Clinical Radiology
Volume 64, Issue 1 , Pages 12-21 , January 2009

Magnetic resonance spectroscopy of the brain: review of metabolites and clinical applications

  • D.P. Soares

      Affiliations

    • Section of Radiology, Department of Surgery, Radiology, Anaesthetics, and Intensive Care, University Hospital of the West Indies, Mona, Kingston, Jamaica
    • Corresponding Author InformationGuarantor and correspondent: D. P. Soares, Section of Radiology, Department of Surgery, Radiology, Anaesthetics and Intensive Care, University Hospital of the West Indies, Mona, Kingston 7, Jamaica. Tel./fax: +876 9775277/9271933.
  • ,
  • M. Law

      Affiliations

    • Department of Radiology and Neurosurgery, Mount Sinai Medical Centre, New York, New York

Received 10 January 2008 ,Revised 1 July 2008 ,Accepted 8 July 2008.

References 

  1. Dendy PP, Heaton B. Physics for diagnostic radiology. 2nd ed.. Bristol, Philadelphia, PA: Institute of Physics Publishing; 1999;
  2. Zimmerman RA, Bilaniuk LT, Johnson MH, et al. MRI of central nervous system: early clinical results. AJNR Am J Neuroradiol. 1986;7:587–594
  3. Danielsen ER, Ross B. Magnetic resonance spectroscopy diagnosis of neurological diseases. 1st ed.. New York: Marcel Dekker, Inc; 1999;
  4. Elster AD, Burdette JH. Questions and answers in magnetic resonance imaging. 2nd ed.. St Louis: Mosby; 2001;
  5. Lenkinski RE, Schnall MD. MR spectroscopy and the biochemical basis of neurological disease. In:  Atlas SW editors. Magnetic resonance imaging of the brain and spine. New York: Raven Press; 1991;p. 1099–1121
  6. Rosen Y, Lenkinski RE. Recent advances in magnetic resonance neurospectroscopy. Neurotherapeutics. 2007;4:330–345
  7. Law M, Cha S, Knopp EA, et al. Glioma grading with multi-slice, multi-voxel, multi-TE spectroscopic MRI and multi-slice perfusion MRI. Annual Meeting of the ISMRM, Hawaii, 2002.
  8. Bolinger L, Lenkinski R. Localization in clinical NMR spectroscopy. In:  Berliner LJ,  Rueben J editor. Biological magnetic resonance. New York: Plenum Press; 1992;p. 1–53
  9. Keevil SF. Spatial localization in nuclear magnetic resonance spectroscopy. Phys Med Biol. 2006;51:R579–R636
  10. Narayana PA, DeLayre JL. Localization methods in NMR. In:  Partain CL,  Price RR,  Patton JA,  Kulkarni MV, et al. editor. Magnetic resonance imaging. 2nd ed.. Philadelphia: W.B. Saunders; 1988;p. 1609–1630
  11. Ross B, Michaelis T. Clinical application of magnetic resonance spectroscopy. Magn Reson Q. 1994;10:191–247
  12. Castillo M, Kwock L, Scatliff J, et al. Proton MR spectroscopy in neoplastic and non-neoplastic brain disorders. Magn Reson Imaging Clin N Am. 1998;6:1–20
  13. Kwock L. Localized MR spectroscopy: basic principles. Neuroimaging Clin N Am. 1998;8:713–731
  14. Ruggieri. Practical MR spectroscopy in paediatric neuroradiology. American Society of Neuroradiology, Advanced imaging symposium, Atlanta, 2000.
  15. Urenjak J, Williams SR, Gadian DG, et al. Specific expression of N-acetylaspartate in neurons, oligodendrocyte-type-2 astrocyte progenitors, and immature oligodendrocytes in vitro. J Neurochem. 1992;59:55–61
  16. Pouwels PJ, Frahm J. Regional metabolite concentrations in human brain as determined by quantitative localized proton MRS. Magn Reson Med. 1998;39:53–60
  17. Bruhn H, Frahm J, Gyngell ML, et al. Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology. 1989;172:541–548
  18. Ross Bd, Colletti P, Lin A. Magnetic resonance spectroscopy of the brain: neurospectroscopy. In:  Edelman RR,  Hesselink JR,  Zlatkin MB,  Crues JV editor. Clinical magnetic resonance imaging. Philadelphia: Saunders; 2006;p. 1840–1901
  19. Baslow MH. Brain N-acetylaspartate as a molecular water pump and its role in the etiology of Canavan disease: a mechanistic explanation. J Mol Neurosci. 2003;21:185–190
