Alejandro Santos Diaz1,2, Diana Harasym1,2, and Michael Noseworthy1,2,3
1School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada, 2Imaging Research Center, St. Joseph's Healthcare, Hamilton, ON, Canada, 3Electrical and Computing Engineering, McMaster University, Hamilton, ON, Canada
Synopsis
Dynamic
31P-MRSI experiments require temporal resolution on the order of
seconds to concurrently assess metabolic change in different muscles. In this study
we developed a pulse sequence using a flyback-EPSI readout combined with
compressed sensing (CS) to achieve a 9 second temporal resolution and tested it
in 11 healthy volunteers during an exercise-recovery challenge of the lower leg
muscles. Our results showed that the
sequence was capable of assessing PCr depletion/recovery and intracellular pH
at rest and following exercise, of multiple muscle groups simultaneously, using
a clinical 3T MR system.
Introduction
Phosphorus magnetic resonance spectroscopy and
spectroscopic imaging (31P-MRS/MRSI) are non-invasive methods
capable of assessing in vivo skeletal muscle energy metabolism. Further to the
analysis of resting spectra, metabolic studies can be performed in a dynamic
fashion through an exercise-recovery challenge and thus assess mitochondrial
function1,2.
Such experiments require temporal resolution on the order of seconds to concurrently
assess different muscles. In this this study we developed a highly accelerated 31P-MRSI
sequence combining flyback-EPSI and compressed sensing capable of tracking
dynamic calf muscle metabolism.Methods
All experiments were performed using a 60cm bore
3T GE MR750 (GE Healthcare, Milwaukee, WI) scanner and home-designed undersampled pulse sequence built on a flyback-EPSI sequence3 (fig.1). The compressed sensing approach
was implemented through the inclusion of pseudo-randomly distributed blips in
the ky direction during
the flyback readout to sample multiple ky-kt
lines within the same phase encoding step4,5,thus
achieving a temporal resolution of 9 seconds. The Flyback-EPSI trajectory was
designed to achieve 2.25x2.25cm2 resolution over an 18x18cm2
field of view (i.e.8x8 voxels), using 1420Hz spectral bandwidth and 512 points.
The sub-sampling scheme was designed to acquire an entire 2D-MRSI dataset (one
frame) using three excitations. Dynamic experiments were performed in 11
healthy volunteers through an exercise-recovery challenge using a home made ergometer6
and an in-house designed/built 31P-tuned (51.705 MHz), 7.62cm
diameter surface coil matched specifically for calf muscles. During the
experiment, volunteers were lying on the ergometer in a supine position with
the coil placed below the right gastrocnemius. The region of interest was
shimmed on a set of T2-weighted proton images used as anatomical
reference. The dynamic protocol consisted of 16 baseline frames at rest (9sec x
16 = 2.4 minutes, TR=1.5s), followed by three minutes of plantar flexion with a
frequency of 0.5Hz, extended knee and acting on a load of 40%-50% maximum
voluntary contraction (MVC). Subsequently, 32 frames (4.8 minutes) were acquired
during recovery with no acquisition during the exercise. Slice thickness, number
of averages and flip angle were set to 4cm, 2 and 40°, respectively. All data
processing and reconstruction was performed using MATLAB R2015b (The Mathworks,
Natick, MA, USA) as follows. First, data were re-shaped from the raw blipped
acquisition to a 4D matrix of k-space
data with dimensions kt-kx-ky-#frame.
The missing k-space samples were determined
using a modified 2D implementation of an iterative low-rank Hankel matrix completion
reconstruction algorithm7. To
assess metabolism of different muscle groups, four voxels were selected an
analyzed containing mostly tissue from the gastrocnemius lateralis (GL),
gastrocnemius medialis (GM), soleus (SOL) and a mixture of muscles (MIX).
Spectral fitting was performed using the OXSA toolbox8. Values
for the time constant of PCr recovery rate (τPCr), PCr drop
percentage (dPCr) and intracellular pH at rest (pHrest) and the end
of exercise (pHend) were calculated. Statistical analysis was
performed to compare dPCr and pH values.Results
Fig.2 depicts an example of different muscle groups
analyzed and the evolution of the fitted amplitudes for PCr and Pi signals. The
visually different metabolic responses stress the importance of spatial
localization in these types of experiments. A statistically significant
difference was found between the percent PCr drop of SOL when compared to GM,
GL and MIX but not between the later three. Sample spectra for each muscle
group taken during baseline and end of exercise are depicted in figs.3a-d. Fig.3e shows spectra acquired over time during baseline and
recovery for the GM, where the PCr depletion is clearly depicted. Fig.4 summarizes the results of the
exercise-recovery experiment including the calculated values for pHi (pHrest
and pHend) and τPCr.Discussion
In this study we present a highly accelerated 31P-MRSI
pulse sequence capable of simultaneously tracking the exercise-induced evolution
of PCr and intracellular pH, within multiple muscle groups using a clinical
field strength (3T). Our sequence was capable of assessing multiple muscle
groups simultaneously as shown in the results of figs2-4. Calculated values for τPCr and pHi are in agreement with
previous reports in healthy volunteers9,10.Conclusion
We presented a highly accelerated 31P-MRSI
sequence that combines a flyback-EPSI readout with compressed sensing capable
to assess energy metabolism of multiple muscle groups from the lower leg
simultaneously during an exercise-recovery challenge, using a clinical 3T MR
system.Acknowledgements
Thank
you to Dr. Peder Larson from UCSF and Dr. Rolf Schulte from GE Healthcare for
their help and insight in regard the implementation of the subsampling scheme.
Funding was provided through a CONACYT (Mexico)
scholarship granted to ASD (CVU: 304930) and a NSERC Discovery Grant (RPGIN-2017-06318)
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