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

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  • MRS consensus submitted

    Accepted author manuscript, 1 MB, PDF document

    Embargo ends: 28/03/20

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DOI

  • Martin Wilson
    Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, England.
  • Ovidiu Andronesi
    Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
  • Peter B Barker
    Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Robert Bartha
    Robarts Research Institute, University of Western Ontario, London, Canada.
  • Alberto Bizzi
    U.O. Neuroradiologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
  • Patrick J Bolan
    Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota.
  • Kevin M Brindle
    Department of Biochemistry, University of Cambridge, Cambridge, England.
  • In-Young Choi
    Department of Neurology, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas.
  • Cristina Cudalbu
    Center for Biomedical Imaging, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland.
  • Ulrike Dydak
    School of Health Sciences, Purdue University, West Lafayette, Indiana.
  • Uzay E Emir
    School of Health Sciences, Purdue University, West Lafayette, Indiana.
  • Ramon G Gonzalez
    Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
  • Stephan Gruber
    High Field MR Center, Department of Biomedical imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
  • Rolf Gruetter
    Laboratory for Functional and Metabolic Imaging, Center for Biomedical Imaging, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland.
  • Rakesh K Gupta
    Fortis Memorial Research Institute, Gurugram, Haryana, India.
  • Arend Heerschap
    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Anke Henning
    Max Planck Institute for Biological Cybernetics, Tuebingen, Germany.
  • Hoby P Hetherington
    Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Petra S Huppi
    Department of Pediatrics, University of Geneva, Geneva, Switzerland.
  • Ralph E Hurd
    Stanford Radiological Sciences Lab, Stanford, California.
  • Kejal Kantarci
    Department of Radiology, Mayo Clinic, Rochester, Minnesota.
  • Risto A Kauppinen
    School of Psychological Science, University of Bristol, Bristol, England.
  • Dennis W J Klomp
    University Medical Centre Utrecht, Utrecht, the Netherlands.
  • Roland Kreis
    Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland.
  • Marijn J Kruiskamp
    Philips Healthcare, Best, the Netherlands.
  • Martin O Leach
    CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, London, England.
  • Alexander P Lin
    Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard University Medical School, Boston, Massachusetts.
  • Peter R Luijten
    University Medical Centre Utrecht, Utrecht, the Netherlands.
  • Małgorzata Marjańska
    Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota.
  • Andrew A Maudsley
    Department of Radiology, University of Miami, Miami, Florida.
  • Dieter J Meyerhoff
    DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
  • Carolyn E Mountford
    Translational Research Institute, Woolloongabba, Australia.
  • Paul G Mullins
  • James B Murdoch
    Canon Medical Research USA, Mayfield Village, Ohio.
  • Sarah J Nelson
    Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
  • Ralph Noeske
    GE Healthcare, Berlin, Germany.
  • Gülin Öz
    Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota.
  • Julie W Pan
    Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Andrew C Peet
    Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England.
  • Harish Poptani
    Centre for Preclinical Imaging, Institute of Translational Medicine, University of Liverpool, Liverpool, England.
  • Stefan Posse
    Department of Neurology, University of New Mexico, Albuquerque, New Mexico.
  • Eva-Maria Ratai
    Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
  • Nouha Salibi
    MR R&D, Siemens Healthineers, Malvern, Pennsylvania.
  • Tom W J Scheenen
    Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Ian C P Smith
    Innovative Biodiagnostics, Winnipeg, Canada.
  • Brian J Soher
    Department of Radiology, Duke University Medical Center, Durham, North Carolina.
  • Ivan Tkáč
    Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota.
  • Daniel B Vigneron
    Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
  • Franklyn A Howe
    Molecular and Clinical Sciences, St George's University of London, London, England.

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.

Keywords

  • brain, consensus, metabolites, MRS, semi-LASER, shimming
Original languageEnglish
Pages (from-to)527-550
Number of pages24
JournalMagnetic Resonance in Medicine
Volume82
Issue number2
Early online date28 Mar 2019
DOIs
Publication statusPublished - Aug 2019

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