NMR Beginning was the beginning of MRI spectroscopy and is at the origin of using magnetic resonance for human and animal imaging purposes.
Two pioneering researchers in the 1940’s, one at each end of the United States, were doing research on different chemical elements and how those chemical frequencies had a signal that registered in measurement pertaining to each chemical component.
Dr. Edward Purcell (at Harvard University in Cambridge, Massachusetts) observed H1 NMR in paraffin wax at 30MHz while Dr. Felix Bloch (at Stanford University in California) observed NMR in water at 8 MHz. They both won the Nobel Prize for Physics in 1952.
From this discovery, came the idea for imaging hydrogen protons in biological tissue through use of this same technology, with the exception that using this technique on a human body, would have to be done significantly on a larger scale. Consequently, MRI spectroscopy, when done correctly, does not only isolate a single chemical type, but also multiples, depending upon the type of signal generated, the particular TE (echo time) used, among other factors. The indication for cancerous signal can be determined in many instances without any biological invasiveness, such as with a needle biopsy requires. Ten years ago, it was the preferred procedure at some pediatric institutions for determining whether children had a benign or malignant brain tumor, as this procedure done correctly, could sometimes avoid biopsying the child.
Initially, hydrogen MRI spectroscopy was predominantly used for brain tissue, but has expanded to use in many other parts of the body as Phosphorus 31 Spectroscopy or other types of signal measurement. While an image is technically not gathered during the actual MRI spectroscopy process, data from the culmination of chemical types is gathered. The particular peaks of certain chemicals indicate to MRI experts whether a tissue type could contain carcinogenic cells or not, as cancer has a particular chemical marker (namely Choline) that indicates when cells are in angiogenesis, the indication the cells are splitting and dividing while they are constantly growing.
In this image, the two peaks on the left are Choline and Creatine respectively, with NAA (N-Acetyl Alcohol) being the highest peak.
While CMS denied submitting any payable code for Medicare reimbursement, some centers (although rare) still utilize MRI Spectroscopy in the brain, breast and/or prostate to help determine tissue types for cancerous signal.
Performing MRI Spectroscopy has its many challenges, for consistency, successful dependable results, and an accurate outcome.
If you were to ask a patient if they would rather a signal that measures for tissue characterization, or an invasive needle biopsy, most would answer the non-invasive MRI Spectroscopy. Unfortunately, due to the rareness with which this procedure is performed, and to the lack of MRI technology skill sets in many locations that can perform this exam, it seems to be trending toward a lost practice.
NMR is the abbreviation for nuclear magnetic resonance. The term “nuclear” can be easily misinterpreted by the general public, so for marketing purposes, the term MRI (magnetic resonance imaging) replaced NMR.
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