Strategies and protocols for clinical 31P research in the heart and brain

Although in vivo 31P NMR permits unique measurements of the body’s stores of high energy phosphate metabolites, their low concentrations place critical limits and demands on spatial resolution, localization techniques, and reproducibility. We argue that optimum reliability and reproducibility of in vivo measurements of metabolite ratios and concentrations is best achieved by preselecting the minimal requirements for spatial localization suited to, and varying with, the particular organ and disease type. Strategies for measuring metabolite ratios and concentrations in the human heart and brain are discussed and demonstrated in the context of the expeditious choice of operating parameters, including localized volume size, localization technique, NMR coils, radiofrequency-field uniformity, patient positioning, and corrections for spectral distortion caused by NMR relaxation, to optimize the return of useful metabolic information in practical clinical research exams of about an hour duration.

[1]  P A Bottomley,et al.  Noninvasive study of high-energy phosphate metabolism in human heart by depth-resolved 31P NMR spectroscopy. , 1985, Science.

[2]  Bruno Hubesch,et al.  Clinical magnetic resonance spectroscopy of brain, heart, liver, kidney, and cancer. A quantitative approach , 1989, NMR in biomedicine.

[3]  G. Radda,et al.  CARDIAC METABOLISM DURING EXERCISE MEASURED BY MAGNETIC RESONANCE SPECTROSCOPY , 1988, The Lancet.

[4]  C. Hardy,et al.  AIDS dementia complex: brain high-energy phosphate metabolite deficits. , 1990, Radiology.

[5]  G K Radda,et al.  Examination of a case of suspected McArdle's syndrome by 31P nuclear magnetic resonance. , 1981, The New England journal of medicine.

[6]  K. Uğurbil,et al.  NMR chemical shift imaging in three dimensions. , 1982, Proceedings of the National Academy of Sciences of the United States of America.

[7]  C J Hardy,et al.  Phosphate metabolite imaging and concentration measurements in human heart by nuclear magnetic resonance , 1990, Magnetic resonance in medicine.

[8]  C J Hardy,et al.  Problems and expediencies in human 31P spectroscopy. The definition of localized volumes, dealing with saturation and the technique‐dependence of quantification , 1989, NMR in biomedicine.

[9]  W. Edelstein,et al.  The intrinsic signal‐to‐noise ratio in NMR imaging , 1986, Magnetic resonance in medicine.

[10]  G B Matson,et al.  P-31 MR spectroscopy of normal human brain and brain tumors. , 1990, Radiology.

[11]  W. Barber,et al.  Comparison of linear and circular polarization for magnetic resonance imaging , 1985 .

[12]  Truman R. Brown,et al.  In vivo1 values of phosphorus metabolites in human liver and muscle determined at 1.5T by chemical shift imaging , 1989 .

[13]  D. Gadian,et al.  31P magnetic resonance spectroscopy of the normal human brain: approaches using four dimensional chemical shift imaging and phase mapping techniques , 1989, NMR in biomedicine.

[14]  Roger J. Ordidge,et al.  Image-selected in Vivo spectroscopy (ISIS). A new technique for spatially selective nmr spectroscopy , 1986 .

[15]  H C Charles,et al.  Human in vivo phosphate metabolite imaging with 31P NMR , 1988, Magnetic resonance in medicine.

[16]  A. Costello,et al.  NON-INVASIVE INVESTIGATION OF CEREBRAL METABOLISM IN NEWBORN INFANTS BY PHOSPHORUS NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY , 1983, The Lancet.

[17]  B. Drayer,et al.  Chronic adult cerebral infarction studied by phosphorus NMR spectroscopy. , 1986, Radiology.

[18]  M. Weiner,et al.  In vivo phosphorus-31 spectroscopic imaging in patients with global myocardial disease. , 1990, The American journal of cardiology.

[19]  F W Wehrli.  Localization methods for nuclear magnetic resonance spectroscopy in vivo. , 1985, Circulation.

[20]  C J Hardy,et al.  Rapid 31P spectroscopy on a 4‐T whole‐body system , 1988, Magnetic resonance in medicine.

[21]  Christopher J. Hardy,et al.  PROGRESS in efficient three-dimensional spatially localized in vivo31P NMR spectroscopy using multidimensional spatially selective (ϱ) pulses , 1987 .

[22]  J. Schenck,et al.  An efficient, highly homogeneous radiofrequency coil for whole-body NMR imaging at 1.5 T , 1985 .

[23]  R. Herfkens,et al.  Altered phosphate metabolism in myocardial infarction: P-31 MR spectroscopy. , 1987, Radiology.

[24]  Hart,et al.  Anatomy and metabolism of the normal human brain studied by magnetic resonance at 1.5 Tesla. , 1984, Radiology.

[25]  Paul A. Bottomley,et al.  Slice-interleaved depth-resolved surface-coil spectroscopy (SLIT DRESS) for rapid 31P NMR in Vivo , 1985 .

[26]  P A Bottomley,et al.  Human in vivo NMR spectroscopy in diagnostic medicine: clinical tool or research probe? , 1989, Radiology.

[27]  C. Hardy,et al.  Rapid, reliable in vivo assays of human phosphate metabolites by nuclear magnetic resonance. , 1989, Clinical chemistry.

[28]  G. Radda,et al.  Biochemistry in vivo: an appraisal of clinical magnetic resonance spectroscopy. , 1989, Magnetic resonance quarterly.

[29]  C J Hardy,et al.  Proton‐decoupled, overhauser‐enhanced, spatially localized carbon‐13 spectroscopy in humans , 1989, Magnetic resonance in medicine.

[30]  Paul A. Bottomley,et al.  Depth-resolved surface-coil spectroscopy (DRESS) for in Vivo 1H, 31P, and 13C NMR , 1984 .

[31]  J. E. Klein,et al.  Characterization of MR spectroscopic imaging of the human head and limb at 2.0 T. , 1988, Radiology.

[32]  G. Radda,et al.  Quantitative studies of human cardiac metabolism by 31P rotating-frame NMR. , 1987, Proceedings of the National Academy of Sciences of the United States of America.