Towards Clinical Development and Implementation of Fast MR Spectroscopic Imaging Techniques

Magnetic resonance spectroscopic imaging (MRSI) is a non-invasive technique that offers a unique ability to provide the spatial distribution of relevant biochemical compounds (metabolites). The ‘spectrum’ of information provided by MRSI is used as biomarkers for the differential diagnosis of several diseases such as cancer or neurological disorders. Treatment responsive brain tumors can appear similar to non-responsive tumors on conventional anatomical MR images, earlier in the therapy, leading to a poor prognosis for many patients. Biomarkers such as lactate are particularly of interest in the oncological studies of solid tumors to determine their energy metabolism, blood flow, and hypoxia. Despite the capability of nearly all clinical MRI scanners to perform MRSI only limited integration of MRSI into routine clinical studies has occurred to date. The major challenges affecting its true potential are the inherently long acquisition time, low signal-to-noise (SNR) of the signals, overlapping of spectral lines, or the presence of artifacts. The goal of this dissertation work is to facilitate MRSI in routine clinical studies without affecting the current patient throughput. In this work, the Compressed Sensing (CS) strategy was used to accelerate conventional Point RESolved Spectroscopy (PRESS) MRSI by sampling well below the Shannon-Nyquist limit. Two undersampling strategies, namely the pseudo-random variable density and a novel a priori method was developed and implemented on a clinical scanner. Prospectively undersampled MRSI data was acquired from patients with various brain-related concerns. Spatial-spectral post-processing and CS reconstruction pipeline was developed for multi-channel undersampled data. The fidelity of the CS-MRSI method was determined by comparing the CS reconstructed data to the fully sampled data. Statistical results showed that the a priori approach maintained high spectral fidelity compared to the fully sampled reference for an 80% reduction in scan time. Next, an improvement to the CS-MRSI reconstruction was achieved by incorporating coil sensitivity maps as support in the iterative process. Further, a CS-MRSI-based fast lactate spectroscopic imaging method was developed and implemented to achieve complete water and fat suppression for accurate spatial localization and quantification of lactate in tumors. In vitro phantoms were developed, and the sequence was tested to determine the efficacy of CS-MRSI for low SNR signals, the efficacy of the CS acceleration was determined with statistical analysis.