Quantitation of proton NMR spectra of the human brain using tissue water as an internal concentration reference

The use of cerebral water as an internal intensity standard for the quantitation of spatially localized proton spectra of the human brain is investigated. The method is validated on standard samples of N-acetyl aspartate (NAA) and lactate, and possible sources of error are discussed. Using the STEAM pulse sequence, concentrations of choline, creatine and NAA in frontal lobe white matter are found to be 1.9 +/- 0.5, 10.6 +/- 1.3 and 16.6 +/- 2.3 mumol/g wet wt, respectively, in 10 normal volunteers. In the thalamus, the concentrations are 2.0 +/- 0.4, 11.6 +/- 2.0 and 17.2 +/- 1.3 mumol/g wet wt, respectively. Choline and creatine concentrations are in good agreement with conventional biochemical values: NAA concentrations are found to be three-fold higher, suggesting overlap of the NAA signal with other compounds. Quantitation relative to tissue water is a convenient and rapid means of quantitating proton spectra of the human brain.