Point-resolved Spectroscopy Research Articles

Pattern recognition of abscesses and brain tumors through MR spectroscopy: Comparison of experimental conditions and radiological findings

Abstract Introduction The interpretation of brain tumors and abscesses MR spectra is complex and subjective. In clinical practice, different experimental conditions such as field strength or echo time (TE) reveal different metabolite information. Our study aims to show in which scenarios magnetic resonance spectroscopy can differentiate among brain tumors, normal tissue and abscesses using classification algorithms. Methods Pairwise classification between abscesses, brain tumor classes, and healthy subjects tissue spectra was performed, also the multiclass classification between meningiomas, grade I-II-III gliomas, and glioblastomas and metastases, in 1.5T short TE (n = 195), 1.5T long TE (n = 231) and 3.0T long TE (n = 59) point resolved spectroscopy setups, using LCModel metabolite concentration as input to classifiers. Results Areas under the curve of the Receiver Operating Characteristic above 0.9 were obtained for the classification between abscesses and all classes except glioblastomas, reaching 0.947 when classifying against metastases, grade I-II gliomas and glioblastomas (0.980), meningiomas and glioblastomas (0.956), grade I-II gliomas and metastases (0.989), meningiomas and metastases (0.990), and between healthy tissue and all other classes in both conditions except for anaplastic astrocytomas in short TE 1.5T setup. When the multiclass classification agrees with radiological diagnosis the accuracy reaches 96.8% for short TE and 98.9% for long TE. Conclusions The results in the three conditions were similar, highlighting comparable quality, robust quantification and good regularization and flexibility in either algorithm. Multiclass classification provides useful information to the radiologist. These findings show the potential of the development of decision support systems as well as tools for the accompaniment of treatments.

The Significance of Lactate and Lipid Peaks for Predicting Primary Neuroepithelial Tumor Grade with Proton MR Spectroscopy.

Purpose:1H-MRS is a non-invasive technique used to assess the metabolic activity of brain tumors. The technique is useful for the preoperative prediction of tumor grade, which is important for treatment planning and accurate prognosis. We used 1H-MRS to study the lactate peak, which appears in various conditions, including hyperglycemia, ischemia, and hypoxia and lipid peak, which is associated with necrotic cells. The purpose of this study was to retrospectively examine the frequency and significance of lactate and lipid peaks in relation to brain tumor grade.Materials and Methods:Fifty-five patients diagnosed with neuroepithelial tumors of Grades I (3 cases), II (11 cases), III (15 cases), and IV (26 cases) were enrolled. Biopsies were excluded. Single voxel (TE = 144 ms) point resolved 1H-MRS spectroscopy sequences were retrospectively analyzed. An inverted doublet peak at 1.3 ppm was defined as lactate, a negative and positive peak was defined as combined lactate and lipid, and a clear upward peak was defined as lipid.Results:Lactate peaks were detected in all grades of brain tumors and were least common in Grade II tumors (9.1%). The frequency of combined lactate-lipid peaks was 0% (Grades I and II), 8.3% (Grade III), and 44% (Grade IV). Grade IV tumors were significantly different to the other grades. There were three cases with a lipid peak. All were glioblastoma.Conclusions:The presence of a lac peak may be useful to largely rule out the Grade II tumors, and allow the subsequent differentiation of Grade I tumors from Grade III or IV tumors by conventional imaging. The presence of a lipid peak may be associated with Grade IV tumors.

Relative cerebral blood volume is a potential biomarker in late delayed radiation-induced brain injury.

