[Show abstract][Hide abstract] ABSTRACT: Several studies and recent models
of effects of nicotine, the main addictive and psychoactive component in tobacco, point to action of the drug on the limbic system during maintenance of addiction, either direct or indirect via projections from the ventral tegmental area. The objective of this study was to demonstrate physiological effects of cigarette smoking on the hippocampus and the grey matter of the dorsal anterior cingulate cortex in the human brain with regard to addiction and withdrawal. This aim was achieved by group comparisons of results of magnetic resonance spectroscopy between non-smokers, smokers and smokers during withdrawal. 12 smokers and 12 non-smokers were measured with single voxel proton magnetic resonance spectroscopy for total N-acetyl aspartate, glutamate and glutamine, choline-containing compounds, myo-inositol and total creatine in the right and the left hippocampus and in the right and the left dorsal anterior cingulate cortex. Smokers were examined twice, first during regular cigarette smoking and second on the third day of nicotine withdrawal. The ratios to total creatine were used for better reliability. In our study, Glx/tCr was significantly increased and tCho/tCr was significantly decreased in the left cingulate cortex in smokers compared to non-smokers (p = 0.01, both). Six out of seven smokers showed normalization of the Glx/tCr in the left cingulate cortex during withdrawal. Although these results are preliminary due to the small sample size, our results confirm the assumption that cigarette smoking interferes directly or indirectly with the glutamate circuit in the dorsal anterior cingulate cortex.
[Show abstract][Hide abstract] ABSTRACT: PURPOSE
Comparison of intravenous Flat-Detector computed tomography (iv-FD-CT) to intravenous multislice computed tomography (iv-MS-CT) and intraarterial DSA (ia-DSA) to evaluate the visualization of experimental aneurysms after endovascular treatment.
METHOD AND MATERIALS
Aneurysms were created in the right common carotid artery in 15 rabbits. Five aneurysms were treated with coils, five with self-expandable stents alone and five with coils and stents. Imaging was performed by ia-DSA, iv-MS-CT and iv-FD-CT directly after treatment. Volume rendering (VRT), maximum intensity projection (MIP) and multiplanar reconstruction (MPR) were performed. Two experienced reviewers evaluated aneurysm size, occlusion rate and diameters of the stents.
In Coil-embolized aneurysms diameter of coil-packages was overestimated in iv-MS-CT by 56 % and in iv-FD-CT by 16 % compared to ia-DSA because of blooming and beam hardening artifacts (p<0,05). Visualisation of the neck of the 10 aneursyms occluded by coils and combination of coils and stents was most accurate in DSA showing in 9 animals residual inflow while in iv-MS-CT in 2 of 10 and in iv-FD-CT in 4 of 10 aneurysms residual inflow was visible. The outer diameter of stents was evaluated identically in ia-DSA and iv-FD-CT and was significantly overestimated in iv-MS-CT compared to ia-DSA and iv-FD-CT (p<0,05). In iv-MS-CT the inner diameter was underrated compared to iv-FD-CT.
Iv-FD-CT is helpful in the imaging of endovascular implants and compared better to results of ia-DSA in the visualization of residual aneurysm inflow and stent lumen than iv-MS-CT.
FD-CT as a non-invasive modality may have the potential to replace DSA for certain follow-up examinations after endovascular treatment of aneurysms.
Radiological Society of North America 2011 Scientific Assembly and Annual Meeting; 11/2011
[Show abstract][Hide abstract] ABSTRACT: The contribution of potential treatable dementia aetiologies diagnosed using cerebral imaging varied considerably in previous studies and was not evaluated in a recent larger German sample of patients from a memory clinic.
MRI images of 502 patients were retrospectively reassessed. Beside the proportion of potentially treatable dementia aetiology, the extent of whole brain atrophy (semiquantitative) and vascular white matter lesions were assessed.
Mean age of the patients was 63.7 ± 13.1 years; 49 % were female, mean MMST was 24.2 ± 5.5. In 74 % there was an agreement between the clinical dementia syndrome and MRI. 9 % (45 patients) had clearly discrepant imaging results, according to MRI criteria (21 × ischaemia, 20 × normal pressure hydrocephalus (NPH), 4 × intracerebral haemorrhage). These patients could not not be differentiated using age and MMST alone as clinical criteria. There was a significant correlation between global brain atrophy and MMST (r = -0.32; p < 0.001) and white matter lesion score (r = 0.28; p < 0.001).
