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Diagnostics
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Advanced Applications of Magnetic Resonance Spectroscopy (MRS)
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Advanced Applications of Magnetic Resonance Spectroscopy (MRS)

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 14569

Special Issue Editor

Dr. Ralf Mekle

E-Mail Website
Guest Editor
Charite, CSB, Campus Benjamin Franklin,Hindenburgdamm 30, D-12200 Berlin, Germany
Interests: in vivo magnetic resonance spectroscopy (MRS); clinical applications of MRS; metabolite quantification; enhanced pulse sequence design; B0 shimming

Special Issue Information

Dear Colleagues,

In vivo magnetic resonance spectroscopy (MRS) is an imaging modality that can be used to non-invasively provide biochemical and metabolic information. In spite of a history of about 30 years of in vivo application of MRS, it has not been established as a widespread clinical tool. This Special Issue will describe already existing clinical and research applications of in vivo MRS, in particular those where MRS can aid with clinical diagnosis and decision-making. Topics for such applications include psychiatric disorders and neurodegenerative diseases, tumor metabolism and cancer, traumatic brain injury, metabolic diseases, and pediatric disorders. Finally, methodological developments that could promote the application of MRS should be emphasized.

Dr. Ralf Mekle
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Magnetic resonance spectroscopy (MRS)
  • Psychiatric disorders
  • Neurodegenerative diseases
  • Tumor metabolism
  • Cancer
  • Diabetes
  • Metabolic diseases
  • Traumatic brain injury
  • Pediatric disorders and brain development

Published Papers (6 papers)