To assess whether relative cerebral blood volume (rCBV) can provide information to reliably evaluate the stages of late delayed radiation-induced brain injury. Forty patients diagnosed with late delayed radiation-induced brain injury were enrolled. The patients were examined using a 1.5T magnetic resonance imaging (MRI) system equipped with an 8-channel head coil. An echo planar imaging (EPI) sequence was used in perfusion-weighted imaging (PWI). The location of 1H-MR spectroscopy scanning was acquired by a point-resolved spectroscopy sequence. Lesions of the temporal lobe were divided into one of two groups according to rCBV value: rCBV<1 (low rCBV [group 1; n = 45]); and rCBV>1 (elevated rCBV [group 2; n = 14]). PWI and MRS parameters, as well as morphological lesion types, in these two groups were compared. Morphological severity was assessed independently and agreed on by two imaging specialists (J.L. and H.X.S., with 16 and 24 years' experience, respectively). If necessary, a third imaging professor (Z.M.H.) with 30 years' experience resolved disagreement(s). Standards for evaluating morphological lesion types were based on previously published criteria. After testing the skewness of data, the Mann-Whitney U-test or Student's t-test was used, as appropriate. rCBV, relative cerebral blood flow (rCBF), and relative mean transit time (rMTT) in group 2 (n = 14) were significantly higher than in group 1 (n = 45) (rCBV: 1.21 ± 0.38 vs. 0.72 ± 0.32, respectively; P < 0.001; rCBF: 1.13 ± 0.02 vs. 0.74 ± 0.04, respectively; P < 0.001; rMTT: 1.10 ± 0.26 vs. 0.96 ± 0.20, P < 0.001). The levels of choline-containing compounds (CHO) / creatine (Cr) and CHO/N-acetylaspartate (NAA) in group 1 were significantly greater than in group 2 (CHO/Cr: 1.89 ± 1.83 vs. 1.22 ± 1.31, respectively; P = 0.016; CHO/NAA: 1.85 ± 3.50 vs. 1.17 ± 0.75, respectively; P = 0.022). More severe morphological lesions were present in lesions with low rCBV compared with elevated rCBV (overall severity: 7.00 ± 4.25 vs. 5.00 ± 5.13, respectively; P = 0.029). Elevated rCBV accompanied by a more conservative metabolic pattern and milder lesion(s) may represent a less advanced stage in the development of late delayed radiation-induced brain injury. 4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1112-1118.

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

ObjectiveTo compare magnetic resonance spectroscopy (MRS) metabolite ratios in preterm infants at term-equivalent age with those in term infants and to evaluate the association between MRS metabolites and neurodevelopmental outcomes...

Transverse relaxation time constants of the five major metabolites in human brain measured in vivo using LASER and PRESS at 3 T.

The goal of this study was to measure and compare the apparent transverse relaxation time constants (T2 ) of five intracellular metabolites using localization by adiabatic selective refocusing (LASER) and point-resolved spectroscopy (PRESS) sequences in the human brain at 3 T. Five healthy subjects were studied at 3 T. 1 H spectra from the prefrontal cortex were acquired at six different echo times using LASER and PRESS sequences. Postprocessed data were analyzed with LCModel, and the resulting amplitudes were fitted using a mono-exponential decay function to determine the T2 of metabolites. Twenty-one percent higher apparent T2 values for the singlet resonances of N-acetyl aspartate, total creatine, and total choline were measured with LASER as compared with PRESS, whereas comparable apparent T2 values were measured for strongly coupled metabolites, glutamate, and myo-inositol, with both sequences. Reliable T2 measurements were obtained with both sequences for the five major intracellular metabolites. The LASER sequence appears to be more efficient in suppressing the diffusion component for singlets (having nonexchangeable protons) compared to J-coupled metabolites. Magn Reson Med 79:1260-1265, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Improved localization, spectral quality, and repeatability with advanced MRS methodology in the clinical setting.

