Abstract
Objective
To study the effects of calcium on the choline peak measurements with 1H MR spectroscopy.
Material and methods
The thigh muscles of two cadaveric specimens were prospectively evaluated on a 3 T MR unit before and after the injection of calcium carbonate (up to 0.4322 g). The choline peaks of 147 spectra from 10 different anatomic locations were quantitatively evaluated. The influence of the calcium concentration and its disposition with respect to the main magnetic field were considered. B0 phase maps were used to evaluate field inhomogeneities.
Results
The presence of calcium led to a 43 % underestimation of the choline peak and the choline concentration (p = 0.0002 and 0.0036). The mean choline concentrations before and after CaCO3 injection were 3.53 ± 1.72 mmol/l and 1.58 ± 0.63 mmol/l. The influence of calcium carbonate on the choline peak estimations was proportional to the calcium concentration. There was a significant position-dependent difference in the estimation of the choline peak amplitude (p < 0.0154). Calcium injection led to a measurable increase in field inhomogeneities.
Conclusion
There was a significant underestimation of the choline peak amplitude and concentration in the presence of calcium, which might cause misinterpretations of MR spectra.
Key Points
• The presence of calcium led to significant underestimation of choline measurements.
• The influence of calcium is dependent on its concentration and distribution.
• Quantitative MR spectroscopy of calcified tumours should be interpreted with caution.
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Abbreviations
- 1H:
-
Proton
- CaCO3 :
-
Calcium carbonate
- Cho:
-
Choline compounds (choline, phosphocholine and glycerophosphocholine)
- PRESS:
-
Point resolved spectroscopy
- CHESS:
-
Chemical shift selective water suppression
- B0 :
-
Main magnetic field
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Acknowledgments
This work was supported by the French Society of Radiology (SFR, Societé Française de Radiologie) through a research grant. The authors wish to thank the FEDER and Region Lorraine for their support on this research.
The scientific guarantor of this publication is Prof. Alain Blum, Service d’imagerie Guilloz, CHU-Nancy, France. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. One of the authors has significant statistical expertise. Gabriela Hossu is an expert on statistics. Institutional review board approval was not required because this work was performed on fully anonymised cadaveric specimens donated to science. Methodology: prospective, experimental, multicentre study.
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Teixeira, P.A.G., Hossu, G., Kauffmann, F. et al. Influence of Calcium on Choline Measurements by 1H MR Spectroscopy of Thigh Muscles. Eur Radiol 24, 1309–1319 (2014). https://doi.org/10.1007/s00330-014-3131-z
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DOI: https://doi.org/10.1007/s00330-014-3131-z