Theresia Ziegs1, Loreen Ruhm1, Andrew Wright1, and Anke Henning1,2
1High-Field MR Center, Max Planck Institute for Biological Cybernetics, Tuebingen, Germany, 2Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
Synopsis
Glutamate is the major
excitatory neurotransmitter in the brain and malfunction of glutamatergic metabolism
is associated with various neurological disorders. Respective metabolic rates can
be determined via direct 13C or indirect 1H-[13C] MRS after intake of 13C
labelled tracers.
In this work, labeling
effects after oral intake of [13C-1]glucose are observed in human brain using a 1H-FID-MRSI
sequence at 9.4T. Spectral time series of GM and WM voxels as well as metabolite
maps show regionally distinct and tissue type specific labelling induced changes
of Glu and Gln spectral pattern that allow for the determination of 13C label
uptake rates.
Introduction
Glutamate
is the major excitatory transmitter in the brain and malfunction of glutamatergic
metabolism is associated with various neurological and psychiatric disorders1-7. For better insights into the function of the glutamatergic system,
metabolic rates can be determined via direct 13C or indirect 1H-[13C] magnetic
resonance spectroscopy after the administration of a 13C labelled tracer such
as [13C-1]glucose. Subsequent changes in
the spectra due to the incorporation of the 13C nuclei from Glc into different
metabolites further downstream from glycolysis to the TCA cycle and into the glutamatergic
metabolism can be observed by either direct 13C or indirect 1H-[13C] MRS. Boumezbeur
et al. showed the feasibility to observe 13C label incorporation by observing
additional peak splitting due to J-coupling between protons and 13C nuclei using conventional 1H
MRS8 in monkeys, which abandons the need
of specialized 13C hardware and scan software. This single voxel 1H MRS approach
has been recently reproduced in the human brain and observation of respective
change in Glu and Gln have been shown9-12.
In the
present work, the feasibility of measuring metabolic uptake curves in a highly spatially and temporally resolved manner by 1H MRSI for more metabolites and in more voxels than ever
before in human brain is shown. The [1-13C]Glc was administered orally instead
of intravenous and the spectra were measured with a 2D 1H MRSI sequence in
the human brain at 9.4T.Methods
The study was performed after IRB approval and signed consent
of all five volunteers, who fastened for 9 hours before the measurement started. For
each volunteer a solution containing 0.75g of [13C-1]glucose (Aldrich Chemical
Company, Miamisburg, Ohio, USA; API for clinical studies) per kilogram body
weight were prepared.
All measurements were performed using a 9.4T Magnetom
whole-body MR scanner (Siemens Healthineers, Erlangen, Germany) with an
in-house built radiofrequency (RF) array coil with 18 transmit and 32 receive
channels13. The transversal MRSI slice
(FOV 220 mm x 220 mm x 7 mm) were positioned just above the Corpus Callosum (Figure
1). The slice was B0 shimmed using the vendor implemented image-based
second-order B0 shimming routine. A customized 1H FID MRSI sequence14 (resolution 32x32, TR = 300
ms, TE*=1.5 ms, flip angle = 48°,
spectral width= 8000 Hz, acquisition time = 128 ms) with water
suppression was acquired15 before a non-water suppressed
reference scan with the same resolutions was acquired with the same parameters
as the MRSI scan. The scan time for one MRSI acquisition was 3.6 minutes.
After the mentioned measurements were executed, the scanner
table was pulled out and the volunteers drunk the [13C-1]glucose solution as fast
as possible (if possible while lying down and keeping the head as still as
possible while drinking). After this short break, the scanner table was pushed
back into the scanner. After verification whether repositioning of the MRSI
slice was needed due to motion, 1H MRSI data acquisition was resumed immediately
and as many as possible MRSI data sets we recorded to fill a total scan time of
2 hours. In a different session, an MP2RAGE image from each volunteer was
acquired.
The MRSI data was reconstructed with in-house-written Matlab code15 and fitted using LCModel16 with a basis set simulated with VeSPA17 that included basis spectra for 12C and 13C Glu and Gln as well as a simulated relaxation corrected MM spectrum18-20. Results
A high
spectral quality and a high reproducibility of the 1H MRSI data was obtained across
the entire transversal brain slice parallel to the Corpus Callosum using ultra-short TE and TR 1H
FID-MRSI in five volunteers (Figure 1). Spectral pattern changes over time related
to 13C label incorporation into glutamate could be observed in individual
voxels (Figure 1). Summed spectra from grey matter (GM) rich and white matter
(WM) rich brain tissue revealed 13C labelling induced spectral pattern changes
for a number of additional metabolites (Figure 2). High quality spatially and
temporally resolved 12C concentration maps and relative change maps could be
derived for [4-12C]Glu,
[3-12C]Glx and [2-12C]Glx peaks with a high temporal (3.6 min) and spatial resolution (32x32 grid with
nominal voxel size of 0.33 μL) (Figure3). These glutamate
metabolism images allow for a distinction of GM and WM in the human brain. In addition whole brain summed spectra
allowed to derive signal intensity curves for [4-12C]Glu, [3-12C]Glx,
[2-12C]Glx, [4-12C]Gln, total Asp and [6-12C]NAA (Figure 4). From the observed decrease in 12C
labelled metabolite concentration the respective increase in 13C label uptake can be derived
(Figure 5). Summed spectra of GM rich
and WM rich spectra finally allowed the investigation of tissue type specific 13C label
incorporation via the decreasing [4-12C]Glu, [3-12C]Glx, [2-12C]Glx and
[4-12C]Gln signal amplitudes (Figure 5). Discussion & Conclusion
This work demonstrates for the first time that glutamatergic metabolism can be investigated with high spatial and temporal resolution by 1H MRSI at 9.4T in the human brain. No specialized 13C hardware or scan software was needed and the scan protocol as well as the oral intake of [13C-1]glucose was well tolerated by all subjects. Since the distinction of Glu and Gln was possible the data allow for modelling of neurotransmitter turnover rates in the human brain in GM versus WM in future. Acknowledgements
Funding by the ERC Starting Grant (SYNAPLAST MR, Grant
Number: 679927) of the European Union and
the Cancer Prevention and Research Institute of
Texas (CPRIT, Grant Number: RR180056) is gratefully acknowledged.References
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