Journal of Neuro-Oncology

, Volume 87, Issue 2, pp 181–187

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

  • Remy Guillevin
  • Carole Menuel
  • Hugues Duffau
  • Michel Kujas
  • Laurent Capelle
  • Agnès Aubert
  • Sophie Taillibert
  • Ahmed Idbaih
  • Joan Pallud
  • Giovanni Demarco
  • Robert Costalat
  • Khê Hoang-Xuan
  • Jacques Chiras
  • Jean-Noel Vallée
Clinical-Patient Studies

DOI: 10.1007/s11060-007-9508-y

Cite this article as:
Guillevin, R., Menuel, C., Duffau, H. et al. J Neurooncol (2008) 87: 181. doi:10.1007/s11060-007-9508-y

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 (< 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.

Keywords

Magnetic resonance spectroscopy KI-67 labeling index Low-grade glioma 

Copyright information

© Springer Science+Business Media, LLC. 2007

Authors and Affiliations

  • Remy Guillevin
    • 1
    • 8
  • Carole Menuel
    • 1
  • Hugues Duffau
    • 2
    • 8
  • Michel Kujas
    • 3
  • Laurent Capelle
    • 4
    • 8
  • Agnès Aubert
    • 5
  • Sophie Taillibert
    • 6
  • Ahmed Idbaih
    • 6
  • Joan Pallud
    • 4
  • Giovanni Demarco
    • 7
  • Robert Costalat
    • 5
  • Khê Hoang-Xuan
    • 6
  • Jacques Chiras
    • 1
  • Jean-Noel Vallée
    • 7
  1. 1.Department of NeuroradiologyPitié Salpêtrière HospitalParisFrance
  2. 2.Department of NeurosurgeryCHU Gui de ChauliacMontpellierFrance
  3. 3.Department of PathologyPitié Salpêtrière HospitalParisFrance
  4. 4.Department of NeurosurgeryPitié Salpêtrière HospitalParisFrance
  5. 5.INSERM U678 Paris-6 UniversityParisFrance
  6. 6.Department of Neuro-oncologyPitié Salpêtrière HospitalParisFrance
  7. 7.Department of NeuroradiologyAmiens HospitalAmiensFrance
  8. 8.Laboratoire d’imagerie fonctionnelleINSERM U678 Paris-6 UniversityParisFrance