To investigate the utility of an advanced magnetic resonance spectroscopy (MRS) protocol in the clinical setting, and to compare the localization accuracy, spectral quality, and quantification repeatability between this advanced and the conventional vendor-provided MRS protocol on a clinical 3T platform. Proton spectra were measured from the posterior cingulate cortices in 30 healthy elderly subjects by clinical MR technologists using a vendor-provided (point resolved spectroscopy with advanced 3D gradient-echo B0 shimming) and an advanced (semi-LASER with FAST(EST)MAP shimming) protocol, in random order. Spectra were quantified with LCModel using standard pipelines for the clinical and research settings, respectively. The advanced protocol outperformed the vendor-provided protocol in localization accuracy (chemical-shift-displacement error: 2.0%/ppm, semi-LASER versus 11.6%/ppm, point resolved spectroscopy), spectral quality (water linewidth: 6.1 ± 1.8 Hz, FAST(EST)MAP versus 10.5 ± 3.7 Hz, 3D gradient echo; P < 7e-6; residual water: 0.08 ± 0.12%, VAPOR versus 0.45 ± 0.50%, WET; P < 2e-5) and within-session repeatability of metabolite concentrations, particularly of low signal-to-noise ratio data with two to eight averages (test-retest coefficients of variance of metabolite concentrations, P < 0.01). Concentrations of J-coupled metabolites such as γ-aminobutyric acid and glutamate were biased when using the default pipeline with simulated macromolecules. The quality of MRS data can be improved using advanced acquisition and analysis protocols on standard 3T hardware in the clinical setting, which can facilitate robust applications in central nervous system diseases. Magn Reson Med 79:1241-1250, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Simultaneous spin-echo and gradient-echo BOLD measurements by dynamic MRS.

This study aimed to dissociate the intravascular and extravascular contributions to spin-echo (SE) and gradient-echo (GE) blood oxygenation level-dependent (BOLD) signals at 7T, using dynamic diffusion-weighted MRS. We simultaneously acquired SE and GE data using a point-resolved spectroscopy sequence with diffusion weightings of 0, 600, and 1200s/mm2 . The BOLD signals were quantified by fitting the free induction decays starting from the SE center to a mono-exponential decay function. Without diffusion weighting, BOLD signals measured with SE and GE increased by 1.6±0.5% (TESE =40ms) and 5.2±1.4% (nominal TEGE =40ms) during stimulation, respectively. With diffusion weighting, the BOLD increase during stimulation measured with SE decreased from 1.6±0.5% to 1.3±0.4% (P<0.001), whereas that measured by GE was unaffected (P>0.05); the post-stimulation undershoots in the BOLD signal time courses were largely preserved in both SE and GE measurements. These results demonstrated the feasiblity of simultaneous SE and GE measurements of BOLD signals with and without interleaved diffusion weighting. The results also indicated a predominant extravascular contribution to the BOLD signal time courses, including post-stimulation undershoots in both SE and GE measurements at 7T.

Fully navigated 3 T proton magnetic resonance spectroscopy of liver metastases with inner-volume saturation.

To demonstrate that fully navigated magnetic resonance spectroscopy (MRS) with inner-volume saturation (IVS) at 3 T results in high-quality spectra that permit evaluating metabolic changes in hepatic metastases without the need for patient compliance. Nine patients with untreated, biopsy-proven large hepatic metastases (minimum diameter of 3cm) were included. In each patient, localized proton MRS was performed in the metastatic lesion and in uninvolved liver parenchyma. To improve quality and consistency of proton MRS, navigator gating was thereby performed not only during acquisition of the spectroscopic data but also during localization imaging and throughout the preparation phases. IVS was utilized to reduce chemical shift displacement between different metabolites and to diminish flow artifacts. Metabolite quantities were normalized relative to the unsuppressed water peak and choline-containing compounds (CCC) to lipid ratios were determined. Wilcoxon signed-rank tests were used to assess differences in the amounts of lipids and CCC as well as the CCC-to-lipid ratios between liver metastases and normal-appearing liver parenchyma. Fully navigated point-resolved spectroscopy with IVS resulted in high-quality spectra in all patients. Navigator gating during localization imaging and spectroscopic acquisition thereby ensured a precise localization of the spectroscopic voxel. Decreased quantities of lipid and CCC were observed in metastatic tissue compared with uninvolved liver parenchyma. However, the latter trend fell short of statistical significance. Moreover, elevated levels of the CCC-to-lipid ratios were detected in metastatic tissue relative to normal-appearing liver parenchyma. The present study demonstrates that fully navigated MRS of the liver with IVS at 3 T allows for a precise localization of the spectroscopic voxel and results in high-quality spectra that permit evaluating liver metabolism without the need for patient compliance.

