Original Paper

Child's Nervous System

, Volume 24, Issue 7, pp 807-813

First online:

Detection and characterization of neurotoxicity in cancer patients using proton MR spectroscopy

  • Emilie A. Steffen-SmithAffiliated withPediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health (NIH)
  • , Pamela L. WoltersAffiliated withPediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health (NIH)Medical Illness Counseling Center
  • , Paul S. AlbertAffiliated withBiometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health
  • , Eva H. BakerAffiliated withClinical Center, National Institutes of Health
  • , Kim C. ShimodaAffiliated withChildren’s National Medical Center
  • , Alan S. BarnettAffiliated withNational Institute of Mental Health, CBDB, National Institutes of Health
  • , Katherine E. WarrenAffiliated withPediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health (NIH)Pediatric Oncology Branch, National Cancer Institute Email author 

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Abstract

Objective

The study objective was to detect abnormalities and identify relationships between brain metabolic ratios determined by proton magnetic resonance spectroscopic imaging (1H-MRSI) and neuropsychological (NP) function in cancer patients at risk for neurotoxicity.

Methods

Thirty-two patients received 1H-MRSI using a multi-slice, multi-voxel technique on a 1.5T magnet. Cho/NAA, NAA/Cr, and Cho/Cr ratios were identified in seven pre-determined sites without tumor involvement. A battery of age-appropriate NP tests was administered within 7 days of imaging. Relationships were examined between test scores and metabolite ratios.

Conclusions

This study identifies relationships between brain metabolite ratios and cognitive functioning in cancer patients. 1H-MRSI may be useful in early detection of neurotoxic effects, but prospective longitudinal studies in a homogeneous population are recommended to determine the prognostic value.

Keywords

MRI MRS Primary brain tumor Pediatric Neuropsychological assessment