Search

Proton magnetic resonance spectroscopy (MRS), considered a connection between metabolism and anatomic and functional information provided by standard MRI, gives information on various tissue metabolites and their pathologic changes. Recently, proton MRS has been added as an adjunct tool to the multiparametric protocol of scrotal MRI, providing a new insight into the extremely complex biochemical milieu of normal and abnormal testes. This article reviews proton MR spectra of normal testes, showing age and bilateralism dependence. Disturbances of various metabolic pathways in testes of infertile men resulting in alterations of metabolite peaks are discussed. Preliminary data on proton MR spectra of testicular mass lesions are presented. LEVEL OF EVIDENCE: 5. TECHNICAL EFFICACY STAGE: 5.

BACKGROUND Due to the overlapping imaging appearances between borderline and malignant epithelial ovarian tumors (EOTs), borderline EOTs often represent a diagnostic challenge on conventional MRI. Proton magnetic resonance spectroscopy (1 H-MRS) might have potential to differentiate borderline from malignant tumors. PURPOSE To investigate the ability of 1 H-MRS to differentiate borderline from malignant EOTs. STUDY TYPE Prospective. POPULATION In all, 278 patients with adnexal masses. FIELD STRENGTH/SEQUENCE 1.5 T Siemens Avanto MRI system and 1 H-MRS using a point-resolved spectroscopy sequence (PRESS). ASSESSMENT Resonance peak integrals of the most common metabolites were analyzed and compared between the two groups. STATISTICAL TESTS The ratios of metabolites between borderline and malignant EOTs were compared with the Mann-Whitney U-test. A receiver operating characteristic (ROC) curve was used to determine their differential diagnosis performances. RESULTS In the solid components of borderline and malignant EOTs, the mean Cho/Cr, NAA/Cr, and NAA/Cho ratios were 4.4 ± 1.1 and 9.9 ± 2.8; 10.4 ± 3.0 and 2.2 ± 1.0; and 2.4 ± 0.7 and 0.3 ± 0.1, respectively (all P

Purpose To detect local cholinergic changes in human medial temporal lobe during configural working memory performance. Materials and Methods Proton magnetic resonance spectroscopy (1H-MRS) measurements were acquired at 3T from a 2 × 2 × 3 cm voxel in right medial temporal lobe from 36 subjects during performance of a configural visual working memory task (cWMT). In order to compensate for expected task-based blood oxygenation level-dependent (BOLD) T2* effects, resonance signal changes of unbound choline-containing metabolites (Cho) were referenced to an internal standard of creatine + phosphocreatine metabolites (Cre) and compared between four task blocks: rest, memorization, active memory maintenance, and recognition. An unannounced memory retention test was conducted in 21 subjects. Quality assurance analyses examined task-based Cho and Cre individually as well as referenced to resonance signal from N-acetylaspartate (NAA). Results Increases from a resting baseline in the Cho/Cre ratio were observed during 60-second blocks of active memory maintenance across the group (P = 0.0042). Behavioral accuracy during task performance correlated with memory retention (r = 0.48, P = 0.027). Quality assurance measures showed task-based changes in Cre resonance signal both individually (P = 0.00099) and when utilized as a noncholinergic internal reference (NAA/Cre, P = 0.00079). Conclusion Increases in human medial temporal lobe 1H-MRS Cho/Cre ratio occur during the maintenance of configural working memory information. However, interpretation of these results as driven by cholinergic activity cannot be assumed, as NAA, a noncholinergic metabolite, shows similar results when utilizing Cre as a reference. Caution is advised when considering Cre as an internal standard for task-based 1H-MRS measurements. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017.

