Utility of 3T single-voxel proton MR spectroscopy for differentiating intracranial meningiomas from intracranial enhanced mass lesions

Background Proton magnetic resonance spectroscopy (MRS) provides structural and metabolic information that is useful for the diagnosis of meningiomas with atypical radiological appearance. However, the metabolite that should be prioritized for the diagnosis of meningiomas has not been established. Purpose To evaluate the differences between the metabolic peaks of meningiomas and other intracranial enhanced mass lesions (non-meningiomas) using MR spectroscopy in short echo time (TE) spectra and the most useful metabolic peak for discriminating between the groups. Material and Methods The study involved 9 meningiomas, 22 non-meningiomas, intracranial enhancing tumors and abscesses, and 15 normal controls. The ranking of the peak at 3.8 ppm, peak at 3.8 ppm/Creatine (Cr), β-γ Glutamine-Glutamate (bgGlx)/Cr, N-acetyl compounds (NACs)/Cr, choline (Cho)/Cr, lipid and/or lactate (Lip-Lac) at 1.3 ppm/Cr, and the presence of alanine (Ala) were derived. The metabolic peaks were compared using the Mann-Whitney U test. ROC analysis was used to determine the cut-off values for differentiating meningiomas from non-meningiomas using statistically significant metabolic peaks. Results The ranking of the peak at 3.8 ppm among all the peaks, peak at 3.8 ppm/Cr, bgGlx/Cr, Lip-Lac/Cr, and the presence of Ala discriminated meningiomas from non-meningiomas with moderate to high accuracy. The highest accuracy was 96.9% at a threshold value of 3 for the rank of the peak at 3.8 ppm. Conclusion A distinct elevated peak at 3.8 ppm, ranked among the top three highest peaks, allowed the detection of meningiomas.

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Evaluation of intracranial neoplasia and noninfectious meningoencephalitis in dogs by use of short echo time, single voxel proton magnetic resonance spectroscopy at 3.0 Tesla

American Journal of Veterinary Research ◽

10.2460/ajvr.77.5.452 ◽

2016 ◽

Vol 77 (5) ◽

pp. 452-462 ◽

Cited By ~ 6

Author(s):

Inés Carrera ◽

Henning Richter ◽

Katrin Beckmann ◽

Dieter Meier ◽

Matthias Dennler ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Proton Magnetic Resonance ◽

Proton Magnetic Resonance Spectroscopy ◽

Resonance Spectroscopy ◽

3.0 Tesla ◽

Single Voxel ◽

Echo Time ◽

Short Echo Time

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Short-echo-time magnetic resonance spectroscopy of single voxel with arbitrary shape in the living human brain using segmented two-dimensional selective radiofrequency excitations based on a blipped-planar trajectory

Magnetic Resonance Imaging ◽

10.1016/j.mri.2008.10.004 ◽

2009 ◽

Vol 27 (5) ◽

pp. 664-671 ◽

Cited By ~ 14

Author(s):

Wolfgang Weber-Fahr ◽

Martin G. Busch ◽

Jürgen Finsterbusch

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Human Brain ◽

Arbitrary Shape ◽

Resonance Spectroscopy ◽

Two Dimensional ◽

Single Voxel ◽

Planar Trajectory ◽

Echo Time ◽

Short Echo Time

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Regional metabolite concentrations in the brain of healthy dogs measured by use of short echo time, single voxel proton magnetic resonance spectroscopy at 3.0 Tesla

American Journal of Veterinary Research ◽

10.2460/ajvr.76.2.129 ◽

2015 ◽

Vol 76 (2) ◽

pp. 129-141 ◽

Cited By ~ 8

Author(s):

Inés Carrera ◽

Henning Richter ◽

Dieter Meier ◽

Patrick R. Kircher ◽

Matthias Dennler

Keyword(s):

Proton Magnetic Resonance ◽

Proton Magnetic Resonance Spectroscopy ◽

Resonance Spectroscopy ◽

3.0 Tesla ◽

Single Voxel ◽

Metabolite Concentrations ◽

Healthy Dogs ◽

Echo Time ◽

Short Echo Time ◽

The Brain

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Proton spectroscopy of the thalamus in a homogeneous sample of patients with easy-to-control juvenile myoclonic epilepsy

Radiologia Brasileira ◽

10.1590/0100-3984.2016.0086 ◽

2017 ◽

Vol 50 (5) ◽

pp. 279-284

Author(s):

Claudia da Costa Leite ◽

Kette Dualibi Ramos Valente ◽

Lia Arno Fiore ◽

Maria Concepción García Otaduy

Keyword(s):

