Author/Editor     Negendank, William G; Sauter, Rolf; Brown, Truman R; Evelhoch, Jeffrey L; Falini, Andrea; Gotsis, Efstathios D; Heerschap, Arend; Kamada, Kyousuke; Lee, Benjamin C; Gomišček, G
Title     Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study
Type     članek
Source     J Neurosurg
Vol. and No.     Letnik 84, št. 3
Publication year     1996
Volume     str. 449-58
Language     eng
Abstract     The authors represent a cooperative group of 15 institutions that examined the feasibility of using metabolic features observed in vivo with 1H-magnetic resonance (MR) spectroscopy to characterize brain tumors of the glial type. The institutions provided blinded, centralized MR spectroscopy data processing long with independent central review of MR spectroscopy voxel placement, composition and contamination by brain, histopathological typing using current World Health Organization criteria, and clinical data. Proton 1H-MR spectroscopy was performed using a spin-echo technique to obtain spectra from 8-cc voxels in the tumor and when feasible in the contralateral brain. Eighty-six cases were assessable, 41 of which had contralateral brain spectra. Glial tumors had significantly elevated intensities of choline signals, decreased intensities of creatine signals, and decreased intensities of N-acetylaspartate compared to brain. Choline signal intensities were highest in astrocytomas and anaplastic astrocytomas, and creatine signal intensities were lowest in glioblastomas. However, whether expressed relative to brain or as intratumoral ratios, these metabolic characteristics exhibited large variations within each subtype of glial tumor. The resulting overlaps precluded diagnostic accuracy in the distinction of low-and high-grade tumors. Although the extent of contamination of the 1H-MR spectroscopy voxel by brain had a marked effect on metabolite concentrations and ratios, selection of cases with minimal contamination did not reduce these overlaps. Thus, each type and grade of tumor is a metabolically hetero-geneous group. Lactate occurred infrequently and in all grades. Mobile lipids, on the other hand, occurred in 41 percent of high-grade tumors with higher mean amounts found in glioblastomas.(trunc.)
Descriptors     BRAIN NEOPLASMS
GLIOMA
ADOLESCENCE
ADULT
AGED
ANALYSIS OF VARIANCE
ASTROCYTOMA
BRAIN
CHILD
CHILD, PRESCHOOL
CHOLINE
CREATINE
FEASIBILITY STUDIES
GLIOBLASTOMA
MIDDLE AGE
NUCLEAR MAGNETIC RESONANCE
PROTONS