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Proton magnetic resonance spectroscopy predicts proliferative activity in diffuse low-grade gliomas

  • Clinical-Patient Studies
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Abstract

The aim of the study was to investigate the ability of 1HMRS to reflect proliferative activity of diffuse low-grade gliomas (WHO grade II). Between November 2002 and March 2007, a prospective study was performed on consecutive patients with suspected supratentorial hemispheric diffuse low-grade tumors. All the patients underwent MR examination using uniform procedures, and then surgical resection or biopsy within 2 weeks of the MR examination. Proliferative activity of the tumors was assessed by Ki-67 immunochemistry (Mb-1) on paraffin embedded tumor sections. Spectroscopic data was compared with Ki-67 labeling index and other histologic data such as histological subtype, cellular atypia, cellular density using univariate and multivariate analysis. 82 of 97 consecutive patients had histologically confirmed WHO grade 2 gliomas. Ki-67 proliferation index (PI) was correlated with specific spectral patterns: (1) low PI (<4%) was associated with increased Cho/Cr and absence of both free lipids or lactates; (2) intermediate PI (4–8%) was associated with resonance of lactates; and (3) high PI (>8%) was characterized by a resonance of free lipids. On multivariate analysis, resonance of lactates and resonance of free lipids appeared as independent predictors of intermediate PI (P < 0.001) and high PI (P < 0.001), respectively; moreover, free lipids resonance was correlated with cellular atypia (P < 0.05). This study suggests that 1HMRS is a reliable tool to evaluate the proliferation activity of WHO grade 2 glioma and to identify potentially more aggressive clinical behavior.

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Authors and Affiliations

  1. Department of Neuroradiology, Pitié Salpêtrière Hospital, 47-83 boulevard de l’hôpital, 75651, Paris, France

    Remy Guillevin, Carole Menuel & Jacques Chiras

  2. Department of Neurosurgery, CHU Gui de Chauliac, Montpellier, France

    Hugues Duffau

  3. Department of Pathology, Pitié Salpêtrière Hospital, Paris, France

    Michel Kujas

  4. Department of Neurosurgery, Pitié Salpêtrière Hospital, Paris, France

    Laurent Capelle & Joan Pallud

  5. INSERM U678 Paris-6 University, Paris, France

    Agnès Aubert & Robert Costalat

  6. Department of Neuro-oncology, Pitié Salpêtrière Hospital, Paris, France

    Sophie Taillibert, Ahmed Idbaih & Khê Hoang-Xuan

  7. Department of Neuroradiology, Amiens Hospital, Amiens, France

    Giovanni Demarco & Jean-Noel Vallée

  8. Laboratoire d’imagerie fonctionnelle, INSERM U678 Paris-6 University, Paris, France

    Remy Guillevin, Hugues Duffau & Laurent Capelle

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  1. Remy Guillevin
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  2. Carole Menuel
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Correspondence to Remy Guillevin.

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Guillevin, R., Menuel, C., Duffau, H. et al. Proton magnetic resonance spectroscopy predicts proliferative activity in diffuse low-grade gliomas. J Neurooncol 87, 181–187 (2008). https://doi.org/10.1007/s11060-007-9508-y

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  • DOI: https://doi.org/10.1007/s11060-007-9508-y

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