Magnetic Resonance ◽

Juvenile Myoclonic Epilepsy ◽

Myoclonic Epilepsy ◽

Resonance Spectroscopy ◽

Homogeneous Sample ◽

Single Voxel ◽

Echo Time ◽

Short Echo Time ◽

Generalized Epilepsy ◽

Genetically Determined

Abstract Objective: Juvenile myoclonic epilepsy (JME) is a subtype of genetically determined generalized epilepsy that does not present abnormalities on conventional magnetic resonance imaging. The aim of this study was to identify metabolic alterations in the thalamus in a clinically homogeneous sample of patients with easy-to-control JME, using short-echo time proton magnetic resonance spectroscopy (MRS). Materials and Methods: We performed single-voxel (2 cm × 2 cm × 2 cm), short-echo time (TE = 35 ms) proton MRS of the thalamus in 21 patients with JME and in 14 healthy age-matched controls. We quantified N-acetylaspartate (NAA), total NAA, creatine (Cr), choline, and myo-inositol (MI), as well as the sum of glutamate and glutamine signals, all scaled to internal water content, and we calculated metabolite ratios using Cr as a reference. Values of p < 0.05 were considered significant. Results: The MI level and the MI/Cr ratio were significantly lower in the thalami of patients diagnosed with JME than in those of the controls. Other metabolites and their ratios did not differ significantly between the two groups. Conclusion: In our sample of 21 JME patients, we identified lower levels of MI in the thalamus. No significant abnormalities were observed in the concentrations or ratios of other metabolites.

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Assessment of mitochondrial impairment in traumatic brain injury using high-resolution proton magnetic resonance spectroscopy

Journal of Neurosurgery ◽

10.3171/jns/2008/108/01/0042 ◽

2008 ◽

Vol 108 (1) ◽

pp. 42-52 ◽

Cited By ~ 63

Author(s):

Stefano Signoretti ◽

Anthony Marmarou ◽

Gunes A. Aygok ◽

Panos P. Fatouros ◽

Gina Portella ◽

...

Keyword(s):

Magnetic Resonance ◽

Mr Spectroscopy ◽

Brain Injuries ◽

Head Injuries ◽

Resonance Spectroscopy ◽

Mitochondrial Impairment ◽

Single Voxel ◽

Scale Scores ◽

Nonsignificant Difference ◽

Poor Outcomes

Object The goal of this study was to demonstrate the posttraumatic neurochemical damage in normal-appearing brain and to assess mitochondrial dysfunction by measuring N-acetylaspartate (NAA) levels in patients with severe head injuries, using proton (1H) magnetic resonance (MR) spectroscopy. Methods Semiquantitative analysis of NAA relative to creatine-containing compounds (Cr) and choline (Cho) was carried out from proton spectra obtained by means of chemical shift (CS) imaging and single-voxel (SV) methods in 25 patients with severe traumatic brain injuries (TBIs) (Glasgow Coma Scale scores ≤ 8) using a 1.5-tesla MR unit. Proton MR spectroscopy was also performed in 5 healthy volunteers (controls). Results The SV studies in patients with diffuse TBI showed partial reduction of NAA/Cho and NAA/Cr ratios within the first 10 days after injury (means ± standard deviations 1.59 ± 0.46 and 1.44 ± 0.21, respectively, in the patients compared with 2.08 ± 0.26 and 2.04 ± 0.31, respectively, in the controls; nonsignificant difference). The ratios gradually declined in all patients as time from injury increased (mean minimum values NAA/Cho 1.05 ± 0.44 and NAA/Cr 1.05 ± 0.30, p < 0.03 and p < 0.02, respectively). This reduction was greater in patients with less favorable outcomes. In patients with focal injuries, the periphery of the lesions revealed identical trends of NAA/Cho and NAA/Cr decrease. These reductions correlated with outcome at 6 months (p < 0.01). Assessment with multivoxel methods (CS imaging) demonstrated that, in diffuse injury, NAA levels declined uniformly throughout the brain. At 40 days postinjury, initially low NAA/Cho levels had recovered to near baseline in patients who had good outcomes, whereas no recovery was evident in patients with poor outcomes (p < 0.01). Conclusions Using 1H-MR spectroscopy, it is possible to detect the posttraumatic neurochemical damage of the injured brain when conventional neuroimaging techniques reveal no abnormality. Reduction of NAA levels is a dynamic process, evolving over time, decreasing and remaining low throughout the involved tissue in patients with poor outcomes. Recovery of NAA levels in patients with favorable outcomes suggests marginal mitochondrial impairment and possible resynthesis from vital neurons.