In 9 % there was a clear discrepancy between MRI results and the clinical syndrome diagnosis in memory-clinic patients. As known from earlier studies and current German 3 rd generation guidelines, it is reasonable to perform MRI imaging in dementia to improve the aetiological and differential diagnoses and to detect a different aetiology that can be missed using the clinical dementia criteria alone.
[Show abstract][Hide abstract] ABSTRACT: To demonstrate the feasibility of intravenous Flat Detector CT Angiography (FD-CTA) for visualisation of intracranial Flow Diverting Devices. Flow Diverting Devices are used increasingly for treatment of intracranial aneurysms. A close follow up is necessary because it becomes obvious that a significant proportion of aneurysms treated with these devices remain patent. A minimally invasive method is highly desirable.
In two patients treated with flow diverters a Flat Detector CT (FD-CT) with intravenous contrast medium application was performed. Post-processing was performed using commercially available software.
In both patients the lumen of the device and the lumen of the aneurysm could be clearly evaluated. Some beam hardening artefacts due to the marker wires of the device were obvious.
Flat Detector CT with intravenous contrast material application to evaluate flow-diverting devices seems to be feasible. Further studies are necessary to perform comparative evaluation of FD-CTA with angiography and other techniques like MRA or conventional CT angiography.
European Radiology 08/2011; 21(8):1797-801. DOI:10.1007/s00330-011-2113-7 · 4.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate the potential contribution of morphometric MRI analysis in comparison to other modalities, such as MEG, SPECT and PET, in identifying the epileptogenic focus in patients with cryptogenic epilepsy.
Study inclusion was limited to epilepsy patients with a monolobar focus hypothesis, as concluded from EEG/seizure semiology and the best individual concordance rate. Feature maps, generated by the MATLAB(®) "morphometric analysis program" (MAP), were evaluated by a neuroradiologist blinded to conventional MRI and the focus hypothesis (MAP(1)). In addition, the feature maps were also interpreted by simultaneous matching conventional MRI but, again, with the reader having no knowledge of the focus hypothesis (MAP(2)).
In 12 out of 51 patients, true-positive findings were achieved (MAP(1): sensitivity 24%; specificity 96%). The sensitivity of the MAP(1) results was superior extratemporally. After matching conventional MRI, FCD was traced in six of the 12 patients (MAP(2): sensitivity 12%; specificity 100%). MEG sensitivity was 62%. Sensitivity of interictal and ictal SPECT was 20% and 50%, respectively. PET was not as sensitive extratemporally (19%) as temporally (82%). The greatest correspondence with the best individual concordance rate was noted with PET (14/16; 88%) and MEG (8/10; 80%), followed by interictal (5/8; 63%) and ictal (9/15; 60%) SPECT. Results for MAP(1) were 53% (10/19), and 100% for MAP(2) (6/6).
Although MAP sensitivity and specificity results are lower in comparison to other modalities, implementation of the technique should be considered first, before arranging any further investigations. The present study results offer guidelines for the implementation, interpretation and concordance of diagnostic procedures.
Journal of Neuroradiology 06/2011; 39(2):87-96. DOI:10.1016/j.neurad.2011.04.004 · 1.75 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In conventional MR imaging, it is often difficult to delineate the heterogeneous structure of gliomas. Proton magnetic resonance spectroscopic imaging ((1)H-MRSI) is a noninvasive tool for investigating the spatial distribution of metabolic changes in brain lesions. The aim of this study was to assess the improvements in delineation of gliomas based on segmentation of metabolic changes measured with (1)H-MRSI.
Twenty patients with gliomas (WHO grade II and III) were examined using a standard (1)H-MRSI sequence. Metabolic maps for choline (Cho), N-acetyl-aspartate (NAA) and Cho/NAA ratios were calculated and segmented based on the assumption of a Gaussian distribution of the Cho/NAA values for normal brain. Areas of hyperintensity on T2-weighted (T2w) MR images were compared with the areas of the segmented tumor on Cho/NAA maps. Stereotactic biopsies were obtained from the MRSI/T2w difference areas.
In all patients, the segmented MRSI tumor areas were greater than the T2w hyperintense areas, on average, by 20% (range 6-34%). In nine patients, biopsy sampling from the MRSI/T2w difference areas showed tumor infiltration ranging from 4-17% (mean 9%) tumor cells, in the areas detected only by MRSI.