1H MRS Assessment of Hepatic Fat Content: Comparison Between Normal- and Excess-weight Children and Adolescents

The purpose of the present study was to obtain a cutoff value of liver fat content for the diagnosis of hepatic steatosis by comparing magnetic resonance (MR) spectroscopy results in children and adolescents with normal and excess weight. The study included 420 children and adolescents (91 normal-weight, 99 overweight, and 230 obese) 8-18 years of age. Proton magnetic resonance spectroscopy was performed with a 3T MR system using point resolved spectroscopy sequence with series echo times. The mean absolute mass concentration of liver fat was obtained: 0.5 ± 0.04% in normal-weight boys; 0.5 ± 0.03% in normal-weight girls; 0.9 ± 0.16% in boys with overweight; 1.1 ± 0.24% in girls with overweight; 1.7 ± 0.24% in boys with obesity; and 1.4 ± 0.21% in girls with obesity. The cutoff value of absolute mass concentration of liver fat for hepatic steatosis was found to be 1.5%. Based on this cutoff value, hepatic steatosis was diagnosed in 16% of boys with overweight, 11% of girls with overweight, 32% of boys with obesity, and 27% of girls with obesity. Proton magnetic resonance spectroscopy was successfully applied to obtain the cutoff value of absolute mass concentration of liver fat for the diagnosis of hepatic steatosis in children and adolescents. Children and adolescents with obesity have higher risk of hepatic steatosis than their peers with overweight.

An acetone-based phantom for quantitative diffusion MRI.

To propose and evaluate an acetone-D2 O phantom that has an extended range of apparent diffusion coefficient (ADC) for quantitative diffusion magnetic resonance imaging (MRI), as well as to compare its properties to previously described water-based phantoms. The proposed acetone-D2 O, and previously described sucrose water solution and polyvinylpyrrolidone (PVP) water solution phantoms, were constructed in a number of concentrations between 0% and 50%. At 1.5T field strength, diffusion-weighted MR spectroscopy (DW-MRS), based on a point-resolved spectroscopy (PRESS) acquisition, nondiffusion-weighted stimulated echo acquisition mode (STEAM)-MRS, and diffusion-weighted echo-planar imaging (DW-EPI) were used to evaluate each phantom. The MR spectra, diffusion-weighted signal decay pattern, tunability of ADC, and ADC range of each phantom were all evaluated. When placed in an ice-water bath, all phantoms provided desirable signal properties, including single-peak signal with Gaussian diffusion and tunable ADC. At 0°C, however, water-based phantoms had ADC limited to less than 1.1·10-3 mm2 ·s-1 (0.2-1.1·10-3 mm2 ·s-1 ), while the proposed acetone-based phantom had ADC values spanning a wider range (0.6-3.5·10-3 mm2 ·s-1 ). The proposed acetone-D2 O phantom provided desirable signal properties over a wide range of ADCs with temperature controlled using an ice-water bath. 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1683-1692.

Multiple breath-hold proton spectroscopy of human liver at 3T: Relaxation times and concentrations of glycogen, choline, and lipids.