Purpose To investigate the response of lipid olefinic protons (≈ 5.35 ppm) as a function of STEAM (Stimulated Echo Acquisition Mode) mixing time (TM), and echo time (TE), to find values that resolve the olefinic resonance from water in vivo while retaining sufficient olefinic signal. Materials and Methods PRESS (Point RESolved Spectroscopy) and STEAM experiments with varying timing parameters (TE and also TM for STEAM) were conducted on nine oils (almond, canola, cod liver, corn, linseed, peanut, sesame, sunflower, and walnut oil), and on vertebral bone marrow in vivo at 3 Tesla (T). Olefinic and methylene (methyl + methylene in vivo) peak areas were measured. Results Optimal STEAM parameters were found to be TM = 20 ms and TE = 100 ms. The STEAM olefinic/methylene area ratios (ranging between 0.1 and 0.4) calculated for each oil correlated well with ratios deduced from oil compositions in the literature (R2 = 0.975). The optimized STEAM sequence resolved the olefinic peak from water in vivo and yielded on average 1.91 times more olefinic signal compared with a previously optimized PRESS (TE = 200 ms) sequence tailored for the same purpose. Olefinic/(methyl + methylene) area ratios obtained with optimized STEAM and PRESS in vivo were linearly correlated (R2 = 0.972). Conclusion A STEAM sequence with TE = 100 ms and TM = 20 ms provides an alternative to the previously optimized PRESS (TE = 200 ms) sequence for determining relative amounts of lipid unsaturation at 3T.J. Magn. Reson. Imaging 2013. © 2013 Wiley Periodicals, Inc. J. Magn. Reson. Imaging 2015;41:481–486.© 2013 Wiley Periodicals, Inc.

Purpose To assess the proton T1 and T2 relaxation of in vivo hepatic water, choline and lipid resonances with possible J-coupling behavior of lipids in healthy volunteers at 7 Tesla (T). Materials and Methods Relaxation measurements were conducted on corn oil phantoms and on the hepatic tissue of 11 healthy volunteers at 7 T using a surface coil and a STEAM sequence. T1's were determined by monoexponential fitting, and T2's by both monoexponential and enhanced-exponential fitting (empirically designed to consider J-coupling of lipid resonances). Results In vivo T1's at 7 T were estimated as follows: water (4.70 ppm), 1362 ± 83 ms; methyl- (0.90 ppm), 1026 ± 162 ms; methylene- (1.30 ppm), 514 ± 25 ms; α-olefinic- (2.02 ppm), 488 ± 220 ms; α-carboxyl- (2.24 ppm), 476 ± 89 ms; diacyl- (2.77 ppm), 479 ± 260 ms group of lipid chains; and choline compounds (3.22 ppm), 1084 ± 52 ms. The T2's calculated with enhanced fitting were as follows: water, 15 ± 2 ms; methyl-, 34 ± 10 ms; methylene-, 41 ± 8 ms; α-olefinic-, 44 ± 19 ms; α-carboxyl-, 39 ± 15 ms; diacyl-, 44 ± 5 ms group of lipid chains; and choline compounds, 32 ± 9 ms. Conclusion An accurate knowledge of in vivo relaxation and J-coupling behavior will significantly improve the quantification of an extended number of resolved liver metabolites at 7 T. J. Magn. Reson. Imaging 2014;40:1365–1374. © 2013 Wiley Periodicals, Inc.

Although conventional MR imaging with contrast-enhanced T1-weighted sequences is of paramount importance for evaluating soft tissue masses, noncontrast MR sequences have emerged that facilitate their characterization. In this article, the utility and pitfalls of conventional MR imaging with T1-weighted, fluid-sensitive, and contrast-enhanced sequences will be discussed, along with that of functional (diffusion weighted imaging) and metabolic (proton MR spectroscopy) non–contrast-enhanced techniques for the purpose of soft tissue mass characterization. In particular, we discuss the application of these techniques to differentiating neoplastic or inflammatory masses that have high fluid content from benign cysts, as this distinction is a common pitfall of conventional sequences. J. Magn. Reson. Imaging 2014;39:504–511. © 2013 Wiley Periodicals, Inc.

Purpose: To retrospectively evaluate the significance of lipid peak in in vivo proton magnetic resonance (MR) spectroscopy for the diagnosis of ovarian thecomas/fibrothecomas in patients with solid gynecologic tumors exhibiting totally or partially low signal intensity on T2-weighted images. Materials and Methods: MR spectroscopy was performed in patients with pathologically diagnosed gynecologic tumors at 3T MRI. Single-voxel MR spectroscopy data were collected from a single square volume of interest that encompassed the gynecologic masses. The lipid concentration level was classified into three classes (high; low; none). Results: A total of 20 gynecologic tumors in 20 patients were evaluated in this study. High lipid peak was observed in all seven thecomas/fibrothecomas, whereas low lipid peak was observed in only one fibroma in 13 nonthecomatous tumors (six benign ovarian tumors and seven subserosal uterine leiomyomas). The presence of lipid peak for the diagnosis of thecomas/fibrothecomas had a sensitivity of 100%, specificity of 92%, positive predictive value of 88%, and negative predictive value of 100%. Conclusion: The high lipid peak reflecting abundant intracellular lipid contents is considered a specific metabolite concentration for thecomas/fibrothecomas. Demonstration of high lipid peak may contribute to the diagnosis of thecomas/fibrothecomas in distinguishing from other benign ovarian fibrous tumors or subserosal uterine leiomyomas. J. Magn. Reson. Imaging 2012;36:907–911. © 2012 Wiley Periodicals, Inc.

