MR spectroscopy

Outline of the module
MRI has been widely accepted as a clinical and research tool. MRI can supply the clinician or the researcher with a broad range of anatomical and physiological information. MR spectroscopy offers a different kind of information, chemical composition of tissue, metabolic information. The resonance frequency in MR depends on the specific nucleus and is proportional to the external magnetic field. On top is this is the so called “chemical shift” which influences the resonance frequency. The magnetic field at the location of the nucleus is dependant by the local chemical environment and therefore differences in resonance frequencies exist between different chemical compounds.

The module “MR spectroscopy” is an introduction in, basic metabolism, MR spectroscopic sequence techniques, spectroscopic data analyses and clinical and research applications of MRS. At the end of this module, students will have basic understanding of how to select a spectroscopic technique and perform data-analysis given a certain clinical or research question.

The module covers the following topics:
• Basic biochemistry of MRS detectable metabolites
• 1H MR sequence techniques, localisation, single voxel and multi voxel techniques, suppression techniques
• 1H data-analysis, time domain and frequency domain, qualitative or quantitative
• Clinical applications of 1H MRS
• MRS & MRI of other nuclei, double resonance techniques, hyperpolarisation
• In vitro MRS


Learning objectives
At the end of this module, students should:
• Understand the basic principles and physics of MR spectroscopy
• Have basic knowledge of metabolites to be examined with MRS and their biochemical and clinical relevance
• Understand 1H MRS sequence techniques
• Understand the different methods of spectroscopic quantification
• Understand sequence techniques and applications of other nuclei
• Have basic knowledge of in vitro applications of MRS
• Have basic knowledge of clinical and research applications of MR spectroscopy


Content
MR spectroscopic techniques have been widely used in research and clinical applications.  In clinical setting 1H MRS is the most used nucleus because of routine MR systems capabilities. Clinical 1H MRS applications are in the field of diagnoses of brain disorders and diagnoses and therapy follow-up in prostate and mamma carcinoma.

Different clinical applications require different approaches in terms of MRS sequence to be used and data analyses. Detailed insight will be given in the multitude of available sequence and analyses techniques and their clinical applications. 31P, 13C and other nuclei offer the possibility to study specific metabolic processes. A number of these research applications will be reviewed, technically as well as their metabolic and research relevance.

Besides the in vivo applications of MRS the in vitro usage of MRS on body fluids and tissue samples will also be reviewed. This module will try to give an overview of current applications and future developments of MRS in the clinical and research environment. 

Overview of tasks and lectures
There will be 10 lectures of 2 hours distributed over 5 days.
• Basic principles of MRS
• Human metabolism and MRS
• 1H sequences
• Data analysis
• Clinical applications of MRS
• Other nuclei MRS I, metabolites and techniques
• Other nuclei MRS II, metabolites and techniques
• Other nuclei MRI
• In vitro MRS
• Summary

Position within the programme
This is a unique module in this Master programme dealing with the study of metabolic processes.  This module is complementary to the modules dealing with MRI physics and systems hardware.


Teaching format

Structure
The module is a one week-long residential module consisting of 10 lectures of 2 hours. Each day, the students will in addition perform implementation of computer algorithms relevant to one the lecture topics guided by tutors. Furthermore, the residential part is combined with a preparatory reading phase and post-module marked assignments.

Grading
For passing the module, an 85% attendance to the lectures and practical sessions, and a satisfactory completion of the hands-on training and data-analyses and the module assignments are required. The module assignments will be summarised by the students in a written form which will be evaluated by the module coordinator(s).


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