Measurement reproducibility of the spiral encoding GABA-edited MEGA-LASER 3D-MRSI in the brain at 3T
Petra Hnilicová1, Michal Považan2, Bernhard Strasser2, Ovidiu C Andronesi3, Dušan Dobrota1, Siegfried Trattnig2, and Wolfgang Bogner2

1Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia, 2Department of Biomedical Imaging and Image-guided Therapy, MR Center of Excellence, Medical University of Vienna, Vienna, Austria, 3Department of Radiology, Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, United States

Synopsis

In vivo assessment of neurotransmitter levels can improve the understanding of several pathological processes. For non-invasive GABA+ and Glx mapping in vivo within one scan, we applied a spiral-encoded GABA-edited MEGA-LASER 3D-MRSI sequence with real time corrections, achieving the ~3 cc nominal resolution in ~20 minutes. Via test-retest assessment in 14 healthy volunteers (7 men/7 women) we confirmed the measurement reproducibility and inter- and intra-subject variability of GABA+ and Glx ratios and thus validated that our method may be used in (pre)clinical studies of neurotransmitters alterations in the brain at 3T.

Purpose

In several neurological, psychiatric and developmental disorders there is an evidence of alternations in neurotransmitter concentrations in the brain,1, 2 especially in the most abundant excitatory and inhibitory neurotransmitters: Glutamate (Glu) and Gamma-aminobutyric acid (GABA), respectively.1, 3 The goal of this study was to estimate the measurement reproducibility of our fast and robust GABA-edited 3D-MRSI method and to validate its feasibility for (pre)clinical neurotransmitters studies.

Methods

The study was performed on a 3T whole-body MR scanner (TIM Trio®, Siemens Healthcare, Erlangen, Germany) using a 32-channel head coil (Siemens Healthcare, Erlangen, Germany) for signal reception. To ensure accurate and reproducible slice positioning we used auto-align and for identical VOI (80×85×60 mm3) placement 3D T1-weighted MPRAGE images in three orthogonal directions. For spectroscopic measurements we applied a spiral-encoded GABA-edited MEGA-LASER 3D-MRSI sequence with real-time correction for motions, frequency, and scanner instability artefacts.4,5 During GABA-editing we applied 60 Hz Gaussian pulses refocusing resonances at 1.9 ppm (EDIT-ON) and symmetrically at 7.5 ppm (EDIT-OFF) using 68 ms echo time. We achieved GABA+ (GABA plus macromolecule contamination) and Glx (Glu plus Glutamine contamination) 3D-mapping with ~3 cc nominal resolution in ~20 min. Fourteen healthy volunteers (age 30 ± 5 years; 7 men and 7 women) were scanned twice with a gap of ≤ 30 minutes for assessing the inter- and intra-subject variability. Measured MR data were finally processed employing LCModel, Matlab, Bash, and MINC software, and statistically evaluated using SPSS package.

Results

For spectral quantification were used two LCModel-fitted data sets, for EDIT-OFF and for DIFF (difference spectrum; subtraction of EDIT-ON and EDIT-OFF) spectrum (Fig. 1). Over all quantified voxels, we achieved FWHM and SNR mean values in the range of 7.2 - 10.1 Hz and 13.7 - 19.4, respectively (Fig. 2). In test-retest intra-subject variability evaluation we found low coefficient of variations (CV: mean of medians) and high intraclass correlation coefficients (ICC: mean) for GABA+ ratios (GABA+/tCr and GABA+/tNAA): CV ~8% / ICC >0.75, as well as Glx ratios (Glx/tCr and Glx/tNAA): CV ~6% / ICC >0.70. Likewise, there were low inter-subject median CV values for GABA+ ratios (~8%) as well as for Glx ratios (~6%). Finally, for all quantification-referencing combination the Bland-Altman plots of test-retest reproducibility investigations across the VOI in all fourteen subjects were displayed on Figure 3.

Discussion

Our spiral-encoding GABA-LASER sequence with real-time artefact correction enables fast metabolites 3D-mapping with minimal voxel size, high SNR, better localization accuracy, and high spectral quality. Furthermore, the intra- and inter-subject CV quantification for the repeated scans for GABA+ and Glx ratios in the voxel by voxel comparison across the whole VOI suggest that our GABA-edited 3D MRSI measurements were highly reproducible. A high degree of reliability between test-retest measurements was also confirmed using ICC analysis. Accordingly, our Bland-Altman plots showed the high 95% agreement of repeatedly measured GABA+ and Glx ratios.

Conclusion

In vivo assessment of GABA+ and Glx levels using our spiral-encoded GABA-edited MEGA-LASER sequence provides highly reproducible 3D mapping of these neurotransmitters and thus can improve the understanding of several neurological as well as psychiatric disorders.

Acknowledgements

This study was supported by the Austrian Science Fund (FWF): KLI-61 and the FFG Bridge Early Stage Grant #846505, by the Slovak Research and Development Agency under the contract No. APVV-14-0088, and by project "Increasing Opportunities for Career Growth in Research and Development in the Field of Medical Sciences", ITMS: 26110230067, co-funded from EU sources and European Social Fund.

References

1. Puts NA, Edden RA. In vivo magnetic resonance spectroscopy of GABA: a methodological review. Prog Nucl Magn Reson Spectrosc. 2012; 60: p. 29-41.

2. Agarwal N, Renshaw PF. Proton MR spectroscopy-detectable major neurotransmitters of the brain: biology and possible clinical applications. AJNR Am J Neuroradiol. 2012; 33: p. 595-602.

3. Buzsaki G, Kaila K, Raichle M. Inhibition and brain work. Neuron. 2007; 56: p. 771-83.

4. Bogner W, Hess AT, Gagoski B, et al. Real-time motion- and B0-correction for LASER-localized spiral-accelerated 3D-MRSI of the brain at 3 T. Neuroimage. 2014; 88C: p. 22-31.

5. Bogner W, Gagoski B, Hess AT, et al. 3D GABA imaging with real-time motion correction, shim update and reacquisition of adiabatic spiral MRSI. Neuroimage. 2014; 103: p. 290-302.

Figures

Figure 1: In vivo proton MR spectra obtained with GABA-editing MEGA-LASER 3D MRSI sequence. There are shown localization of the selected voxel on T1-weighted images in transversal plane; metabolites LCModel-fits in EDIT-ON (suppression at 1.9 ppm), EDIT-OFF (suppression at 7.5 ppm), and DIFF (subtraction of EDIT-ON and EDIT-OFF) spectrum, respectively.

Figure 2: 3D metabolic maps of GABA+ and Glx obtained in GABA-edited MEGA-LASER 3D-MRSI in transversal plane along with T1-weighted MRI, SNR and FWHM maps.

Figure 3: Bland-Altman plots for test-retest reproducibility of GABA+ and Glx ratios evaluated for the whole group of volunteer across all VOI. In graphs are shown mean as bias and ± 1.96 SD as bias confidence interval bands of difference between test and retest measurements.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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