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Title: Magnetic resonance spectroscopy as part of a comprehensive neuroimaging assessment tool
Author: Sanaei Nezhad, Faezeh
ISNI:       0000 0004 7225 5977
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2018
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Magnetic resonance spectroscopy (MRS) allows the non-invasive measurement of selected biological compounds in vivo. Despite MRS proven potential it is not yet a routine clinical tool operated by clinicians. This is mainly due to the complex procedure of MRS acquisition, lack of standardisation in both acquisition and analysis protocols along with lack of a standard quality control. This thesis intended to address these issues with the focus on four metabolites glutathione, glutamate, glutamine and GABA using MEGA-PRESS pulse sequence. Recommendations on acquisition and spectra analysis is made for the MRS protocol MEGA-PRESS aiming to detect glutathione in vivo. This is based on an investigation of glutathione acquisition in vivo and in vitro and was aimed to answer the question: can glutathione be measured reliably using conventional pulse sequence PRESS or does it require editing? The results showed strong evidence of using editing in order to have a reliable glutathione concentration measurement. An analysis along with a quality control method is also presented to enable the extraction of glutamate and glutamine from a GABA-optimised MEGA-PRESS pulse sequence. This enables simultaneous measurements of GABA, glutamate and glutamine in a single acquisition. A criterion of NAA linewidth < 8 Hz and Glx CRLB < 16% were defined as optimum features in the GABA-edited spectrum for a reliable glutamate and glutamine quantification. Finally, due to the increasing interest in functional MRS of GABA using MEGAPRESS an investigation on the feasibility of measuring GABA in a functional-MRS setting was performed with recommendations on study designs and subject size. Power calculations suggest that detecting a 40% change in GABA using a 4'30" acquisition requires 9-93 subjects per group in a between-group study design and 13- 68 participants in a within-session design, depending on the region of interest. This thesis is set out in the Journal format thesis. Three introductory chapters, with each experimental study presented as a chapter and a final chapter that summarizes and discusses the work. Results in this thesis provide a basis for a standard and reliable MRS pipeline to reliably measure glutathione, glutamate, glutamine and GABA using MEGA-PRESS pulse sequence at 3 Tesla.
Supervisor: Williams, Stephen ; Parkes, Laura Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: J-editing ; PRESS ; GABA ; MEGA-PRESS ; Glutamate ; Glutathione ; spectroscopy ; Glutamine