Our method for automated segmentation of the lesion-related metabolic changes achieved significantly improved delineation for gliomas compared to routine clinical methods. We demonstrate that this method can improve delineation of tumor borders compared to routine imaging strategies in clinics. Metabolic images of the segmented tumor may thus be helpful for therapeutic planning.
Central European neurosurgery 05/2011; 72(2):63-9. DOI:10.1055/s-0030-1253410 · 0.87 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: As stents for treating intracranial atherosclerotic stenosis may develop in-stent re-stenosis (ISR) in up to 30%, follow-up imaging is mandatory. Residual stenosis (RS) is not rare. We evaluated an optimised Flat Detector CT protocol with intravenous contrast material application (i.v. FD-CTA) for non-invasive follow-up.
In 12 patients with intracranial stents, follow-up imaging was performed using i.v. FD-CTA. MPR, subtracted MIP and VRT reconstructions were used to correlate to intra-arterial angiography (DSA). Two neuroradiologists evaluated the images in anonymous consensus reading and calculated the ISR or RS. Correlation coefficients and a Wilcoxon test were used for statistical analysis.
In 4 patients, no stenosis was detected. In 6 patients RS and in two cases ISR by intima hyperplasia perfectly visible on MPR reconstructions of i.v. FD-CTA were detected. Wilcoxon's test showed no significant differences between the methods (p > 0.05). We found a high correlation with coefficients of the pairs DSA/ FD-CT MIP r = 0.91, DSA/ FD-CT MPR r = 0.82 and FD-CT MIP/ FD-CT MPR r = 0.8.
Intravenous FD-CTA could clearly visualise the stent and the lumen, allowing ISR or RS to be recognised. FD-CTA provides a non-invasive depiction of intracranial stents and might replace DSA for non-invasive follow-up imaging.
European Radiology 02/2011; 21(2):411-8. DOI:10.1007/s00330-010-1931-3 · 4.01 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Unilateral monofocal temporal magnetoencephalography (MEG) findings might determine epileptogenicity of a lesion in symptomatic epilepsy during presurgical evaluation. To evaluate the additive effect of video-electroencephalography (vEEG), monofocal temporal lobe MEG findings were compared to electrophysiological findings from vEEGs of patients with lesional epilepsy.
In 28 patients with drug-resistant lesional temporal lobe epilepsy (TLE), epileptogenicity of the lesion was determined by monofocal temporal MEG localisations. Findings for lesions of different aetiologies (20 mesial, 6 lateral, and 2 extended mesiolateral lesions) were compared to electrophysiological findings from long-term vEEG monitoring and validated by histology and postsurgical outcome (mean follow-up: 2 years (range 0.5-5)).
The mean distance between a lesion and MEG localisation was 11mm (range 0-30mm). The distance to the lesion was on average 5mm (range 0-22mm) in patients with neocortical foci and on average 13mm (range 0-30mm) in patients with mesial foci. Predominant interictal and ictal vEEG findings were consistent with MEG findings in all patients, although they were sometimes distributed over multiple lobes and bilaterally pronounced on the side of the MEG findings. Postsurgical outcome of Engel 1 could be achieved in 82% (23 patients), and none of the patients had an outcome worse than Engel 2.
MEG localisations in lesional TLE are able to determine epileptogenicity of mesial and lateral temporal lobe lesions. MEG results are consistent with predominant electrophysiological findings from long-term vEEG. Future studies should assess the substitutability of vEEG by MEG in selected cases.
Epilepsy research 11/2010; 92(1):54-62. DOI:10.1016/j.eplepsyres.2010.08.007 · 2.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of our study was to gain further insight into the extent of local metabolic alterations in patients with idiopathic generalised epilepsy (IGE), respectively, the subgroup with generalised tonic-clonic seizures (GTCS). The extent of regional metabolic involvement perhaps indicates the key structures in generation of seizures and involvement of specific network of dysfunction.
Using the multi-voxel technique at a 3 T MRI Scanner metabolite levels of 25 age-matched healthy controls and 18 patients with GTCS were obtained from the basal ganglia, insular cortex, cingulum, hippocampus and along both hemispheres in the fronto-parietal white and grey matter.
