitive to the choice and parameterization of the quantification algorithm than to the choice of the classifier. Furthermore, linear methods based on magnitude spectra easily achieve equal performance and also allow for biochemical interpretation in combination with subspace methods. Nonlinear methods operating directly on magnitude spectra achieve the best results but are less transparent than the linear methods.     

Reducing gradient imperfections for spiral magnetic resonance spectroscopic imaging.

Spiral k-space magnetic resonance spectroscopic imaging (MRSI) requires high performance from gradient hardware systems. During the readout phase, oscillating gradients are continuously played out, which can cause undesired effects. These effects on the quality of SI data are non-intuitive because of their time-varying nature. In this work we describe the effects of undesirable gradient performance on SI. Measurements of the true readout trajectories were performed and the results were then used in the reconstruction process. The effects of these imperfections resulted in a spatially and spectrally varying amplitude and frequency modulation. The use of the measured trajectories in the reconstruction process yielded an up to 20% increase in signal amplitude recovery.     

Quantitative (31)P spectroscopic imaging of human brain at 4 Tesla: assessment of gray and white matter differences of phosphocreatine and ATP.

This report describes the implementation and application of a multicompartment analysis of (31)P spectroscopic imaging data to determine the tissue-specific heterogeneities in metabolite content in the human brain and surrounding tissue. Using this information and a multicompartment regression analysis the phosphocreatine and ATP content of "pure" cerebral gray and white matter, the cerebellum, and skeletal muscle was determined in a group of 10 healthy volunteers. The data were converted to mM units using previously reported values for the T(1)s of phosphocreatine and ATP at 4 T, the water content of human brain, and an external reference for absolute quantification. The phosphocreatine concentration in cerebral gray and white matter, the cerebellum, and skeletal muscle was 3.53 +/- 0.33, 3.33 +/- 0.37, 3.75 +/- 0.66, and 25.8 +/- 2.3 mM, respectively. The ATP concentration in cerebral gray and white matter, the cerebellum, and skeletal muscle was 2.19 +/- 0.33, 3.41 +/- 0.33, 1.75 +/- 0.58, and 8.5 +/- 1.9 mM, respectively. Magn Reson Med 45:46-52, 2001.