Child's Nervous System

, Volume 24, Issue 7, pp 807–813

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

  • Emilie A. Steffen-Smith
  • Pamela L. Wolters
  • Paul S. Albert
  • Eva H. Baker
  • Kim C. Shimoda
  • Alan S. Barnett
  • Katherine E. Warren
Original Paper



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.


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.


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.


MRI MRS Primary brain tumor Pediatric Neuropsychological assessment 


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Emilie A. Steffen-Smith
    • 1
  • Pamela L. Wolters
    • 1
    • 2
  • Paul S. Albert
    • 3
  • Eva H. Baker
    • 4
  • Kim C. Shimoda
    • 5
  • Alan S. Barnett
    • 6
  • Katherine E. Warren
    • 1
    • 7
  1. 1.Pediatric Oncology Branch, National Cancer Institute, Center for Cancer ResearchNational Institutes of Health (NIH)BethesdaUSA
  2. 2.Medical Illness Counseling CenterChevy ChaseUSA
  3. 3.Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer InstituteNational Institutes of HealthBethesdaUSA
  4. 4.Clinical CenterNational Institutes of HealthBethesdaUSA
  5. 5.Children’s National Medical CenterWashingtonUSA
  6. 6.National Institute of Mental Health, CBDBNational Institutes of HealthBethesdaUSA
  7. 7.Pediatric Oncology BranchNational Cancer InstituteBethesdaUSA

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