Group analysis of GTCS patients versus healthy controls revealed significant (p < 0.05) decrease of tNAA in the cortex of the central region and cingulum, but also in the thalami. Glx was elevated broadly in both hemispheres, in particular in central region, cingulum, insular cortex and left putamen, yet also in the right thalamus. Cho and mI demonstrated a significant coincidental decrease pronounced in the grey and white matter of the central region. Significant metabolic correlation (p ≤ 0.05) based on tNAA, respectively, Glx occurred between the thalamus and the central region, cingulum, putamen and medial frontal cortex. In patients with > 2 tonic-clonic seizures in the last 12 months a trend towards higher Glx and lower tNAA levels was observed.
Our results demonstrate the altered metabolic interconnection of cerebral anatomic regions in patients with GTCS, in particular the major role of basal ganglia-central region relay in seizure generation.
[Show abstract][Hide abstract] ABSTRACT: In diagnosis of epilepsies electrophysiological findings play a key role. While spontaneous electroencephalography (EEG) and EEG with sleep deprivation (EEGsd) are widely evaluated and used, application of magnetoencephalography (MEG) in this field is primarily limited to presurgical assessment of focal epilepsies.
In this study we retrospectively compared MEG (M/EEG) and EEGsd in 63 (55) patients with focal and generalized epilepsy with regard to occurrence of epileptic spikes.
MEG could record epileptic spikes in 38 patients (60%), while EEGsd recorded spikes in only 32 patients (51%). In a group of 55 patients simultaneous MEG/EEG (M/EEG) was able to record spikes in 38 patients (71%) compared to epileptic spikes in 28 patients (51%) recorded by EEGsd. In a subgroup of 17 MR-negative patients simultaneous M/EEG could record epileptic spikes in all patients, while EEGsd was successful in only 11 (64%) of them.
In this study, MEG showed a tendency to record epileptic spikes in more patients than EEGsd. Furthermore, simultaneous M/EEG has been shown to be especially successful in detection of epileptic spikes in patients with MR-negative epilepsy. This might at least in parts be explained by neocortical predominance of MR-negative epilepsy. Thus, this study motivates prospective studies to evaluate the substitutability of EEGsd by MEG more extensively.
[Show abstract][Hide abstract] ABSTRACT: The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT imaging modality.
Neuroimages obtained in 65 patients, including 24 with EVDs, were reviewed by 2 independent, experienced clinicians. Lesions in all patients were investigated with FD CT and MS CT. The numbers of slices positive for ICH and SAH were counted, and for ICH the diameter and area of the lesion was measured. The positioning of drains was assessed. The presence of ventricular blood was noted. Statistical analysis was performed by calculating the Pearson correlation coefficient (r) to evaluate the level of inter- and intraobserver agreement, and linear regression analysis was done to visualize the results of the numbers of ICH- and SAH-positive slices.
The authors found high interobserver agreement regarding the number of slices with evidence of ICH (r = 0.89 for MS CT, r = 0.78 for FD CT) and SAH (r = 0.88 for MS CT, r = 0.9 for FD CT). Thin layers of blood in the ventricles were not detected on FD CT in 36.4% of cases. Six of 7 perimesencephalic SAHs were not seen on FD CT scans. The EVDs could be assessed with both modalities in 83.3% of cases, but the position of the drain could not be determined with FD CT in 16.7% (4 of 24 cases).
In some respects, FD CT is of limited use for the visualization of intracranial hemorrhage. However, despite limited contrast resolution, ICH and EVDs can be reliably demonstrated. Perimesencephalic SAH and thin layers of blood in the occipital horns may not be detected using FD CT. Further evaluation and improvement of the image quality is necessary before FD CT will provide identical quality in comparison with MS CT.
Journal of Neurosurgery 03/2010; 113(4):901-7. DOI:10.3171/2010.2.JNS091054 · 3.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to determine if levetiracetam (LEV) modulates brain γ-aminobutyric acid (GABA) in patients with epilepsy.
Occipital GABA was assessed by protein magnetic resonance spectroscopy (¹H-MRS) in 16 patients with focal epilepsy at baseline and following the initiation of oral administration of LEV as monotherapy. Responder profiles were calculated as percentage of baseline seizure frequency. Alterations of GABA/Cr (creatine) of baseline measurements compared to GABA/Cr under LEV therapy were analyzed by Student's t-test for paired samples.
