Proton MR spectroscopy of cerebral gliomas at 3 T: spatial heterogeneity, and tumour grade and extent
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This study aimed to evaluate the usefulness of proton MR spectroscopic imaging (1H-MRSI) at 3 T in differentiating high- from low-grade gliomas, and tumour from necrosis, oedema or normal tissue. Forty-four patients with brain gliomas and four with meningiomas were retrospectively reviewed. The normalised metabolites choline (nCho), N-acetylaspartate (nNAA), creatine (nCr) and lactate/lipids (nLL), and the metabolite ratios Cho/NAA, NAA/Cr and Cho/Cr were calculated. Necrotic-appearing areas showed two spectroscopic patterns: “necrosis” with variable nCho and high nLL, and “cystic necrosis” with variable nLL or nonevident peaks. Peri-enhancing oedematous-appearing areas showed three spectroscopic patterns (“tumour” with abnormal Cho/NAA, “oedema” with normal Cho/NAA and “tumour/oedema” with normal nCho and abnormal Cho/NAA) in gliomas, and one (“oedema”) in meningiomas. Peri-enhancing or peri-tumour normal-appearing areas showed two patterns (“infiltrated” with abnormal nCho and/or Cho/NAA and “normal” with normal spectra) in gliomas and one (“normal”) in meningiomas. Discriminant analysis showed that classification accuracy between high- and low-grade glioma masses was better with normalised metabolites or all parameters together than metabolite ratios and that among peri-enhancing areas was much better with normalised metabolites. The analysis of spatial distribution of normalised metabolites by 3-T 1H-MRSI helps to discriminate among different tissues, offering information not available with conventional MRI.
KeywordsBrain tumour Magnetic resonance imaging Magnetic resonance spectroscopy
The authors are grateful to Italia Di Maggio, Giovanni Miscio and Piero Ghedin (GE Healthcare) for expert technical assistance.
- 6.Croteau D, Scarpace L, Hearshen D, Gutierrez J, Fisher JL, Rock JP, Mikkelsen T (2001) Correlation between magnetic resonance spectroscopy imaging and image-guided biopsies: semiquantitative and qualitative histopathological analyses of patients with untreated glioma. Neurosurgery 49:823–829PubMedCrossRefGoogle Scholar
- 7.Dowling C, Bollen AW, Noworolski SM, McDermott MW, Barbaro NM, Day MR, Henry RG, Chang SM, Dillon WP, Nelson SJ, Vigneron DB (2001) Preoperative proton MR spectroscopic imaging of brain tumors: correlation with histopathologic analysis of resection specimens. AJNR Am J Neuroradiol 22:604–612PubMedGoogle Scholar
- 13.Majós C, Alonso J, Aguilera C, Serrallonga M, Pérez-Martín J, Acebes JJ, Arús C, Gili J (2003) Proton magnetic resonance spectroscopy (1H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization. Eur Radiol 13:582–591PubMedGoogle Scholar
- 27.Yang D, Korogi Y, Sugahara T, Kitajima M, Shigematsu Y, Liang L, Ushio Y, Takahashi M (2002) Cerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar perfusion and diffusion-weighted MRI. Neuroradiology 44:656–666PubMedCrossRefGoogle Scholar
- 29.Di Costanzo A, Scarabino T, Trojsi F, Giannatempo GM, Popolizio T, Catapano D, Bonavita S, Maggialetti N, Tosetti M, Salvolini U, d’Angelo VA, Tedeschi G (2006) Multiparametric 3T MR approach to the assessment of cerebral gliomas: tumor extent and malignancy. Neuroradiology 48:622–631PubMedCrossRefGoogle Scholar
- 37.Bulakbasi N, Kocaoglu M, Örs F, Tayfun C, Üçöz T (2003) Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors. AJNR Am J Neuroradiol 23:225–233Google Scholar