Gradient Scheme Optimization for PRESS-Localized Edited MRS Using Weighted Pathway Suppression

This study aimed to design and implement an optimized gradient scheme for PRESS-localized edited magnetic resonance spectroscopy (MRS) to enhance suppression of out-of-voxel (OOV) artifacts. These artifacts, which originate from insufficient crushing of unwanted coherence transfer pathways (CTPs), are particularly challenging in editing schemes for metabolites like gamma-aminobutyric acid and glutathione. To address this, a volume-based likelihood model was developed to guide gradient scheme optimization, prioritizing suppression of CTPs based on likelihood. The volume-based likelihood model for CTP weighting was integrated into a Dephasing optimization through coherence order pathway selection (DOTCOPS) gradient optimization. Using a genetic algorithm with a weighted dual-penalty cost function, gradient schemes were optimized to maximize pathway-specific suppression. Hardware and sequence constraints, maximum gradient amplitudes and delay durations respectively, informed the optimization. Validation of the optimized scheme was performed with simulations by calculating the k-space crushing efficiency analytically with k-space trajectory and in vivo using an edited MRS sequence in three brain regions (posterior cingulate cortex PCC, thalamus, and medial prefrontal cortex [mPFC]), with particular focus on OOV artifact reduction and spectral quality improvements. A three-way Analysis of Variance was used to assess the significance level of OOV artifact reduction. The optimized gradient scheme demonstrated improved k-space crushing efficiency (by an average of 197%). OOV artifacts were reduced in all brain regions, particularly in highly OOV-susceptible regions (thalamus and mPFC). Improvements were most notable around 4.3 ppm with significant OOV artifact amplitude reductions (p < 0.001). By using a volume-based likelihood model for CTP prioritization, the optimized DOTCOPS scheme ensures robust and region-agnostic performance in reducing OOV artifacts.