To evaluate the feasibility of an expiration multiple breath-hold 1 H-MRS technique to measure glycogen (Glycg), choline-containing compounds (CCC), and lipid relaxation times T1 , T2 , and their concentrations in normal human liver. Thirty healthy volunteers were recruited. Experiments were performed at 3T. Multiple expiration breath-hold single-voxel point-resolved spectroscopy (PRESS) technique was used for localization. Water-suppressed spectra were used for the estimation of Glycg, CCC, lipid methylene (CH2 )n relaxation times and concentrations. Residual water lines were removed by the Hankel Lanczos singular value decomposition filter. After phase correction and frequency alignment, spectra were averaged and processed by LCModel. Summed signals of Glycg resonances H2H4', H3, and H5 between 3.6 and 4 ppm were used to estimate their apparent relaxation times and concentration. Glycg, CCC, and lipid content were estimated from relaxation corrected spectral intensity ratios to unsuppressed water line. Relaxation times were measured for liver Glycg (T1 , 892 ± 126 msec; T2 , 13 ± 4 msec), CCC (T1 , 842 ± 75 msec; T2 , 50 ± 5 msec), lipid (CH2 )n (T1 , 402 ± 19 msec; T2 , 52 ± 3 msec), and water (T1 , 990 ± 89 msec; T2 , 30 ± 2 msec). Mean CCC and lipid concentrations of healthy liver were 7.8 ± 1.3 mM and 15.8 ± 23.6 mM, respectively. Glycg content was found lower in the morning (48 ± 21 mM) compared to the afternoon (145 ± 50 mM). Multiple breath-hold 1 H-MRS together with dedicated postprocessing is a feasible technique for the quantification of liver Glycg, CCC, and lipid relaxation times and concentrations. 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:410-417.

Richness in Functional Connectivity Depends on the Neuronal Integrity within the Posterior Cingulate Cortex.

The brain's connectivity skeleton—a rich club of strongly interconnected members—was initially shown to exist in human structural networks, but recent evidence suggests a functional counterpart. This rich club typically includes key regions (or hubs) from multiple canonical networks, reducing the cost of inter-network communication. The posterior cingulate cortex (PCC), a hub node embedded within the default mode network, is known to facilitate communication between brain networks and is a key member of the “rich club.” Here, we assessed how metabolic signatures of neuronal integrity and cortical thickness influence the global extent of a functional rich club as measured using the functional rich club coefficient (fRCC). Rich club estimation was performed on functional connectivity of resting state brain signals acquired at 3T in 48 healthy adult subjects. Magnetic resonance spectroscopy was measured in the same session using a point resolved spectroscopy sequence. We confirmed convergence of functional rich club with a previously established structural rich club. N-acetyl aspartate (NAA) in the PCC is significantly correlated with age (p = 0.001), while the rich club coefficient showed no effect of age (p = 0.106). In addition, we found a significant quadratic relationship between fRCC and NAA concentration in PCC (p = 0.009). Furthermore, cortical thinning in the PCC was correlated with a reduced rich club coefficient after accounting for age and NAA. In conclusion, we found that the fRCC is related to a marker of neuronal integrity in a key region of the cingulate cortex. Furthermore, cortical thinning in the same area was observed, suggesting that both cortical thinning and neuronal integrity in the hub regions influence functional integration of at a whole brain level.

Neurometabolic alterations in a depression-like rat model of chronic forced swimming stress using in vivo proton magnetic resonance spectroscopy at 7 T

Although recent investigations of major depressive disorder (MDD) have focused on the monoaminergic system, accumulating evidence suggests that alternative pathophysiological models of MDD and treatment options for patients with MDD are needed. Animals subjected to chronic forced swim stress (CFSS) develop behavioral despair. The purpose of this study was to investigate the in vivo effects of CFSS in the rat prefrontal cortex (PFC) with 7 T and short-echo-time proton magnetic resonance spectroscopy (1H MRS). Ten male Wistar rats underwent 14 days of CFSS, and in vivo1H MRS and forced swim tests were performed before and after CFSS. Point-resolved spectroscopy was used to quantify metabolite levels in the rat PFC. The spectral analyses showed that in vivo1H MRS can be used to reliably assess the Glu system. The rats showed significantly increased immobility times and decreased climbing times in the FST after CFSS, which suggested that the rats developed behavioral despair. The pre-CFSS and post-CFSS Glu and Gln levels did not significantly differ (P &gt; 0.050). The levels of myo-inositol, total choline, and N-acetylaspartate, myo-inositol/creatine, and total choline/creatine increased significantly (P &lt; 0.050). Similar findings have been reported in patients with MDD. Taken together, these results suggested that the CFSS-induced metabolic alterations were similar to those found in patients and that high-field and short-echo-time in vivo1H MRS can be used to investigate depression-induced metabolic alterations. Such investigations might provide alternative insights into the nonmonoaminergic pathophysiology and treatment of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

