• Patricia Lani Lee, Constantin T Yiannoutsos, Thomas Ernst, Linda Chang, Christina M Marra, Jeffrey G Jarvik, Todd L Richards, Edmund W Kwok, Dennis L Kolson, David Simpson, Cheuk Y Tang, Giovanni Schifitto, Leena M Ketonen, Dieter J Meyerhoff, Robert E Lenkinski, R Gilberto Gonzalez, Bradford A Navia, and HIV MRS Consortium.
• NMR Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02111, USA. bnavia@lifespan.org
• J Magn Reson Imaging. 2003 Jun 1; 17 (6): 625-33.

PurposeTo demonstrate the technical feasibility and reliability of a multi-center study characterizing regional levels of the brain metabolite ratios choline (Cho)/creatine (Cr) and myoinositol (MI)/Cr, markers of glial cell activity, and N-acetyl aspartate (NAA)/Cr, a marker of mature neurons, in subjects with AIDS dementia complex (ADC).Materials And MethodsUsing an automated protocol (GE PROBE-P), short echo time spectra (TE = 35 msec) were obtained at eight sites from uniformly prepared phantoms and from three brain regions (frontal white matter, basal ganglia, and parietal cortex) of normal volunteers and ADC and HIV-negative subjects.ResultsA random-effects model of the phantom and volunteer data showed no significant inter-site differences. Feasibility of a multi-center study was further validated by detection of significant differences between the metabolite ratios of ADC subjects and HIV-negative controls. ADC subjects exhibited significantly higher Cho/Cr and MI/Cr in the basal ganglia and significantly reduced NAA/Cr and significantly higher MI/Cr in the frontal white matter. These results are consistent with the predominantly subcortical distribution of the pathologic abnormalities associated with ADC.ConclusionThis is the first study to ascertain and validate the reliability and reproducibility of a short echo time (1)H-MRS acquisition sequence from multiple brain regions in a multi-center setting. It should now be possible to examine the regional effects of HIV infection in the brain in a large number of subjects and to study the metabolic effects of new therapies for the treatment of ADC in a clinical trial setting.Copyright 2003 Wiley-Liss, Inc.

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