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Research

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19 pages, 2165 KiB  
Article
In Vivo Parieto-Occipital White Matter Metabolism Is Correlated with Visuospatial Deficits in Adult DM1 Patients
by Stefania Evangelisti, Laura Ludovica Gramegna, Silvia De Pasqua, Magali Jane Rochat, Luca Morandi, Micaela Mitolo, Claudio Bianchini, Gianfranco Vornetti, Claudia Testa, Patrizia Avoni, Rocco Liguori, Raffaele Lodi and Caterina Tonon
Diagnostics 2022, 12(10), 2305; https://doi.org/10.3390/diagnostics12102305 - 24 Sep 2022
Cited by 3 | Viewed by 1572
Abstract
Myotonic dystrophy type 1 (DM1) is a genetic disorder caused by a (CTG) expansion in the DM protein kinase (DMPK) gene, representing the most common adult muscular dystrophy, characterized by a multisystem involvement with predominantly skeletal muscle and brain affection. Neuroimaging [...] Read more.
Myotonic dystrophy type 1 (DM1) is a genetic disorder caused by a (CTG) expansion in the DM protein kinase (DMPK) gene, representing the most common adult muscular dystrophy, characterized by a multisystem involvement with predominantly skeletal muscle and brain affection. Neuroimaging studies showed widespread white matter changes and brain atrophy in DM1, but only a few studies investigated the role of white matter metabolism in the pathophysiology of central nervous system impairment. We aim to reveal the relationship between the metabolic profile of parieto-occipital white matter (POWM) as evaluated with proton MR spectroscopy technique, with the visuoperceptual and visuoconstructional dysfunctions in DM1 patients. MR spectroscopy (3 Tesla) and neuropsychological evaluations were performed in 34 DM1 patients (19 F, age: 46.4 ± 12.1 years, disease duration: 18.7 ± 11.6 years). The content of neuro-axonal marker N-acetyl-aspartate, both relative to Creatine (NAA/Cr) and to myo-Inositol (NAA/mI) resulted significantly lower in DM1 patients compared to HC (p-values < 0.0001). NAA/Cr and NAA/mI correlated with the copy of the Rey-Osterrieth complex figure (r = 0.366, p = 0.033; r = 0.401, p = 0.019, respectively) and with Street’s completion tests scores (r = 0.409, p = 0.016; r = 0.341, p = 0.048 respectively). The proportion of white matter hyperintensities within the MR spectroscopy voxel did not correlate with the metabolite content. In this study, POWM metabolic alterations in DM1 patients were not associated with the white matter morphological changes and correlated with specific neuropsychological deficits. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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18 pages, 3550 KiB  
Article
Noninvasive NMR/MRS Metabolic Parameters to Evaluate Metabolic Syndrome in Rats
by Khin Thandar Htun, Krit Jaikumkao, Jie Pan, Aye Thidar Moe Moe, Nuttawadee Intachai, Sasivimon Promsan, Anusorn Lungkaphin, Monruedee Tapanya, Duanghathai Pasanta, Montree Tungjai, Siriprapa Kaewjaeng, Hong Joo Kim, Jakrapong Kaewkhao, Christopher Lai and Suchart Kothan
Diagnostics 2022, 12(7), 1621; https://doi.org/10.3390/diagnostics12071621 - 4 Jul 2022
Cited by 1 | Viewed by 1741
Abstract
(1) Background: Ectopic fat deposition and its effects, metabolic syndrome, have been significantly correlated to lifestyle and caloric consumption. There is no specific noninvasive evaluation tool being used in order to establish clinical markers for tracing the metabolic pathway implicated in obesity-related abnormalities [...] Read more.
(1) Background: Ectopic fat deposition and its effects, metabolic syndrome, have been significantly correlated to lifestyle and caloric consumption. There is no specific noninvasive evaluation tool being used in order to establish clinical markers for tracing the metabolic pathway implicated in obesity-related abnormalities that occur in the body as a result of a high-fat diet (HFD). The purpose of this work is to investigate in vivo ectopic fat distribution and in vitro metabolite profiles given by HFDs, as well as how they are inter-related, in order to find surrogate metabolic biomarkers in the development of metabolic syndrome utilizing noninvasive approaches. (2) Methods: Male Wistar rats were divided into a standard normal chow diet, ND group, and HFD group. After 16 weeks of different diet administration, blood samples were collected for proton nuclear magnetic resonance (1H NMR) and biochemical analysis. Magnetic resonance imaging/proton magnetic resonance spectroscopy (MRI/1H MRS) was performed on the abdomen, liver, and psoas muscle of the rats. (3) Results: Visceral fat showed the strongest relationship with blood cholesterol. Although liver fat content (LFC) was not associated with any biophysical profiles, it had the highest correlation with metabolites such as (-CH2)n very-low-density lipoprotein/low-density lipoprotein (VLDL/LDL), lactate, and N-acetyl glycoprotein of serum 1H NMR. HFD showed no obvious influence on muscle fat accumulation. Acetoacetate, N-acetyl glycoprotein, lactate, (-CH2)n VLDL/LDL, and valine were the five possible metabolic biomarkers used to differentiate HFD from ND in the present study. (4) Conclusions: Our study has validated the influence of long-term HFD-induced ectopic fat on body metabolism as well as the metabolic profile deterioration both in vivo and in vitro. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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17 pages, 2095 KiB  
Article
Analytical Validation of GFRNMR: A Blood-Based Multiple Biomarker Assay for Accurate Estimation of Glomerular Filtration Rate
by Markus Fuhrmann, Amauri Schwaeble Santamaria, Renee Scott, Jeffrey W. Meeusen, Marianna Fernandes, John Venz, Victoria Rothe, Frank Stämmler, Jochen Ehrich and Eric Schiffer
Diagnostics 2022, 12(5), 1120; https://doi.org/10.3390/diagnostics12051120 - 30 Apr 2022
Cited by 5 | Viewed by 2309
Abstract
Accurate and precise monitoring of kidney function is critical for a timely and reliable diagnosis of chronic kidney disease (CKD). The determination of kidney function usually involves the estimation of the glomerular filtration rate (eGFR). We recently reported the clinical performance of a [...] Read more.
Accurate and precise monitoring of kidney function is critical for a timely and reliable diagnosis of chronic kidney disease (CKD). The determination of kidney function usually involves the estimation of the glomerular filtration rate (eGFR). We recently reported the clinical performance of a new eGFR equation (GFRNMR) based on the nuclear magnetic resonance (NMR) measurement of serum myo-inositol, valine, and creatinine, in addition to the immunoturbidometric quantification of serum cystatin C, age and sex. We now describe the analytical performance evaluation of GFRNMR according to the Clinical and Laboratory Standards Institute guidelines. Within-laboratory coefficients of variation (CV%) of the GFRNMR equation did not exceed 4.3%, with a maximum CV% for repeatability of 3.7%. Between-site reproducibility (three sites) demonstrated a maximum CV% of 5.9%. GFRNMR stability was demonstrated for sera stored for up to 8 days at 2–10°C and for NMR samples stored for up to 10 days in the NMR device at 6 ± 2°C. Substance interference was limited to 4/40 (10.0%) of the investigated substances, resulting in an underestimated GFRNMR (for glucose and metformin) or a loss of results (for naproxen and ribavirin) for concentrations twice as high as usual clinical doses. The analytical performances of GFRNMR, combined with its previously reported clinical performance, support the potential integration of this NMR method into clinical practice. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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16 pages, 848 KiB  
Article
Estimating Glomerular Filtration Rate from Serum Myo-Inositol, Valine, Creatinine and Cystatin C
by Frank Stämmler, Marcello Grassi, Jeffrey W. Meeusen, John C. Lieske, Surendra Dasari, Laurence Dubourg, Sandrine Lemoine, Jochen Ehrich and Eric Schiffer
Diagnostics 2021, 11(12), 2291; https://doi.org/10.3390/diagnostics11122291 - 7 Dec 2021
Cited by 8 | Viewed by 2763
Abstract
Assessment of renal function relies on the estimation of the glomerular filtration rate (eGFR). Existing eGFR equations, usually based on serum levels of creatinine and/or cystatin C, are not uniformly accurate across patient populations. In the present study, we expanded a recent proof-of-concept [...] Read more.
Assessment of renal function relies on the estimation of the glomerular filtration rate (eGFR). Existing eGFR equations, usually based on serum levels of creatinine and/or cystatin C, are not uniformly accurate across patient populations. In the present study, we expanded a recent proof-of-concept approach to optimize an eGFR equation targeting the adult population with and without chronic kidney disease (CKD), based on a nuclear magnetic resonance spectroscopy (NMR) derived ‘metabolite constellation’ (GFRNMR). A total of 1855 serum samples were partitioned into development, internal validation and external validation datasets. The new GFRNMR equation used serum myo-inositol, valine, creatinine and cystatin C plus age and sex. GFRNMR had a lower bias to tracer measured GFR (mGFR) than existing eGFR equations, with a median bias (95% confidence interval [CI]) of 0.0 (−1.0; 1.0) mL/min/1.73 m2 for GFRNMR vs. −6.0 (−7.0; −5.0) mL/min/1.73 m2 for the Chronic Kidney Disease Epidemiology Collaboration equation that combines creatinine and cystatin C (CKD-EPI2012) (p < 0.0001). Accuracy (95% CI) within 15% of mGFR (1-P15) was 38.8% (34.3; 42.5) for GFRNMR vs. 47.3% (43.2; 51.5) for CKD-EPI2012 (p < 0.010). Thus, GFRNMR holds promise as an alternative way to assess eGFR with superior accuracy in adult patients with and without CKD. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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12 pages, 6877 KiB  
Article
Magnetic Resonance Spectroscopy for Risk Stratification of Sonographically Indeterminate Ovarian Neoplasms: Preliminary Study
by Yenpo Lin, Ching-Yi Hsieh, Yen-Ling Huang, Kueian Chen, Yu-Ting Huang, Ren-Chin Wu, Huei-Jean Huang, Hung-Hsueh Chou, Angel Chao, Chyong-Huey Lai and Gigin Lin
Diagnostics 2021, 11(10), 1847; https://doi.org/10.3390/diagnostics11101847 - 6 Oct 2021
Cited by 2 | Viewed by 1914
Abstract
We aim to assess the additional value of diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) for the risk stratification of sonographically indeterminate ovarian neoplasms. A total of 21 patients with diagnosed adnexal masses between 2014 and 2017 were divided into malignant (four [...] Read more.
We aim to assess the additional value of diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) for the risk stratification of sonographically indeterminate ovarian neoplasms. A total of 21 patients with diagnosed adnexal masses between 2014 and 2017 were divided into malignant (four serous cystadenocarcinomas, four endometrioid carcinomas, three clear cell carcinomas, and one carcinosarcoma) and benign (four cystadenomas, two teratomas, one fibroma, one endometrioma, and one corpus luteal cyst) groups. An apparent diffusion coefficient (ADC) value of 1.27 × 10−3 mm2/s was considered as the optimal threshold in distinguishing malignant from benign ovarian tumors (sensitivity and specificity: 100% and 77.8%, respectively). Choline peaks were detected in six of seven O-RADS (Ovarian-Adnexal Imaging-Reporting Data System) 4 lesions and corrected all of the DWI false-negative clear cell carcinoma. Based on the presence of the choline peaks, the diagnostic performance of MRS showed a sensitivity of 77.8%, a specificity of 100%, and an accuracy of 85.7%, respectively. In conclusion, MRS could potentially play a complementary role for DWI in tumor characterization, particularly for O-RADS 4 tumors or clear cell carcinomas. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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Review