After administration of LEV, partial seizure reduction (> 50%) was noticed in 5 of 16 patients (31%; 7 of 16 (44%) patients turned out to be free of seizures. Patients with 50-100% seizure reduction under LEV titration were referred to as LEV responders. Of the 32 GABA spectra, only 22 (approximately 70%) yielded a result that met the criteria for spectral quality; therefore, GABA/Cr data from only seven patients were paired. A significant increase of GABA/Cr during titration with LEV was noted in patients responding to LEV (n = 5; p = 0.007). No differences in baseline GABA/Cr levels were detected between patients with and without previous antiepileptic treatment (p = 0.74).
The increasing GABA/Cr levels under drug titration only in LEV-responding epilepsy patients suggest a more complex and indirect influence of LEV on the GABAergic system.
[Show abstract][Hide abstract] ABSTRACT: Despite limited soft tissue resolution flat-detector computed tomography (FD-CT) provides substantial superior spatial resolution in comparison with multislice computed tomography (MS-CT). This may add value in the visualization of small vascular structures if intravenous contrast application leads to substantial opacification and visibility of intracranial vessels or aneurysms.
To evaluate the feasibility of visualization of vascular structures by FD-CT angiography (FD-CTA) after intravenous contrast injection compared with MS-CTA and intra-arterial digital subtracted angiography (IADSA) in an animal model.
Aneurysms were created in the right common carotid artery in six New Zealand White Rabbits using the elastase technique. Imaging was performed using FD-CTA, MS-CTA (injection of 1 ml/kg body weight) and IADSA. Anonymized volume rendering reconstruction (VRT), maximum intensity projection (MIP), and multiplanar reconstruction (MPR) images were reconstructed and evaluated by two experienced reviewers for aneurysm geometry and vascular structure anatomy using standard tools of a dedicated workstation.
Aneurysms could be successfully created in all animals. Measurements of aneurysm geometry (aneurysm height, width, neck width) and vascular structures (brachiocephalic trunk, carotid artery diameter and plane) were nearly identical in all three modalities. Intra- and inter-observer correlations of the different parameters showed high r values between 0.83 and 0.99.
Our results show the feasibility of FD-CTA in comparison with MS-CTA and IADSA in an animal model. Despite limited soft tissue resolution, opacification of vascular structures with sufficient contrast to the surrounding structures was possible in all animals. Vascular structures appeared better delineated in FD-CTA than in MS-CTA, probably due to the superior spatial resolution.
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to determine how metabolite values (total N-acetyl aspartate [tNAA], glutamate plus glutamine [Glx], total choline [tCho], myoinositol [mI], and total creatine [tCr]) vary across brain regions in healthy subjects. This study was implemented to create an internal reference database for patients with psychiatric disorders and epilepsy.
Using the multivoxel technique with a voxelwise phantom calibration on a 3-T magnetic resonance imaging scanner, metabolite levels of 29 healthy controls (13 men, 16 women; average age, 29 years) were obtained from the hippocampi, basal ganglia, insula cortex, cingulum, and precuneus. Additionally, gray and white matter metabolite values were obtained from the frontal and parietal lobes.
No significant effect of gender was noticed. The total magnitude of variation was greatest for Glx, followed by tNAA, mI, tCho, and tCr. Glx/tCr, Glx, and tCr were increased in gray matter, while tNAA/tCr, tCho/tCr, respectively tNAA and tCho, were elevated in white matter. These findings indicate (1) anterior-to-posterior increases of tNAA/tCr and Glx/tCr, respectively tNAA and Glx, along the midline in gray matter (cingulum); (2) increased tNAA/tCr, respectively tNAA, in white matter in the fiber tracts of the precentral region; (3) an accentuated anterior-to-posterior increase of tCr in the insula cortex; and (4) an anterior-to-posterior decrease of tCho/tCr and tCho in white matter.
There are significant metabolic differences within tissue types and within tissue types at different locations; therefore, the spectra and metabolite values presented should provide a useful internal reference for both clinical and research studies.
[Show abstract][Hide abstract] ABSTRACT: The use of self-expandable microstents for treatment of broad-based intracranial aneurysms is widely spread. However, poor fluoroscopic visibility of the stents remains disadvantageous during the coiling procedure. Flat detector angiographic computed tomography (ACT) provides high resolution imaging of microstents even though integration of this imaging modality in the neurointerventional workflow has not been widely reported.