PD11-03 IMPACT OF MAGNETIC RESONANCE SPECTROSCOPIC IMAGING ON DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2017PD11-03 IMPACT OF MAGNETIC RESONANCE SPECTROSCOPIC IMAGING ON DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS Masahiro Sumura, Haruki Ajiki, Chiaki Koike, Keita Inoue, Keisuke Nakanishi, Hiroaki Yasumoto, Tsuyoshi Yoshizako, Hajime Kitagaki, and Hiroaki Shiina Masahiro SumuraMasahiro Sumura More articles by this author , Haruki AjikiHaruki Ajiki More articles by this author , Chiaki KoikeChiaki Koike More articles by this author , Keita InoueKeita Inoue More articles by this author , Keisuke NakanishiKeisuke Nakanishi More articles by this author , Hiroaki YasumotoHiroaki Yasumoto More articles by this author , Tsuyoshi YoshizakoTsuyoshi Yoshizako More articles by this author , Hajime KitagakiHajime Kitagaki More articles by this author , and Hiroaki ShiinaHiroaki Shiina More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.579AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The utility of magnetic resonance imaging (MRI) for diagnosis of a renal tumor is controversial. MR spectroscopy (MRS), a noninvasive method utilized for assessment of biochemical tissue characteristics in vivo, has value for differentiation of tumors in the brain, breast, and prostate. However, there are few reports of MRS examinations of kidneys. Here, we evaluated the diagnostic potential of MRS for renal tumors. METHODS We analyzed 45 renal tumors in 45 patients (age 60-82 years, median 62 years; clinical stage: T1a, n=25; T1b, n=9; T2a, n=1; T2b, n=1; T3a, n=6; T4, n=1). All patients underwent pre-operative MRS examinations with a 1.5 T MR device equipped with a phased array type external surface coil, in which respiratory-triggered single voxel MRS was performed with a point-resolved spectroscopy sequence (TR, 2000 ms; TE, 135 ms). The obtained spectra were analyzed for choline resonances at 3.2 ppm, after normalization for noise outside the diagnostic range. Choline/noise ratio (CNR) values were automatically calculated using the “R” software package, then the CNRs in spectra obtained from both cancerous and benign tumors were compared. Histological results were defined as the standard for reference. RESULTS Of the 45 tumors examined, 41 including 3 cystic tumors were malignant in histological findings, while 2 were histologically diagnosed as angiomyolipoma (AML), 1 as oncocytoma and 1 as tuberculous granuloma (TG). In all cases, the obtained spectra were of sufficient quality for diagnosis. The mean choline CNR value for malignant lesions was 3.4, while that was 1.01 for AML, 1.05 for oncocytoma, and 1.12 for TG. Malignant renal tumors tended to show higher CNR values than benign tumors as well as in tumors with higher grade. CONCLUSIONS Although further studies are necessary, our findings indicate that MRS has potential to differentiate malignant from benign renal tumors. Furthermore, it may be an effective diagnostic tool for cystic renal tumor cases. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e206 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Masahiro Sumura More articles by this author Haruki Ajiki More articles by this author Chiaki Koike More articles by this author Keita Inoue More articles by this author Keisuke Nakanishi More articles by this author Hiroaki Yasumoto More articles by this author Tsuyoshi Yoshizako More articles by this author Hajime Kitagaki More articles by this author Hiroaki Shiina More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Noninvasive assessment of isocitrate dehydrogenase mutation status in cerebral gliomas by magnetic resonance spectroscopy in a clinical setting.

