Quality Control Pipeline for Skeletal Muscle Energy Metabolism Assessed by ³¹P MRS in Patients with Muscle Weakness

Phosphorus magnetic resonance spectroscopy (<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">31</sup>P MRS) is a valuable noninvasive tool for assessing muscle metabolism. However, ensuring data quality remains a challenge due to variations in patient characteristics and experimental setups. This study assesses the applicability and transferability of the quality control score (QCS) developed by Naegel et al., using our dataset collected at the High-Field MR Center (HFMRC) in Vienna. A total of 124 datasets were included, comprising healthy controls, obese volunteers, and patient groups with muscle-related conditions. Dynamic <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">31</sup>P MRS spectra were acquired using <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">31</sup>P MRS each site, and metabolic parameters such as mitochondrial capacity (Qmax) and phosphocreatine (PCr) recovery time constants (τ) were analyzed. The original QCS-REF criteria based on Naegel et. al. proved inadequate, leading to the development of modified quality control thresholds (QCS1 and QCS2). These adjustments improved data classification, ensuring a more reliable assessment of muscle metabolism. The study highlights the need for adaptable QC parameters in <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">31</sup>P MRS research, particularly when applied across diverse patient populations and experimental settings. The modified QC thresholds enhance the robustness of muscle metabolism assessments, supporting their use in clinical diagnostics and research applications.