Test-retest reliability of GABA and Glx with JPRESS, PRESS, and MEGA-PRESS MRS sequences at 3T

Poster No:

M412 

Submission Type:

Abstract Submission 

Authors:

Arwa Baeshen1, Patrik Wyss2,3,4, Anke Henning2,3, Ruth O'Gorman5, Spyros Kollias6, Lars Michels7

Institutions:

1University Zurich Hospital, Zurich, Switzerland, 2Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland, 3Max Planck Institute for Biological Cybernetics, Tubingen, Germany, 4Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland, 5MR Centre, Children’s University Hospital, Zurich, Switzerland, 6University Hospital of Zürich, Zürich, Switzerland, 7Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland

Introduction:

To evaluate the test-retest and inter-sequence reliability of neuro-metabolite concentrations in human brain measured by three different MR spectroscopy sequences: standard Point RESolved Spectroscopy (PRESS), J-resolved PRESS (JPRESS), and MEscher-GArwood Point RESolved Spectroscopy (MEGA-PRESS). For all three sequences, Inner Volume Saturation (IVS) was employed to minimize the chemical shift displacement. The present work aims at assessing the expected improvements in terms of test-retest reliability of the JPRESS and MEGA-PRESS sequences, compared to conventional PRESS

Methods:

18 healthy participants were scanned twice with identical protocols (range: one day to one week between the two sessions). Data were acquired on a 3-Tesla Philips MRI (Magnetic Resonance Imaging) scanner using the 32-channel SENSE head coil. Metabolite concentrations were estimated using LCModel (for PRESS and MEGA-PRESS) or ProFit2 (for JPRESS). The test-retest reliability was evaluated by Wilcoxon signed-rank tests, Pearson's r correlation coefficients, Bland-Altman plots (BA), intraclass correlation coefficients (ICC), and by inspecting the averages of the coefficients of variation (CV). The inter-sequence reliability was assessed with Wilcoxon signed-rank tests, Pearson's r correlation coefficients, and BA plots.

Results:

For GABA (gamma-aminobutyric acid), only the MEGA-PRESS sequence showed a moderate correlation between measurements (r = 0.53, ICC = 0.5, CV = 8.8%) and the related BA plot indicated for all three sequences a good test-retest agreement (p > 0.05). JPRESS provided less precise results (r = 0.38, ICC = 0.3, CV = 49.7%). Only PRESS was observed to be insensitive to GABA. In the case of Glx [Glutamate (Glu) + Glutamine (Gln)], the r and ICC values for PRESS (r = 0.86, ICC = 0.9, CV = 2.9%) and MEGA-PRESS (r = 0.69, ICC = 0.7, CV = 5.3%) reflect higher correlations, compared to JPRESS (r = 0.38, ICC = 0.4, CV = 20.1%). Furthermore, the inter-sequence reliability analysis demonstrated that JPRESS and MEGA-PRESS exhibit a significant agreement between them (p = 0.17, from the BA plot), whereas both the sequences report differences, if compared separately to PRESS (p value of 0.005 and <0.001, respectively). Finally, JPRESS exhibits a higher level of agreement for distinguishing Glu signals from Gln.

Conclusions:

MEGA-PRESS and JPRESS prove to be suitable for the detection of GABA, with a competing trade-off between accuracy and precision. For Glx, all three sequences are a viable solution for MRS (Magnetic Resonance Spectroscopy) investigations, although PRESS and MEGA-PRESS appear to be more precise than JPRESS. Nevertheless, JPRESS exhibited the highest reliability in the distinction between Glu and Gln. This may reflect the higher accuracy of JPRESS and MEGA-PRESS compared to PRESS in estimating Glx and also the Glu and Gln concentrations separately.

Imaging Methods:

MR Spectroscopy 1

Modeling and Analysis Methods:

Other Methods

Physiology, Metabolism and Neurotransmission :

Physiology, Metabolism and Neurotransmission Other 2

Keywords:

GABA
MR SPECTROSCOPY

1|2Indicates the priority used for review

My abstract is being submitted as a Software Demonstration.

No

Please indicate below if your study was a "resting state" or "task-activation” study.

Other

Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

Healthy subjects

Was any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.

Yes

Was any animal research approved by the relevant IACUC or other animal research panel? NOTE: Any animal studies without IACUC approval will be automatically rejected.

Not applicable

Please indicate which methods were used in your research:

Other, Please specify  -   MRS

For human MRI, what field strength scanner do you use?

3.0T

Provide references using author date format

Edden, R.A. (2007), 'Spatial effects in the detection of γ‐aminobutyric acid: Improved sensitivity at high fields using inner volume saturation', Magnetic resonance in Medicine, Vol. 58, no 6, pp. 1276-82
Fuchs, A. (2014), 'ProFit revisited', Magnetic Resonance in Medicine, vol. 71, no. 2, pp. 458-68
Long, Z. (2015), 'Reproducibility and effect of tissue composition on cerebellar γ‐aminobutyric acid (GABA) MRS in an elderly population', Nuclear Magnetic Resonance in Biomedicine, vol. 28 , no. 10, pp. 1315-23
O'gorman, R.L. (2011), 'In vivo detection of GABA and glutamate with MEGA‐PRESS: reproducibility and gender effects', Journal of magnetic resonance imaging, vol. 33, no. 5, pp. 1262-7
Prescot, A.P. (2013), 'Two‐dimensional J‐resolved proton MR spectroscopy and prior knowledge fitting (ProFit) in the frontal and parietal lobes of healthy volunteers: Assessment of metabolite discrimination and general reproducibility', Journal of Magnetic Resonance Imaging, vol. 37, no. 3, pp. 642-51
Shungu, D.C. (2016), 'Brain GABA Detection in vivo with the J-editing 1H MRS Technique: A Comprehensive Methodological Evaluation of Sensitivity Enhancement, Macromolecule Contamination and Test-Retest Reliability'. Nuclear Magnetic Resonance in biomedicine, vol. 29, no. 7, pp.932
Van Veenendaal, T.M. (2008), 'Glutamate quantification by PRESS or MEGA-PRESS: Validation, repeatability, and concordance', Journal of Magnetic Resonance Imaging, vol. 48, pp. 107-14.