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@ARTICLE{Alcicek:300296,
      author       = {S. Alcicek$^*$ and M. W. Ronellenfitsch$^*$ and J. P.
                      Steinbach$^*$ and A. Manzhurtsev and D. C. Thomas$^*$ and K.
                      Weber$^*$ and V. Prinz and M.-T. Forster and E.
                      Hattingen$^*$ and U. Pilatus and K. J. Wenger$^*$},
      title        = {{O}ptimized {L}ong-{TE} 1{H} s{LASER} {MR} {S}pectroscopic
                      {I}maging at 3{T} for {S}eparate {Q}uantification of
                      {G}lutamate and {G}lutamine in {G}lioma.},
      journal      = {Journal of magnetic resonance imaging},
      volume       = {62},
      number       = {3},
      issn         = {1053-1807},
      address      = {New York, NY},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2025-00749},
      pages        = {890-901},
      year         = {2025},
      note         = {2025 Sep;62(3):890-901},
      abstract     = {Glutamate and glutamine are critical metabolites in
                      gliomas, each serving distinct roles in tumor biology.
                      Separate quantification of these metabolites using in vivo
                      MR spectroscopy (MRS) at clinical field strengths (≤ 3T)
                      is hindered by their molecular similarity, resulting in
                      overlapping, hence indistinguishable, spectral peaks.To
                      develop an MRS imaging (MRSI) protocol to map glutamate and
                      glutamine separately at 3T within clinically feasible time,
                      using J-modulation to enhance spectral differentiation,
                      demonstrate its reliability/reproducibility, and quantify
                      the metabolites in glioma subregions.Prospective.Phantoms, 5
                      healthy subjects, and 30 patients with suspected glioma. IDH
                      wild-type glioblastoma cases were evaluated to establish a
                      uniform group.3T, Research protocol: 2D 1H sLASER MRSI (40
                      and 120 ms TE) with water reference, 3D T1-weighted and 2D
                      T2-weighted. Trial-screening process: T1-weighted,
                      T1-weighted contrast-enhanced, T2-weighted, FLAIR.Spectral
                      simulations and phantom measurements were performed to
                      design and validate the protocol. Spectral quality/fitting
                      parameters for scan-rescan measurements were obtained using
                      LCModel. The proposed long-TE data were compared with
                      short-TE data. BraTS Toolkit was employed for fully
                      automated tumor segmentation.Scan-rescan comparison was
                      performed using Bland-Altman analysis. LCModel coefficient
                      of modeling covariance (CMC) between glutamate and glutamine
                      was mapped to evaluate their model interactions for each
                      spectral fitting. Metabolite levels in tumor subregions were
                      compared using one-way ANOVA and Kruskal-Wallis. A p value <
                      0.05 was considered statistically significant.Spectral
                      quality/fitting parameters and metabolite levels were highly
                      consistent between scan-rescan measurements. A negative
                      association between glutamate and glutamine models at short
                      TE (CMC = -0.16 ± 0.06) was eliminated at long TE (0.01 ±
                      0.05). Low glutamate in tumor subregions
                      (non-enhancing-tumor-core: 5.35 ± 4.45 mM,
                      surrounding-non-enhancing-FLAIR-hyperintensity: 7.39 ± 2.62
                      mM, and enhancing-tumor: 7.60 ± 4.16 mM) was found compared
                      to contralateral (10.84 ± 2.94 mM), whereas glutamine was
                      higher in surrounding-non-enhancing-FLAIR-hyperintensity
                      (9.17 ± 6.84 mM) and enhancing-tumor (7.20 ± 4.42 mM), but
                      not in non-enhancing-tumor-core (4.92 ± 3.38 mM, p = 0.18)
                      compared to contralateral (2.94 ± 1.35 mM).The proposed
                      MRSI protocol (~12 min) enables separate mapping of
                      glutamate and glutamine reliably along with other
                      MRS-detectable standard metabolites in glioma subregions at
                      3T.1 TECHNICAL EFFICACY: Stage 3.},
      keywords     = {1H sLASER long‐TE (Other) / MR spectroscopy (Other) /
                      brain tumor (Other) / glutamate (Other) / glutamine (Other)
                      / reproducibility (Other)},
      cin          = {FM01},
      ddc          = {610},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40197808},
      doi          = {10.1002/jmri.29787},
      url          = {https://inrepo02.dkfz.de/record/300296},
}