• Arwa Baeshen, Patrik O Wyss, Anke Henning, Ruth L O'Gorman, Marco Piccirelli, Spyridon Kollias, and Lars Michels.
• Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
• J Magn Reson Imaging. 2020 Apr 1; 51 (4): 1181-1191.

BackgroundThe optimization of magnetic resonance spectroscopy (MRS) sequences allows improved diagnosis and prognosis of neurological and psychological disorders. Thus, to assess the test-retest and intersequence reliability of such MRS sequences in quantifying metabolite concentrations is of clinical relevance.PurposeTo evaluate the test-retest and intersequence reliability of three MRS sequences to estimate GABA and Glx = Glutamine+Glutamate concentrations in the human brain.Study TypeProspective.SubjectsEighteen healthy participants were scanned twice (range: 1 day to 1 week between the two sessions) with identical protocols.Field Strength/Sequence3T using a 32-channel SENSE head coil in the PCC region; PRESS, JPRESS, and MEGA-PRESS sequences.AssessmentMetabolite concentrations were estimated using LCModel (for PRESS and MEGA-PRESS) and ProFit2 (for JPRESS).Statistical TestsThe test-retest reliability was evaluated by Wilcoxon signed-rank tests, Pearson's r correlation coefficients, intraclass-correlation coefficients (ICC), coefficients of variation (CV), and by Bland-Altman (BA) plots. The intersequence reliability was assessed with Wilcoxon signed-rank tests, Pearson's r correlation coefficients, and BA plots.ResultsFor GABA, only the MEGA-PRESS sequence showed a moderate test-retest correlation (r = 0.54, ICC = 0.5, CV = 8.8%) and the BA plots indicated good agreement (P > 0.05) for all sequences. JPRESS provided less precise results and PRESS was insensitive to GABA. For Glx, the r and ICC values for PRESS (r = 0.87, ICC = 0.9, CV = 2.9%) and MEGA-PRESS (r = 0.70, ICC = 0.7, CV = 5.3%) reflect higher correlations, compared with JPRESS (r = 0.39, ICC = 0.4, CV = 20.1%).Data ConclusionMEGA-PRESS and JPRESS are suitable for the reliable detection of GABA, the first being more precise. The three sequences included in the study can measure Glx concentrations.Level Of Evidence2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1181-1191.© 2019 International Society for Magnetic Resonance in Medicine.

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