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PC.26 Feasibility of Magnetic Resonance Spectroscopy in Examining Thalamic Metabolite Concentrations in a Multi-Centre Study of Neonatal Encephalopathy
  1. PJ Lally1,
  2. DL Price2,
  3. A Bainbridge2,
  4. SS Pauliah1,
  5. P Satodia3,
  6. SC Wayte3,
  7. L Abernethy4,
  8. M Turner4,
  9. AN Basheer1,
  10. A Alavi1,
  11. O Kirmi1,
  12. B Jones1,
  13. S Shankaran5,
  14. EB Cady2,
  15. S Thayyil1
  1. 1Imperial College, London, UK
  2. 2University College Hospital, London, UK
  3. 3Coventry and Warwickshire University Hospital NHS Trust, Coventry, UK
  4. 4Alderhey Children’s Hospital, Liverpool, UK
  5. 5Wayne State University, Detroit, Michigan, USA


Background Proton magnetic resonance spectroscopy (MRS) has high prognostic value in hypoxic ischaemic encephalopathy (HIE), however its multi-centre application is limited by inconsistencies between scanners and protocols. N-acetylaspartate (NAA) is predominantly neuronal: cerebral NAA concentration may be a more reliable HIE-severity biomarker than lactate/NAA.

Objective To quantify the inter-site and inter-subject variability of NAA concentration measurements.

Design/Methods We recruited 5 healthy adult volunteers (aged 24–38, 2 male, 3 female) whom we scanned at 3 UK sites participating in a multi-centre neonatal-brain study (University Hospital, Coventry (UHC); Alder Hey Children’s Hospital, Liverpool (AH); University College Hospital, London (UCLH)). Thalamic NAA concentration was measured using the neonatal brain-water concentration reference protocol (15 × 15 × 15mm3 voxel; PRESS; water-suppressed TR/TE = 2s/288&60ms; TR/TE = 5s/60ms; non-water-suppressed TR = 10s, TE = 60/124/205/316/495/1000 ms). Spectra were post-processed in jMRUI and metabolites fitted with LCModel.

Results One volunteer was unavailable for scanning at AH. The mean (SD) NAA concentrations across the remaining four subjects were 15.5(3.4)mmol/kg wet weight, 14.4(0.1) mmol/kg wet weight, and 15.2(0.1) mmol/kg wet weight at UHC, AH and UCLH respectively. This corresponds to a maximum inter-site group mean variation (range/mean) of 8%. The inter-subject variability of mean NAA concentration (SD/mean) was 10%.

Conclusions The variation of thalamic NAA concentration between sites was 8% and the standard deviation across subjects was 10%, hence [NAA] may be suitable for multi-centre studies.

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