An acrylic glass model was used to simulate the situation of a broad-based sidewall aneurysm. After insertion of a self-expandable microstent, ACT was performed. The resulting 3D dataset of the Microstent was subsequently projected into a conventional 2D fluoroscopic roadmap. This 3D visualization of the stent supported the coil embolization procedure of the in vitro aneurysm.
In vitro 2D-3D coregistration with integration of 3D ACT data of a self-expandable microstent in a conventional 2D roadmap is feasible.
Unsatisfying stent visibility constrains clinical cases with complex parent vessel anatomy and challenging aneurysm geometry; hence, this technique potentially may be useful in such cases. In our opinion, the clinical feasibility and utility of this new technique should be verified in a clinical aneurysm embolization study series using 2D-3D coregistration.
[Show abstract][Hide abstract] ABSTRACT: Standard magnetic resonance imaging (MRI) does not depict the true extent of tumour cell invasion in gliomas. We investigated the feasibility of advanced imaging methods, i.e. diffusion tensor imaging (DTI), fibre tracking and O-(2-[(18)F]-fluoroethyl)-L: -tyrosine ((18)F-FET) PET, for the detection of tumour invasion into white matter structures not visible in routine MRI.
DTI and fibre tracking was performed on ten patients with gliomas, WHO grades II-IV. Five patients experienced preoperative sensorimotor deficits. The ratio of fractional anisotropy (FA) between the ipsilateral and contralateral pyramidal tract was calculated. Twenty-one stereotactic biopsies from five patients were histopathologically evaluated for the absolute numbers and percentages of tumour cells. (18)F-FET PET scans were performed and the bilateral ratio [ipsilateral-to-contralateral ratio (ICR)] of (18)F-FET-uptake was calculated for both cross-sections of pyramidal tracts and biopsy sites.
The FA ratio within the pyramidal tract was lower in patients with sensorimotor deficits (0.61-1.06) compared with the FA ratio in patients without sensorimotor deficits (0.92-1.06). In patients with preoperative sensorimotor deficits, we found a significantly (p = 0.028) higher ICR of (18)F-FET uptake (1.01-1.59) than in patients without any deficits (0.96-1.08). The ICR of (18)F-FET-uptake showed a strong correlation (r = 0.696, p = 0.001) with the absolute number of tumour cells and a moderate correlation (r = 0.535, p = 0.012) with the percentage of tumour cells.
Our data show an association between preoperative sensorimotor deficits, increased (18)F-FET uptake and decreased FA ratio in the pyramidal tract. We demonstrated a correlation between tumour invasion and (18)F-FET uptake. These findings may help to distinguish between edema versus tumour-associated neurological deficits and could prevent the destruction of important structures, like the pyramidal tract, during tumour operations by allowing more precise preoperative planning.
[Show abstract][Hide abstract] ABSTRACT: Gamma aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the human brain. It plays a decisive role in a variety of nervous system disorders, such as anxiety disorders, epilepsy, schizophrenia, insomnia, and many others. The reproducibility of GABA quantification results obtained with a single-voxel spectroscopy J-difference editing sequence with Point Resolved Spectroscopy localization (MEGA-PRESS) was determined on a 3.0 Tesla MR scanner in healthy adults. Eleven volunteers were measured in long- and short-term intervals. Intra- and inter-subject reproducibility were evaluated. Internal referencing of GABA+ to total creatine (tCr) and water (H(2)O), as well as two different post-processing methods for the evaluation (signal integration and time-domain fitting) were compared. In all subjects lower coefficient of variation and therefore higher reproducibility can be observed for fitting compared to integration. The GABA+/tCr ratio performs better than the GABA+/H(2)O ratio or GABA+ without internal referencing for both fitting and integration (GABA+/tCr: 13.3% and 17.0%; GABA+/H(2)O: 15.0% and 17.8%; GABA+: 19.2% and 21.7%). Four-day measurements on three subjects showed higher intra- than inter-subject reproducibility (GABA+/tCr approximately 10-12%). With a coefficient of variation of about 13% for inter-subject and 10-12% for intra-subject variability of GABA+/tCr, this technique seems to be a precise tool that can detect GABA confidently. The results of this study show the reproducibility limitations of GABA quantification in vivo, which are necessary for further clinical studies.
European journal of radiology 03/2009; 73(3):526-31. DOI:10.1016/j.ejrad.2009.01.014 · 2.37 Impact Factor