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AJNR - American Journal of Neuroradiology

Published ahead of print on October 5, 2007
doi: 10.3174/ajnr.A0774

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American Journal of Neuroradiology 28:1843-1849, November-December 2007
© 2007 American Society of Neuroradiology

Review Article

Whole-Brain N-Acetylaspartate as a Surrogate Marker of Neuronal Damage in Diffuse Neurologic Disorders

D.J. Rigotti^a, M. Inglese^a and O. Gonen^a

^a From the Department of Radiology, New York University School of Medicine, New York, NY

Please address correspondence to Oded Gonen, PhD, Department of Radiology, New York University School of Medicine, 650 First Ave, New York, NY 10016; e-mail: oded.gonen{at}med.nyu.edu

SUMMARY: Proton MR spectroscopy (¹H-MR spectroscopy) is a quantitative MR imaging technique often used to complement the sensitivity of conventional MR imaging with specific metabolic information. A key metabolite is the amino acid derivative N-acetylaspartate (NAA), which is almost exclusive to neurons and their processes and is, therefore, an accepted marker of their health and attenuation. Unfortunately, most ¹H-MR spectroscopy studies only account for small 1- to 200-cm volumes of interest (VOI), representing less than 20% of the total brain volume. These VOIs have at least 5 additional restrictions: 1) To avoid contamination from subcutaneous and bone marrow lipids, they must be placed away from the skull, thereby missing most of the cortex. 2) They must be image-guided onto MR imaging–visible pathology, subjecting them to the implicit assumption that metabolic changes occur only there. 3) They encounter misregistration errors in serial studies. 4) The time needed to accumulate sufficient signal-intensity quality is often restrictive, and 5) they incur (unknown) T1- and T2-weighting. All these issues are avoided (at the cost of specific localization) by measuring the nonlocalized average NAA concentration over the entire brain. Indeed, whole-brain NAA quantification has been applied to several diffuse neurodegenerative diseases (where specific localization is less important than the total load of the pathology), and the results are presented in this review.

This article has been cited by other articles:

				J.-B. Hovener, D.J. Rigotti, M. Amann, S. Liu, J.S. Babb, P. Bachert, A. Gass, R.I. Grossman, and O. Gonen Whole-Brain N-Acetylaspartate MR Spectroscopic Quantification: Performance Comparison of Metabolite versus Lipid Nulling AJNR Am. J. Neuroradiol., September 1, 2008; 29(8): 1441 - 1445. [Abstract] [Full Text] [PDF]