  20. Baslow MH. N-acetylaspartate in the vertebrate brain: metabolism and function. Neurochem Res. 2003;28:941–953
  21. Baslow MH. Evidence supporting a role for N-acetyl-l-aspartate as a molecular water pump in myelinated neurons in the central nervous system. An analytical review. Neurochem Int. 2002;40:295–300
  22. Baslow MH, Hrabe J, Guilfoyle DN. Dynamic relationship between neurostimulation and N-acetylaspartate metabolism in the human visual cortex: evidence that NAA functions as a molecular water pump during visual stimulation. J Mol Neurosci. 2007;32:235–245
  23. Bluml S, McComb JG, Ross BD. Differentiation between cortical atrophy and hydrocephalus using 1H MRS. Magn Reson Med. 1997 Mar;37:395–403
  24. Barker Pb, Lin DDM. In vivo proton MR spectroscopy of the human brain. Prog NMR Spectrosc. 2006;49:99–128
  25. Law M. Magnetic resonance spectroscopy. New York City: MRI: Clinical-State-of-the-Art; 2002;
  26. Law M, Meltzer DE, Cha S. Spectroscopic magnetic resonance imaging of a tumefactive demyelinating lesion. Neuroradiology. 2002;44:986–989
  27. Saindane AM, Cha S, Law M, et al. Proton MR spectroscopy of tumefactive demyelinating lesions. AJNR Am J Neuroradiol. 2002;23:1378–1386
  28. Ernst T, Chang L, Walot I, et al. Physiologic MRI of a tumefactive multiple sclerosis lesion. Neurology. 1998;51:1486–1488
  29. Butteriss DJ, Ismail A, Ellison DW, et al. Use of serial proton magnetic resonance spectroscopy to differentiate low grade glioma from tumefactive plaque in a patient with multiple sclerosis. Br J Radiol. 2003;76:662–665
  30. Li BS, Wang H, Gonen O. Metabolite ratios to assumed stable creatine level may confound the quantification of proton brain MR spectroscopy. Magn Reson Imaging. 2003;21:923–928
  31. Lowry OH, Berger SJ, Chi MM, et al. Diversity of metabolic patterns in human brain tumors—I. High energy phosphate compounds and basic composition. J Neurochem. 1977;29:959–977
  32. Hanefeld F, Holzbach U, Kruse B, et al. Diffuse white matter disease in three children: an encephalopathy with unique features on magnetic resonance imaging and proton magnetic resonance spectroscopy. Neuropediatrics. 1993;24:244–248
  33. Mason GF, Pan JW, Ponder SL, et al. Detection of brain glutamate and glutamine in spectroscopic images at 4.1 T. Magn Reson Med. 1994;32:142–145
  34. Pan JW, Mason GF, Pohost GM, et al. Spectroscopic imaging of human brain glutamate by water-suppressed J-refocused coherence transfer at 4.1 T. Magn Reson Med. 1996;36:7–12
  35. Ugurbil K, Adriany G, Andersen P, et al. Ultrahigh field magnetic resonance imaging and spectroscopy. Magn Reson Imaging. 2003;21:1263–1281
  36. Tkac I, Rao R, Georgieff MK, et al. Developmental and regional changes in the neurochemical profile of the rat brain determined by in vivo 1H NMR spectroscopy. Magn Reson Med. 2003;50:24–32
  37. Srinivasan R, Cunningham C, Chen A, et al. TE-averaged two-dimensional proton spectroscopic imaging of glutamate at 3 T. Neuroimage. 2006;30:1171–1178
  38. Lopez-Villegas D, Lenkinski RE, Wehrli SL, et al. Lactate production by human monocytes/macrophages determined by proton MR spectroscopy. Magn Reson Med. 1995;34:32–38
  39. Kizu O, Yamada K, Nishimura T. Proton chemical shift imaging in normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2001;22:1659–1664
  40. Font C, Garia-Campos M, Hansen AJ, et al. Simultaneous diffusion of inositol and mannitol in the rat brain. Rev Esp Fisiol. 1982;38:317–319[In Spanish]
  41. Brand A, Richter-Landsberg C, Leibfritz D. Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. Dev Neurosci. 1993;15:289–298
  42. Strange K, Emma F, Paredes A, et al. Osmoregulatory changes in myo-inositol content and Na+/myo-inositol cotransport in rat cortical astrocytes. Glia. 1994;12:35–43
