Human cardiac high-energy phosphate metabolite concentrations by 1D-resolved NMR spectroscopy

We have developed a method that can measure high-energy phosphate metabolite concentrations in humans with 1D resolved surface-coil NMR spectroscopy. The metabolites are measured by phosphorus (31P) NMR spectroscopy, and the tissue water proton (1H) resonance from the same volume serves as an internal concentration reference. The method requires only the additional acquisition of a 1H data set, and a simple calibration, performed separately, to determine the ratio of the signal per proton to the signal per phosphorus nucleus. The quantification method is particularly useful for human cardiac spectroscopy, where it eliminates image-based tissue volumetry and the corrections for signal sensitivity and phase nonuniformity necessary in prior approaches. Corrections are introduced to account for blood and fat contributions to the spectra. The method was validated on phantoms of phosphate of varying concentrations and on the human calf muscle. In calf, the adenosine triphosphate (ATP) and phosphocreatine (PCr) concentrations were 5.6 +/- 1.6 (mean +/- SD) and 26 +/- 4 mmol/kg wet wt, respectively. In normal heart, [ATP] was 5.8 +/- 1.6 and [PCr] was 10 +/- 2 mmol/kg wet wt. These values are in excellent agreement with prior NMR studies and biopsy data. The protocol is easily accommodated within existing 1D cardiac patient protocols, and the same approach is advantageous for eliminating tissue volumetry and sensitivity corrections when measuring concentrations by 2D and 3D resolved spectroscopy.