Purpose: To determine lipid composition of excised healthy and metastatic sentinel lymph nodes of breast cancer patients, as lipids are a potential discriminatory marker for malignancy. Materials and Methods: Ten breast cancer patients undergoing surgical nodal staging were included. 1H-magnetic resonance spectroscopic images (MRSI) were acquired without water and lipid suppression (resolution 3.0 × 3.0 × 5.0 mm3). MRSI was compared to histopathology. Six groups of lipid resonances (5.4–5.2, 4.3–4.1, 2.8, 2.3–2.0, 1.6–1.3, 0.9 ppm) were identified. The intensity ratios of the total of these resonances to this total including the water resonance and of each lipid resonance to the total of all lipid resonances were determined. For statistical analysis, a mixed model was applied after logistic transformation. The results were expressed as ratios of the median values of these lipid compositions in metastatic to benign nodes. Results: In all, 6/32 (19%) of the excised nodes contained metastases. The ratios of the lipid resonances 5.4–5.2, 4.3–4.1, 2.8, 2.3–2.0, 1.6–1.3, 0.9 ppm between metastatic vs. benign were 0.3, 1.2, 0.2, 0.2, 1.2, and 0.9, respectively. Only the ratios of signals from unsaturated fatty acids to the total lipid signal differed significantly. Conclusion: Metastatic axillary lymph nodes contained fewer unsaturated fatty acids than benign nodes. 7T 1H-MRS may be useful for detecting axillary breast cancer metastases. J. Magn. Reson. Imaging 2012;387-392. © 2011 Wiley Periodicals, Inc.

Purpose To explore the MR (magnetic resonance) signatures of brown adipose tissue (BAT) compared to white adipose tissue (WAT) using single-voxel MR spectroscopy.

Purpose To assess the systematic errors in liver methylene fraction (LMF) resulting from fat–fat interference effects with dual- and triple-echo gradient-recalled-echo Dual/Triple GRE) sequences and to test the robustness of these sequences after iron overloading. Materials and Methods Forty type-2 diabetic patients underwent LMF measurement by 3.0T 1H magnetic resonance spectroscopy (corrected for T1 and T2 decays) as the reference standard and liver fat fraction (%Fat) measurement by four Dual/Triple GRE sequences with 20° and 60° flip angle (α), corrected for T1 recovery. The same four sequences were repeated in eight patients after ferumoxide injection. Corrections for systematic errors were determined from the linear regressions (spectroscopy LMF values over Dual/Triple GRE %Fat values). Robustness was tested using Wilcoxon's signed-rank test. Results Fat–fat interference effects produced a ∼10% relative systematic error and T2* decay produced a 1.9%–4.2% absolute systematic error in LMF. When comparing before and after ferumoxide, dual-echo imaging with α = 20° and α = 60°, even when corrected, showed absolute differences of 7.23% [2.81%–10.25%] (P = 0.0117) and 5.65% [1.89%–8.216.8%] (P = 0.0117), respectively; compared to only 1.17% [0.08%–2.83%] (P = 0.0251) and 1.15% [0.37%–2.73%] (P = 0.2626) with triple-echo imaging and α = 20° and α = 60°, respectively. Conclusion Triple-echo imaging with α = 60° corrected for both T1 recovery and fat–fat interference effects is robust after superparamagnetic iron oxide (SPIO) administration and can reliably quantify LMF. J. Magn. Reson. Imaging 2011;33:119–127. © 2010 Wiley-Liss, Inc.