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19 pages, 1103 KiB  
Review
Magnetic Resonance Spectroscopy of Hepatic Fat from Fundamental to Clinical Applications
by Duanghathai Pasanta, Khin Thandar Htun, Jie Pan, Montree Tungjai, Siriprapa Kaewjaeng, Hongjoo Kim, Jakrapong Kaewkhao and Suchart Kothan
Diagnostics 2021, 11(5), 842; https://doi.org/10.3390/diagnostics11050842 - 7 May 2021
Cited by 20 | Viewed by 3292
Abstract
The number of individuals suffering from fatty liver is increasing worldwide, leading to interest in the noninvasive study of liver fat. Magnetic resonance spectroscopy (MRS) is a powerful tool that allows direct quantification of metabolites in tissue or areas of interest. MRS has [...] Read more.
The number of individuals suffering from fatty liver is increasing worldwide, leading to interest in the noninvasive study of liver fat. Magnetic resonance spectroscopy (MRS) is a powerful tool that allows direct quantification of metabolites in tissue or areas of interest. MRS has been applied in both research and clinical studies to assess liver fat noninvasively in vivo. MRS has also demonstrated excellent performance in liver fat assessment with high sensitivity and specificity compared to biopsy and other imaging modalities. Because of these qualities, MRS has been generally accepted as the reference standard for the noninvasive measurement of liver steatosis. MRS is an evolving technique with high potential as a diagnostic tool in the clinical setting. This review aims to provide a brief overview of the MRS principle for liver fat assessment and its application, and to summarize the current state of MRS study in comparison to other techniques. Full article
(This article belongs to the Special Issue Advanced Applications of Magnetic Resonance Spectroscopy (MRS))
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