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Short echo time single voxel 1H magnetic resonance spectroscopy in the diagnosis and characterisation of pineal tumours in children

Pediatric Blood & Cancer ◽

10.1002/pbc.23044 ◽

2011 ◽

Vol 57 (6) ◽

pp. 972-977 ◽

Cited By ~ 12

Author(s):

Lisa M. Harris ◽

Nigel P. Davies ◽

Shaun Wilson ◽

Lesley MacPherson ◽

Kal Natarajan ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Resonance Spectroscopy ◽

1H Magnetic Resonance Spectroscopy ◽

Single Voxel ◽

Echo Time ◽

Short Echo Time

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Diagnostic potential of short echo time MR spectroscopy of gliomas with single-voxel and point-resolved spatially localised proton spectroscopy of brain

Neuroradiology ◽

10.1007/s002340000473 ◽

2001 ◽

Vol 43 (5) ◽

pp. 353-363 ◽

Cited By ~ 67

Author(s):

M. Kaminogo ◽

H. Ishimaru ◽

M. Morikawa ◽

M. Ochi ◽

R. Ushijima ◽

...

Keyword(s):

Mr Spectroscopy ◽

Proton Spectroscopy ◽

Diagnostic Potential ◽

Single Voxel ◽

Echo Time ◽

Short Echo Time

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Clinical Application of Magnetic Resonance Spectroscopy in Diagnosis of Intracranial Mass Lesions

Radiology Research and Practice ◽

10.1155/2021/6673585 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Callen Kwamboka Onyambu ◽

Mufaddal Nuruddin Wajihi ◽

Alfred Otieno Odhiambo

Keyword(s):

Mr Spectroscopy ◽

Neuronal Cell ◽

Resonance Spectroscopy ◽

Low Grade ◽

Mri Imaging ◽

Imaging Diagnosis ◽

Membrane Turnover ◽

Intracranial Mass ◽

Study Results ◽

Mass Lesions

Introduction. Conventional MR imaging provides highly detailed anatomic information with unrivalled soft tissue contrast making it the mainstay in the diagnosis of suspected brain lesions. Despite this, MRI alone at times cannot answer the diagnostic questions in quite a few patients. Proton MR Spectroscopy (H-MRS) provides information on the metabolic composition within an area under interrogation. By comparing the relative concentrations of specific metabolites, the neuroradiologist can deduce critical information regarding neuronal cell density and integrity, cell membrane turnover, metabolic fuel, and possible necrosis in the region of interest. This provides a biochemical picture of the underlying pathology and thus aids in the diagnosis. Methods. This was a cross-sectional comparative study. Results. Of the 63 patients examined by MRI and MRS for intracranial mass lesions, the radiologists were able to offer a single imaging diagnosis based on MRI alone in only 15 patients (23.8%) while when MRI imaging was combined with MR spectroscopy, a single imaging diagnosis was offered in 47 patients (74.6%). This was an overall statistically significant improvement. Conclusion. MRS aided the radiologist in offering a single diagnosis in high versus low-grade gliomas, high-grade gliomas versus tuberculomas, and recurrent tumours versus radiation necrosis.

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Single Voxel Proton MR Spectroscopy Methods and Applications in Neuropediatrics

Rivista di Neuroradiologia ◽

10.1177/197140090001300103 ◽

2000 ◽

Vol 13 (1) ◽

pp. 7-15

Author(s):

J. Frahm ◽

F. Hanefeld

Keyword(s):

Mr Spectroscopy ◽

Total N ◽

Proton Mr Spectroscopy ◽

Promising Tool ◽

Single Voxel ◽

Localization Sequence ◽

Short Echo Time ◽

Clinical Potential ◽

Pathologic Processes

The purpose of this contribution is to introduce quantitative single voxel proton MR spectroscopy of the human brain as an easy-to-use method for a noninvasive assessment of cellular composition and metabolism and to demonstrate its clinical potential in the field of neuropediatrics. The chosen approach transforms fully relaxed (TR = 6000 ms) short echo time (TE = 20 ms) proton MR spectra (STEAM localization sequence) into absolute metabolite concentrations by automatically fitting the raw data with a library of model spectra comprising all metabolites at known concentration (LCModel). The procedure includes total N-acetylaspartyl compounds as a marker for viable neuroaxonal tissue and myo-inositol as a purely glial constituent as well as total creatine, choline-containing compounds, glutamate and glutamine, and lactate. Extensive studies of brain disorders in childhood suggest the use of proton MRS as a promising tool for an in vivo histopathologic characterization of brain tissue. Typical metabolite patterns are observed for pathologic processes such as lactic acidosis, loss of functioning neurons, astrocytosis, myelin breakdown, or loss of oligodendrocytes. Examples deal with the diagnostic workup of enzyme deficiencies, demyelinating white matter diseases, and focal brain lesions.

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