Quantification of glutathione in the human brain by MR spectroscopy at 3 Tesla: Comparison of PRESS and MEGA‐PRESS

PURPOSE Glutathione (GSH) is an important intracellular antioxidant in the brain. A number of studies report its measurement by localized 1 H spectroscopy using PRESS and STEAM. This study evaluates the reliability and accuracy of GSH measurements from PRESS at 3 Tesla (T) and compares the results to those obtained with MEGA-PRESS. METHODS Phantoms containing brain metabolites, identical except for variable GSH concentration between 0 and 24 mM, were scanned using PRESS (echo time (TE) = 35 ms) and MEGA-PRESS (optimized TE = 130 ms) at 3 T. Spectra of the anterior cingulate cortex and occipital cortex in seven healthy volunteers were also acquired. RESULTS Phantom GSH concentrations from 0 to 3mM were unreliably quantified using PRESS, although at 4 mM and above there was a linear relationship between measured and true concentrations (R2  = 0.99). Using MEGA-PRESS, there was no signal detected at 0 mM GSH, plus a linear relationship (R2  = 0.99) over the full range from 0-24 mM. In brain, concentrations calculated from MEGA-PRESS and PRESS were significantly different in occipital cortex (P < 0.001). Moreover, only MEGA-PRESS reported significant differences in GSH between the two brain regions (P = 0.003). CONCLUSION Due to uncertainties in GSH quantification raised by the study, the authors conclude that physiological concentrations (<4 mM) of GSH cannot be reliably quantified from PRESS (TE = 35 ms) spectra at 3 T. Magn Reson Med 78:1257-1266, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.