  43. Kruse B, Hanefeld F, Christen HJ, et al. Alterations of brain metabolites in metachromatic leukodystrophy as detected by localized proton magnetic resonance spectroscopy in vivo. J Neurol. 1993;241:68–74
  44. Kaminogo M, Ishimaru H, Morikawa M, et al. Diagnostic potential of short echo time MR spectroscopy of gliomas with single-voxel and point-resolved spatially localised proton spectroscopy of brain. Neuroradiology. 2001;43:353–363
  45. Alger JR, Frank JA, Bizzi A, et al. Metabolism of human gliomas: assessment with H-1 MR spectroscopy and F-18 fluorodeoxyglucose PET. Radiology. 1990;177:633–641
  46. Bruhn H, Michaelis T, Merboldt KD, et al. On the interpretation of proton NMR spectra from brain tumours in vivo and in vitro. NMR Biomed. 1992;5:253–258
  47. Fulham MJ, Bizzi A, Dietz MJ, et al. Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology. 1992;185:675–686
  48. Meyerand ME, Pipas JM, Mamourian A, et al. Classification of biopsy-confirmed brain tumors using single-voxel MR spectroscopy. AJNR Am J Neuroradiol. 1999;20:117–123
  49. Fountas KN, Kapsalaki EZ, Gotsis SD, et al. In vivo proton magnetic resonance spectroscopy of brain tumors. Stereotact Funct Neurosurg. 2000;74:83–94
  50. Tamiya T, Kinoshita K, Ono Y, et al. Proton magnetic resonance spectroscopy reflects cellular proliferative activity in astrocytomas. Neuroradiology. 2000;42:333–338
  51. Wilken B, Dechent P, Herms J, et al. Quantitative proton magnetic resonance spectroscopy of focal brain lesions. Pediatr Neurol. 2000;23:22–31
  52. Gupta RK, Cloughesy TF, Sinha U, et al. Relationships between choline magnetic resonance spectroscopy, apparent diffusion coefficient and quantitative histopathology in human glioma. J Neurooncol. 2000;50:215–226
  53. Lehnhardt FG, Rohn G, Ernestus RI, et al. 1H- and (31)P-MR spectroscopy of primary and recurrent human brain tumors in vitro: malignancy-characteristic profiles of water soluble and lipophilic spectral components. NMR Biomed. 2001;14:307–317
  54. Tedeschi G, Lundbom N, Raman R, et al. Increased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study. J Neurosurg. 1997;87:516–524
  55. Shimizu H, Kumabe T, Tominaga T, et al. Noninvasive evaluation of malignancy of brain tumors with proton MR spectroscopy. AJNR Am J Neuroradiol. 1996;17:737–747
  56. Daumas-Duport C, Scheithauer B, O'Fallon J, et al. Grading of astrocytomas. A simple and reproducible method. Cancer. 1988;62:2152–2165
  57. Law M, Yang S, Wang H, et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol. 2003;24:1989–1998
  58. Tzika AA, Astrakas LG, Zarifi MK, et al. Spectroscopic and perfusion magnetic resonance imaging predictors of progression in pediatric brain tumors. Cancer. 2004;15(100):1246–1256
  59. Castillo M, Smith JK, Kwock L. Correlation of myo-inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol. 2000;21:1645–1649
  60. Yang D, Korogi Y, Sugahara T, et al. Cerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar perfusion and diffusion-weighted MRI. Neuroradiology. 2002;44:656–666
  61. Poptani H, Kaartinen J, Gupta RK, et al. Diagnostic assessment of brain tumours and non-neoplastic brain disorders in vivo using proton nuclear magnetic resonance spectroscopy and artificial neural networks. J Cancer Res Clin Oncol. 1999;125:343–349
  62. Moller-Hartmann W, Krings T, Brunn A, et al. Proton magnetic resonance spectroscopy of neurocytoma outside the ventricular region—case report and review of the literature. Neuroradiology. 2002;44:230–234
  63. Shimizu H, Kumabe T, Shirane R, et al. Correlation between choline level measured by proton MR spectroscopy and Ki-67 labeling index in gliomas. AJNR Am J Neuroradiol. 2000;21:659–665
