Abstract
In conventional magnetic resonance imaging (MRI) it is often difficult to delineate the border zone of gliomas. Proton magnetic resonance spectroscopic imaging (1H-MRSI) is a noninvasive tool for investigating the spatial distribution of metabolic changes in brain lesions. In this chapter we describe the improvements in delineation of gliomas based on segmentation of metabolic changes measured with 1H-MRSI. Metabolic maps for choline (Cho), N-acetyl-aspartate (NAA) and Cho/NAA ratios were calculated and segmented based on the assumption of Gaussian distribution of the Cho/NAA values for normal brain. Areas of hyperintensity on T2-weighted MR images were compared with the areas of the segmented tumour on Cho/NAA maps. Stereotactic biopsies were obtained from the MRSI/T2w difference areas. We found that the segmented MRSI tumour areas were greater than the T2w hyperintense areas on average by 20% (range 6–34%). In nearly half of the patients biopsy sampling from the MRSI/T2w difference areas showed tumour infiltration ranging from 4 to 17% (mean 9%) tumour cells in the areas detected only by MRSI. This method for automated segmentation of the lesions related metabolic changes achieves significantly improved delineation for gliomas compared clinical routine. In this chapter we demonstrate that this method can improve delineation of tumour borders compared to imaging strategies in clinical routine. Metabolic images of the segmented tumour may thus be helpful for therapeutic planning.
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Ganslandt, O., Stadlbauer, A. (2011). Infiltration Zone in Glioma: Proton Magnetic Resonance Spectroscopic Imaging. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 1. Tumors of the Central Nervous System, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0344-5_9
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DOI: https://doi.org/10.1007/978-94-007-0344-5_9
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