Purpose To determine the optimal method to correct air and tissue susceptibility differences in the head and neck to allow proton (1H) chemical shift imaging (CSI) to be performed at 3T. Materials and Methods Shimming protocols (iterative, first-order, and second-order) and perfluorocarbon (PFC) pads were evaluated using water peak linewidth measurements obtained from single-voxel magnetic resonance spectroscopy (MRS) on a head and neck phantom. After optimization of the technique, CSI was then tested on 14 patients with head and neck tumors. Results Second-order shimming (water peak linewidth, 4.6 Hz) performed significantly (P < 0.001) better than first-order (16.5 Hz) and iterative shimming (18 Hz) and the water peak linewidth was significantly reduced using PFC pads (P < 0.001). Using second-order shimming and PFC pads, CSI was successful in 10 patients with nodal metastases (n = 8) and benign tumors (n = 2) and unsuccessful in four patients with primary tumors along the aerodigestive tract. Conclusion Proton CSI can be successfully performed in the head and neck using second-order shimming and PFC pads to correct air and tissue susceptibility differences. CSI was more successfully performed on nodal metastases, while CSI for primary tumors along the aerodigestive tract remains a challenge. J. Magn. Reson. Imaging 2010;32:1248–1254. © 2010 Wiley-Liss, Inc.

Purpose To examine preprocessing methods affecting the potential use of Magnetic Resonance Spectroscopy (MRS) as a noninvasive modality for detection and characterization of brain lesions and for directing therapy progress. Materials and Methods Two reference point re-calibration with linear interpolation (to compensate for magnetic field nonhomogeneity), weighting of spectra (to emphasize consistent peaks and depress chemical noise), and modeling based on chemical shift locations of 97 biomarkers were investigated. Results for 139 categorized scans were assessed by comparing Leave-One-Out (LOO) cross-validation and external validation. Results For distinction of nine brain tissue categories, use of re-calibration, variance weighting, and biomarker modeling improved LOO classification of MRS spectra from 31% to 95%. External validation of the two best nine-category models on 47 unknown samples gave 96% or 100% accuracy, respectively, compared with pathological diagnosis. Conclusion Preprocessing of MRS spectra can significantly improve their diagnostic utility for automated consultation of pattern recognition models. Use of several techniques in combination greatly increases available proton MRS information content. Accurate assignment of unknowns among nine tissue classes represents a significant improvement, for a much more demanding task, than has been previously reported. J. Magn. Reson. Imaging 2010;32:818–829. © 2010 Wiley-Liss, Inc.

Purpose: To measure interindividual, repositioning, and time-of-day effects of single voxel PRESS (Point RESolved Spectroscopy) proton magnetic resonance spectroscopy (1H-MRS) acquisition of the anterior cingulate cortex (AC) in healthy human subjects. Materials and Methods: AC 1H-MRS measurements were performed in 15 healthy adult volunteers using a short echo PRESS sequence (GE Healthcare 3 Tesla, TE/TR = 30/2500 ms, 192 acquisitions, 6 cm3 voxels). For each individual, a total of eight spectra were obtained during two identical scanning sessions separated by 3.5 h. In each, two consecutive AC spectra were acquired. After the first two scans, the subject left the scanner, then immediately returned for repositioning and acquisition of two more consecutive spectra. The subject then left the imaging centre to return 3.5 h later for a repeated procedure. Spectroscopic postprocessing was done using LCmodel. Interindividual, repositioning and time-of-day effects were measured using restricted maximum likelihood (REML) models of variance components analysis, where response variables were levels of creatine/phosphocreatine (Cr), N-acetyl-aspartate (NAA), myo-inositol (mI), choline (Cho), and the glutamate-glutamine complex (Glx). Results: Interindividual effects were markedly higher than time-of-day and repositioning effects for all metabolites. Conclusion: Our findings show that 1H-MRS measurements of the AC are sensitive to interindividual differences, while time of day and repositioning are markedly less important. J. Magn. Reson. Imaging 2010;32:276–282. © 2010 Wiley-Liss, Inc.

To study the features of proton magnetic resonance spectroscopy ((1)H-MRS) on amyotrophic lateral sclerosis (ALS) and its relation with clinical scale.Fifteen patients with definite or probable ALS and 15 age- and gender-matched normal controls were enrolled. (1)H-MRS was performed on a 3.0 Tesla GE imaging system (GE Healthcare, Milwaukee, WI). TE-averaged Point Resolved Selective Spectroscopy was used. N-acetylaspartate (NAA), creatine (Cr), Glu, and Glx (glutamate + glutamine) values of the motor cortex and posterior limb of internal capsule were acquired. The t-test was used to compare differences between groups, and the correlations between the above values and clinical scale were analyzed.The motor area and posterior limb of the internal capsule of ALS patients had lower NAA/Cr (1.91 +/- 0.34, 1.53 +/- 0.17) compared with normal subjects (2.23 +/- 0.33, 1.66 +/- 0.07), and the differences between groups were statistically significant (P0.01, 0.01). ALS patients had higher Glu/Cr (0.34 +/- 0.05, 0.29 +/- 0.06) and Glx/Cr (0.40 +/- 0.04, 0.33 +/- 0.06) compared with normal subjects (0.30 +/- 0.03, 0.25 +/- 0.04) and (0.32 +/- 0.05, 0.26 +/- 0.03), and the differences between groups were statistically significant (P0.01, 0.01). The Norris scale was negatively correlated with Glx/Cr of primary motor cortex by lineal correlation analysis (r = -0.75), and this correlation had statistical significance (F = 16.60; P = 0.001).Neuronal loss and Glu+Gln increase can be detected by using proton MRS in ALS patients. (1)H-MRS is an useful tool in reflecting the characteristic changes of metabolite in ALS.