OBJECTIVE Mutations in the isocitrate dehydrogenase (IDH) genes are of proven diagnostic and prognostic significance for cerebral gliomas. The objective of this study was to evaluate the clinical feasibility of using a recently described method for determining IDH mutation status by using magnetic resonance spectroscopy (MRS) to detect the presence of 2-hydroxyglutarate (2HG), the metabolic product of the mutant IDH enzyme. METHODS By extending imaging time by 6 minutes, the authors were able to include a point-resolved spectroscopy (PRESS) MRS sequence in their routine glioma imaging protocol. In 30 of 35 patients for whom this revised protocol was used the lesions were subsequently diagnosed histologically as gliomas. Of the remaining 5 patients, 1 had a gangliocytoma, 1 had a primary CNS lymphoma, and 3 had nonneoplastic lesions. Immunohistochemistry and/or polymerase chain reaction were used to detect the presence of IDH mutations in the glioma tissue resected. RESULTS In vivo MRS for 2HG correctly identified the IDH mutational status in 88.6% of patients. The sensitivity and specificity was 89.5% and 81.3%, respectively, when using 2 mM 2HG as threshold to discriminate IDH-mutated from wildtype tumors. Two glioblastomas that had elevated 2HG levels did not have detectable IDH mutations, and in 2 IDH-mutated gliomas 2HG was not reliably detectable. CONCLUSIONS The noninvasive determination of the IDH mutation status of a presumed glioma by means of MRS may be incorporated into a routine diagnostic imaging protocol and can be used to obtain additional information for patient care.

Improving labeling efficiency in automatic quality control of MRSI data.

To improve the efficiency of the labeling task in automatic quality control of MR spectroscopy imaging data. 28'432 short and long echo time (TE) spectra (1.5 tesla; point resolved spectroscopy (PRESS); repetition time (TR)= 1,500 ms) from 18 different brain tumor patients were labeled by two experts as either accept or reject, depending on their quality. For each spectrum, 47 signal features were extracted. The data was then used to run several simulations and test an active learning approach using uncertainty sampling. The performance of the classifiers was evaluated as a function of the number of patients in the training set, number of spectra in the training set, and a parameter α used to control the level of classification uncertainty required for a new spectrum to be selected for labeling. The results showed that the proposed strategy allows reductions of up to 72.97% for short TE and 62.09% for long TE in the amount of data that needs to be labeled, without significant impact in classification accuracy. Further reductions are possible with significant but minimal impact in performance. Active learning using uncertainty sampling is an effective way to increase the labeling efficiency for training automatic quality control classifiers. Magn Reson Med 78:2399-2405, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Effect of Bilingualism in the Anterior Cingulate Cortex: A Proton Magnetic Resonance Spectroscopy Study in Two Centres

Effect of Bilingualism in the Anterior Cingulate Cortex: A Proton Magnetic Resonance Spectroscopy Study in Two Centres

The Impact of Venoarterial and Venovenous Extracorporeal Membrane Oxygenation on Cerebral Metabolism in the Newborn Brain.

BackgroundExtracorporeal membrane oxygenation (ECMO) is an effective therapy for supporting infants with reversible cardiopulmonary failure. Still, survivors are at risk for long-term neurodevelopmental impairments, the cause of which is not fully understood.ObjectiveTo elucidate the effects of ECMO on the newborn brain. We hypothesized that the cerebral metabolic profile of neonates who received ECMO would differ from neonates who did not receive ECMO. To address this, we used magnetic resonance spectroscopy (1H-MRS) to investigate the effects of venoarterial and venovenous ECMO on cerebral metabolism.Methods41 neonates treated with ECMO were contrasted to 38 age-matched neonates.ResultsAll 1H-MRS data were acquired from standardized grey matter and white matter regions of interest using a short-echo (TE = 35 milliseconds), point-resolved spectroscopy sequence (PRESS) and quantitated using LCModel. Metabolite concentrations (mmol/kg) were compared across groups using multivariate analysis of covariance. Elevated creatine (p = 0.002) and choline (p = 0.005) concentrations were observed in the grey matter among neonates treated with ECMO relative to the reference group. Likewise, choline concentrations were elevated in the white matter (p = 0.003) while glutamate was reduced (p = 0.03). Contrasts between ECMO groups revealed lower osmolite concentrations (e.g. myoinositol) among the venovenous ECMO group.ConclusionNeonates who underwent ECMO were found to have an abnormal cerebral metabolic profile, with the pattern of abnormalities suggestive of an underlying inflammatory process. Additionally, neonates who underwent venovenous ECMO had low cerebral osmolite concentrations as seen in vasogenic edema.