  64. Dowling C, Bollen AW, Noworolski SM, et al. Preoperative proton MR spectroscopic imaging of brain tumors: correlation with histopathologic analysis of resection specimens. AJNR Am J Neuroradiol. 2001;22:604–612
  65. McKnight TR, von dem Bussche MH, Vigneron DB, et al. Histopathological validation of a three-dimensional magnetic resonance spectroscopy index as a predictor of tumor presence. J Neurosurg. 2002;97:794–802
  66. Nelson SJ, McKnight TR, Henry RG. Characterization of untreated gliomas by magnetic resonance spectroscopic imaging. Neuroimaging Clin N Am. 2002;12:599–613
  67. Kwock L, Smith JK, Castillo M, et al. Clinical applications of proton MR spectroscopy in oncology. Technol Cancer Res Treat. 2002;1:17–28
  68. Lin A, Bluml S, Mamelak AN. Efficacy of proton magnetic resonance spectroscopy in clinical decision making for patients with suspected malignant brain tumors. J Neurooncol. 1999;45:69–81
  69. Li X, Lu Y, Pirzkall A, et al. Analysis of the spatial characteristics of metabolic abnormalities in newly diagnosed glioma patients. J Magn Reson Imaging. 2002;16:229–237
  70. Howe FA, Barton SJ, Cudlip SA, et al. Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy. Magn Reson Med. 2003;49:223–232
  71. Howe FA, Opstad KS. 1H MR spectroscopy of brain tumours and masses. NMR Biomed. 2003;16:123–131
  72. Bronen RA. Epilepsy: the role of MR imaging. AJR Am J Roentgenol. 1992;159:1165–1174
  73. Bourgeois BFD. General concepts of medical intractibility. In:  Luders HO editors. Epilepsy surgery. New York: Raven Press; 1992;p. 77–81
  74. Bruton C. The neuropathology of temporal lobe epilepsy. Oxford: Oxford University Press; 1988;
  75. Berkovic SF, Andermann F, Olivier A, et al. Hippocampal sclerosis in temporal lobe epilepsy demonstrated by magnetic resonance imaging. Ann Neurol. 1991;29:175–182
  76. Gates JR, Cruz-Rodriguez R. Mesial temporal sclerosis: pathogenesis, diagnosis, and management. Epilepsia. 1990;31(Suppl. 3):S55–S66
  77. Jackson GD, Berkovic SF, Tress BM, et al. Hippocampal sclerosis can be reliably detected by magnetic resonance imaging. Neurology. 1990;40:1869–1875
  78. Miller BL, Moats RA, Shonk T, et al. Alzheimer disease: depiction of increased cerebral myo-inositol with proton MR spectroscopy. Radiology. 1993;187:433–437
  79. Soher BJ, Doraiswamy PM, Charles HC. A review of 1H MR spectroscopy findings in Alzheimer's disease. Neuroimaging Clin N Am. 2005;15:847–852xi
  80. den Heijer T, Sijens PE, Prins ND, et al. MR spectroscopy of brain white matter in the prediction of dementia. Neurology. 2006;66:540–544
  81. Metastasio A, Rinaldi P, Tarducci R, et al. Conversion of MCI to dementia: role of proton magnetic resonance spectroscopy. Neurobiol Aging. 2006;27:926–932
  82. Kantarci K, Smith GE, Ivnik RJ, et al. 1H magnetic resonance spectroscopy, cognitive function, and apolipoprotein E genotype in normal aging, mild cognitive impairment and Alzheimer's disease. J Int Neuropsychol Soc. 2002;8:934–942
  83. Doraiswamy PM, Charles HC, Krishnan KR. Prediction of cognitive decline in early Alzheimer's disease. Lancet. 1998;352:1678
  84. Kubo H, Harada M, Sakama M, et al. Reproducibility of metabolite concentration evaluated by intraclass correlation coefficient using clinical MR apparatus. J Comput Assist Tomogr. 2003;27:449–453
  85. Barker PB, Hearshen DO, Boska MD. Single-voxel proton MRS of the human brain at 1.5T and 3.0T. Magn Reson Med. 2001;45:765–769
  86. Al-Okaili RN, Krejza J, Wang S, et al. Advanced MR imaging techniques in the diagnosis of intraaxial brain tumors in adults. RadioGraphics. 2006;26(Suppl.1):S173–S189
  87. Al-Okaili RN, Krejza J, Woo JH, et al. Intraaxial brain masses: MR imaging-based diagnostic strategy—initial experience. Radiology. 2007;243:539–550

PII: S0009-9260(08)00271-7

doi: 10.1016/j.crad.2008.07.002

Clinical Radiology
Volume 64, Issue 1 , Pages 12-21 , January 2009