Optimization and Standardization of Magnetic Resonance Spectroscopy Techniques for Multicenter Longitudinal Multiple Sclerosis Studies

Abstract

Magnetic resonance spectroscopy (MRS) is a noninvasive tool providing a probe into the biochemistry of acute and chronic disease. It has demonstrated promise in the investigation of the natural history and pathogenesis of multiple sclerosis (MS). It certainly has potential for application in longitudinal and multicenter studies, including treatment trials of novel therapeutic agents. There also exist challenges in its implementation. MRS has been used to date largely as a research tool, despite the fact that one application of MRS (PROBE, General Electric Medical Systems, Milwaukee, Wis.) has been approved for clinical use in the United States. This might be seen as contrasting with magnetic resonance imaging (MRI), which has ubiquitous application in the range of brain pathology. However, a better comparison would be with quantitative applications of MRI, including diffusion weighting, magnetization transfer, and functional MRI. Viewed from this angle, it can be seen that MRS faces many of the optimization and standardization challenges of quantitative MRI, and that similar questions need to be considered with both modalities.