Purpose To investigate the impact of cerebrospinal fluid (CSF) contamination on metabolite evaluation in the superior cerebellar vermis with single-voxel 1H-MRS in normal subjects and patients with degenerative ataxias. Materials and Methods Twenty-nine healthy volunteers and 38 patients with degenerative ataxias and cerebellar atrophy were examined on a 1.5 Tesla scanner. Proton spectra of a volume of interest placed in the superior vermis were acquired using a four TE PRESS technique. We calculated N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, and NAA/Cho ratios, T2 relaxation times and concentrations of the same metabolites using the external phantom method. Finally, concentrations were corrected taking into account the proportion of nervous tissue and CSF, that was determined as Volume Fraction (VF). Results In healthy subjects, a significant difference was observed between metabolite concentrations with and without correction for VF. As compared to controls, patients with ataxias showed significantly reduced NAA/Cr and NAA concentrations, while only corrected Cr concentration was significantly increased. The latter showed an inverse correlation with VF. Conclusion CSF contamination has a not negligible effect on the estimation of brain metabolites. The increase of Cr concentration in patients with cerebellar atrophy presumably reflects the substitutive gliosis which takes place along with loss of neurons. J. Magn. Reson. Imaging 2009;30:11–17. © 2009 Wiley-Liss, Inc.

Purpose To evaluate the use of the water-to-fat (W-F) value obtained from in vivo proton (1H) MR spectroscopy (MRS) as a response indicator of cytologically confirmed patients with locally advanced breast cancer (LABC), and to monitor the therapeutic response of such patients to neoadjuvant chemotherapy (NACT) Materials and Methods Serial 1H MR spectra were recorded both before and after the completion of chemotherapy in 33 LABC patients (with infiltrating ductal carcinoma (IDC)) at 1.5T. In addition, spectra from normal breast tissues of 28 healthy volunteers were recorded. Results Malignant breast tissues showed elevated W-F values compared to normal breast tissues of controls. Statistically significant higher pretherapy W-F value (P < 0.01) was observed in patients compared to controls. In patients who received NACT resulting in the reduction of the primary tumor size, the W-F value showed a decrease that was statistically significant (P < 0.01). Analysis of the MR data further indicates that the W-F value had no correlation with the menstrual status of the patients. A comparison of pretherapy W-F value with pretherapy tumor volume showed a fair correlation (P = 0.05), while the posttherapy W-F value showed no such correlation with the posttherapy tumor volume. Conclusion This study demonstrates that simple, conventional in vivo 1H MRS is a useful technique for monitoring the therapeutic response of breast cancer patients. The observed trend in the reduction of W-F value provides a noninvasive response indicator to monitor the clinical outcome of locally advanced breast cancer patients to NACT J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.

Purpose To assess the marrow lipid water ratio (LWR) and spectral line width (LW) of lumbar vertebra by proton MR spectroscopy (1H MRS) and correlate with the marrow blood perfusion (MBP) by contrast-enhanced dynamic MRI (dMRI) in female subjects. Materials and Methods A total of 50 female subjects were included. Single-voxel 1H MRS was measured at the L3 vertebrae. In the dMRI study, the maximum enhancement percentage (Emax) and enhancement slope were calculated from time-intensity curves. Pearson's correlation was calculated to explore the association of 1H MRS, age, and perfusion parameters. Partial correlation was then used to control confounder effect. Results LWR was negatively correlated with Emax (r = –0.72; P < 0.0001), but positively correlated with age (r = 0.63; P < 0.0001). Lipid LW was negatively correlated with age (r = –0.33; P

