Paper Title
Characterization of Differential Metabolic Regions in People with Multiple Sclerosis using fast MRSI Techniques

Abstract
Multiple Sclerosis (MS), is a chronic neurodegenerative disease that relies heavily on the use of MRI in disease diagnosis and management, however, reliable markers of disease progression are still needed. The project aims to determine the precise biochemical nature of normal-appearing white matter (NAWM) and white matter lesions (WML) in people with MS (pwMS), compared to healthy controls (HCs). Hence, a novel pipeline for multi-dimensional metabolic mapping using fast MR Spectroscopic Imaging (MRSI) with differential metabolic regions (DMRs) techniques was designed.3D-fast MRSI was applied on a 3T MR scanner covering most of the brain in 16 pwMS and 13 HCs. Multi-sliceMRSI data was processed using a novel pipeline with DMRs classifications. Results from the neurometabolic mapping of DMRs showedthat N-acetylaspartate (NAA) in WML was significantly lower than in NAWM-MS and HCs,while themyo-inositol (m-Ins) levels from WMLwere significantly increased compared to NAWM in MS and HCs. FastMRSI coupled with DMRs in multi-slices mayenhance the clinical monitoring of pwMS. Keywords - Multiple Sclerosis, MRI, MRSI, Differential Metabolic Regions.