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Journal of Neuro-Oncology

, Volume 84, Issue 1, pp 63–69 | Cite as

Multivoxel 3D proton MR spectroscopy in the distinction of recurrent glioma from radiation injury

  • Qing-Shi ZengEmail author
  • Chuan-Fu Li
  • Kai Zhang
  • Hong Liu
  • Xiao-Shui Kang
  • Jun-Hui Zhen
Original Paper

Abstract

Objective

To explore the usefulness of multivoxel 3D proton MR spectroscopy (1H-MRS) in assessing the recurrent contrast-enhancing areas at the site of the previously treated gliomas.

Materials and methods

In 28 patients who had new contrast-enhancing lesions in the vicinity of the previously resected and irradiated high-grade glioma, 3D 1H-MRS examinations were performed on a 3.0T MR scanner. Spectral data for N-acetylaspartate (NAA), choline (Cho), and creatine (Cr) were analyzed in all patients. Receiver operating characteristic analysis was performed, and the threshold value for tumor differentiation was determined. Diagnosis of these lesions was assigned by means of histopathology and follow-up.

Results

Diagnostic-quality 3D 1H-MRS with quantifiable Cho, Cr, and NAA peaks was obtained in 92.9% of the cases. The Cho/NAA and Cho/Cr ratios were significantly higher in recurrent tumor than in radiation injury (P < 0.01), whereas the NAA/Cr ratios were lower in recurrent tumor than in radiation injury (P = 0.02). The Cho/Cr and Cho/NAA ratios were significantly higher in radiation injury than in normal-appearing white matter (P < 0.01), however, the NAA/Cr ratios were lower in radiation injury than in normal-appearing white matter (P = 0.01). Using receiver operating characteristic analysis, the resulting sensitivity, specificity and diagnostic accuracy of 3D 1H-MRS were 94.1%, 100%, and 96.2%, respectively, based on the cut-off values of 1.71 for Cho/Cr or 1.71 for Cho/NAA or both as tumor criterion.

Conclusion

3D 1H-MRS could differentiate recurrent tumor from radiation injury in patients with recurrent contrast-enhancing lesions in the vicinity of the previously treated gliomas.

Keywords

3D-MRS Brain Glioma Neoplasm recurrence Proton MRS 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Qing-Shi Zeng
    • 1
    Email author
  • Chuan-Fu Li
    • 1
  • Kai Zhang
    • 1
  • Hong Liu
    • 2
  • Xiao-Shui Kang
    • 1
  • Jun-Hui Zhen
    • 3
  1. 1.Department of RadiologyQilu Hospital of Shandong UniversityJinanChina
  2. 2.Department of RadiotherapyQilu Hospital of Shandong UniversityJinanChina
  3. 3.Department of PathologyQilu Hospital of Shandong UniversityJinanChina

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