Application of Single Voxel 1H Magnetic Resonance Spectroscopy in Hepatic Benign and Malignant Lesions

BackgroundTo quantify the metabolite changes in hepatic tumors by single-voxel 1H magnetic resonance spectroscopy (MRS) at 3.0 T and explore the application value of 1HMRS in the diagnosis of hepatic benign and malignant lesions.Material/MethodsA total of 45 patients (55 lesions) diagnosed with hepatic lesions by ultrasound and/or computer topography (CT) from November 2006 to March 2007 were included in this study. All patients underwent 3D-dynamic enhanced scan with liver acquisition with acceleration volume acquisition (LAVA) sequence and single-voxel 1HMRS imaging with PRESS (point-resolved spectroscopy) sequence. The metabolite concentrations such as choline (Cho) and lipids (Lip) were measured.ResultsThere was significant difference regarding the occurrence rate of the obvious elevated Cho peaks between benign and malignant tumors (7/27 vs. 21/28, p=0.000). There was statistical significant differences regarding the Cho/Lip ratios in hepatic benign (0.0686±0.0283, 95% CI: 0.0134–0.1245) and malignant (0.1266±0.1124, 95% CI: 0.0937–0.2203) lesions (p<0.05). When compared with the pathological results, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were 85.7% (24/28), 92.6% (25/27), 92.3% (24/26), 86.2% (25/29), and 89.1% (49/55) respectively for the MRI assessment, and 92.6% (26/28), 88.9% (24/27), 89.7 (26/29), 92.3 (24/26), and 90.9% (50/55) respectively for 1HMRS combined with MRI assessment.ConclusionsSingle Cho peaks or Lip peaks cannot be used for the diagnosis of hepatic benign and malignant lesions. Combined use of 1HMRS and MRI can greatly improve the application value of MRI assessment in the diagnosis of hepatic benign and malignant lesions with a higher sensitivity, negative predictive value, and overall accuracy.

Effects of repeated dizocilpine treatment on glutamatergic activity in the prefrontal cortex in an animal model of schizophrenia: An in vivo proton magnetic resonance spectroscopy study at 9.4 T

Repeated exposure to dizocilpine (MK-801) can be used as a model of schizophrenia that incorporates disease progression. Proton magnetic resonance spectroscopy (1H MRS) has been widely used to investigate schizophrenia-related alterations in glutamate (Glu). The purpose of this study was to investigate metabolic alterations in the prefrontal cortex (PFC) in an animal model of schizophrenia by using in vivo 1H MRS. Because of the spectral overlap of Glu and glutamine (Gln), high-field 1H MRS with short echo time (TE) was used. A point-resolved spectroscopy sequence was used to measure the levels of Glu and Gln, and the brain metabolites in a volume of interest (22.5μL) located in the PFC region of rats (n=13) before and after 6days of MK-801 (0.5mg/kg) treatment. Analysis of the spectra showed that the cross-contamination of Glu and Gln can be considered to comparably low. No metabolic parameters were altered (p>0.05). However, differences in Glu and N-acetylaspartate (NAA) levels between two times were significantly correlated (p<0.01). The results showed both decreased (in 6 of the 13 rats) and increased (7 of the 13 rats) levels of Glu and NAA, which suggested that these opposite metabolic alterations reflect two stage of disease progression. The results suggest that high-field and short TE in vivo 1H MRS can quantify Glu and Gln with reliably low level of cross-contamination and that repeated exposure to MK-801 induces the progressive development of schizophrenia.