It is important to make a rapid diagnosis to provide appropriate treatment, however, specific diagnosis of causative organisms of pelvic abscesses on conventional MR imaging is difficult. MR spectroscopy provides metabolic information noninvasively, and has the potential to characterize etiology of the abscesses. The presence of acetate (Ac) peak with or without succinate (Suc) peak may suggest anaerobic bacterial infection, whereas the absence of Ac and Suc peaks in the spectra may suggest aerobic infection. This report describes two cases of uterine pyogenic abscesses, which showed Ac and Suc peaks on in vivo MR spectroscopy.J. Magn. Reson. Imaging 2013;38:955–957. © 2013 Wiley Periodicals, Inc.

In vivo magnetic resonance spectroscopy (MRS) addresses metabolic pathways and their steady states in different tissue types. The brain has by tradition, and due to technical limitations in other organs, been one of the tissues most studied by MRS, and both 1H- and 31P-MRS have been used. Although 31P-MRS is outstanding for the evaluation of sources of metabolic energy in the brain, 1H-MRS has become the major clinically applied method in neurospectroscopy, as it provides information on markers of neuronal function, myelin, cell membranes, and metabolic active compounds. Furthermore, MR sensitivity is much greater for protons than it is for phosphorus and 1H-MRS, therefore allowing better spatial resolution. This review focuses on neurospectroscopy and diagnostic insights into diverse neurological problems provided by 1H-MRS applied as a clinical tool.

This report focuses on proton magnetic resonance spectroscopy (1H MRS) of spine vertebra acquired with two-dimensional chemical shift imaging (2D CSI), utilizing the stimulated echo acquisition mode (STEAM) sequence. Both validity and reproducibility studies were performed. To validate the 2D CSI method, its spectra were compared with those obtained with the single-voxel (SV) method. Five normal volunteers were scanned. The reproducibility of 2D CSI was examined by performing spectroscopy on two different occasions, on three normal volunteers. Data show that the STEAM 2D CSI technique results in MRI spectra comparable to those obtained with the STEAM SV method. 2D CSI offers significant time savings and convenient multi-voxel spectral analysis at a substantially higher signal-to-noise ratio. The 2D CSI method was then applied to a patient with a small vertebral hemangioma. The results demonstrated that the voxels containing the hemangioma exhibit different spectra than the neighboring voxels of the same vertebra. Additionally, a case of vertebral osteoporosis was investigated. Results showed a significant increase in the lipid-to-water ratio (LWR). It is suggested that 2D CSI may be powerful in identifying physiological as well as pathological changes of the bone marrow. Furthermore, covering a more extensive area of the vertebral body will maximize the chances of depicting a small focus of pathologic tissue. A more detailed bone marrow pattern was noticed in on one subject whose spectra show more lipid peaks. J. Magn. Reson. Imaging 2000;11:287–293. © 2000 Wiley-Liss, Inc.

The aim of this study was to evaluate comparatively the information given by proton magnetic resonance spectroscopy (MRS) with short echo time (TE 20 msec) stimulated echo acquisition mode and long TE (270 msec) point-resolved spectroscopy in predicting long-term outcome in children suffering from acute brain injury. At 1.5 T, we performed single-voxel proton MRS with both methods in occipital gray matter of 70 children. A linear discriminant analysis used to predict outcomes based on MRS variables was compared with actual neurologic outcome assigned at least 6 months after injury by a pediatric neurologist. Using peak area metabolite ratios and lactate presence, the short and long TE methods were equally predictive in children over 1 month of age. In neonates less than 1 month of age, the long TE method produced a higher percentage of correct outcome predictions (91%) than the short TE method (79%). The long TE method detected lactate more often in all age groups. J. Magn. Reson. Imaging 2000;11:9–19. © 2000 Wiley-Liss, Inc.

Image-guided localized proton MR spectroscopy (MRS) of normal breasts and breast tumors (ductal and undifferentiated carcinomas) was performed using a dedicated double breast coil. In vivo 1H MR spectra from 10 normal volunteers showed signals from water and lipids only, even in breasts with small contribution of fatty breast tissue. In the spectra from 6 of the 12 examined patients, an intense signal assigned to choline compounds was detected. The signal was also detected at lower levels in the remaining patients. This study shows that in vivo 1H MRI/MRS examinations of breast tumors can be performed within an examination time of 45 to 60 minutes. Signals from breast tumor metabolites may be detected using in vivo 1H MRS.