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Neuroradiology

, Volume 50, Issue 9, pp 759–767 | Cite as

Prognostic value of choline and creatine in WHO grade II gliomas

  • Elke Hattingen
  • Peter Raab
  • Kea Franz
  • Heiner Lanfermann
  • Matthias Setzer
  • Rüdiger Gerlach
  • Friedhelm E. Zanella
  • Ulrich Pilatus
Diagnostic Neuroradiology

Abstract

Introduction

The purpose of this study was to evaluate whether proton magnetic resonance spectroscopy (1H-MRS) predicts survival time, tumor progression, and malignant transformation in patients with WHO grade II gliomas.

Materials and methods

1H-MRS and MR imaging (MRI) were performed before surgery in 45 patients with histologically proven WHO grade II gliomas. Metabolite concentrations of choline-containing compounds (Cho) and creatine/phosphocreatine (tCr) were normalized to contralateral brain tissue. Spectroscopic data as well as the extent of tumor resection, contrast enhancement, size and histopatholocical type of the tumor, age, sex, and first neurological symptoms of the patients were analyzed for survival, tumor progression, and malignant transformation for a follow-up period of 1 to 5 years.

Results

The normalized tCr of WHO grade II gliomas was a significant predictor for tumor progression (p = 0.011) and for malignant tumor transformation (p = 0.016). Further, contrast enhancement of the tumor (p = 0.014) at the time of diagnosis was significant for malignant tumor transformation and extent of tumor resection for the tumor progression (p = 0.007). All other parameters failed to predict any of the three endpoints.

Conclusion

Normalized values of tCr in WHO grade II gliomas may have prognostic implications for this group of gliomas. As a rule of the thumb, low-grade gliomas with decreased tCr (relative tCr values below 1.0) may show longer progression-free times and later malignant transformation than low-grade gliomas with regular or increased tCr values.

Keywords

1H-MR spectroscopy WHO grade II gliomas Creatine Choline Progression Malignant transformation 

Notes

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Elke Hattingen
    • 1
  • Peter Raab
    • 1
    • 3
  • Kea Franz
    • 2
  • Heiner Lanfermann
    • 3
  • Matthias Setzer
    • 2
  • Rüdiger Gerlach
    • 2
  • Friedhelm E. Zanella
    • 1
  • Ulrich Pilatus
    • 1
  1. 1.Institute of NeuroradiologyJohann Wolfgang Goethe University of Frankfurt/MainFrankfurt/MainGermany
  2. 2.Department of NeurosurgeryJohann Wolfgang Goethe University of Frankfurt/MainFrankfurt/MainGermany
  3. 3.Institute of NeuroradiologyMedizinische Hochschule Hannover (MHH)HannoverGermany

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