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Follow-up gliomas after radiotherapy: 1H MR spectroscopic imaging for increasing diagnostic accuracy

  • Diagnostic Neuroradiology
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Abstract

We evaluated the value of magnetic resonance imaging (MRI) and the additional benefit of proton MR spectroscopic imaging (1H SI) in patients with a new suspicious lesion after fractionated stereotactic radiotherapy (FSRT) of a glioma. Thirty-four patients with histologically proven astrocytoma WHO II–IV after treatment by FSRT and a new suspect lesion in the follow-up were included in this study. Data were analysed by three independent radiologists with different experience in 1H SI: Data were verified by clinical follow-up (PT, progressive tumour; nPT, non-progressive tumour) and a kappa analysis was performed. Sensitivity and specificity of T1 weighted (w) and T2w MRI was compared (imaging at radiotherapy and follow-up) using further follow-up controls as gold standard and the additional benefit of 1H SI (imaging at follow-up) was calculated. Mean interval between last irradiation and detection of a suspicious lesion was 37 ± 32 months. Time to clinical evaluation was 13 ± 8 months. Interobserver agreement was significantly high in all analyses (kappa always >0.8, P < 0.05). T2w imaging proved to be superior to contrast enhanced T1w imaging in sensitivity (87.5 vs 81.25%) and specificity (85.7 vs 57.1%). Solitary 1H SI had similar results as T2w (sensitivity 87.5%, specificity 71.4%). Taking all techniques into account, all PT were correctly diagnosed. Radiologists’ experience had no significant influence on correct interpretation of a suspicious lesion. We conclude that 1H SI is helpful in characterising new suspicious lesions in irradiated gliomas, particularly if pre-MRI is not available for evaluating follow-up.

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Authors and Affiliations

  1. Department of Radiology, German Cancer Research Center, Heidelberg, Germany

    Matthias Philipp Lichy, Christian Plathow & Hans-Ulrich Kauczor

  2. Department of Radiation Therapy, University of Heidelberg, Heidelberg, Germany

    Daniela Schulz-Ertner

  3. Department of Diagnostic Radiology, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen, Germany

    Matthias Philipp Lichy, Christian Plathow & Heinz-Peter Schlemmer

Authors
  1. Matthias Philipp Lichy
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  2. Christian Plathow
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  3. Daniela Schulz-Ertner
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  4. Hans-Ulrich Kauczor
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  5. Heinz-Peter Schlemmer
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Correspondence to Matthias Philipp Lichy.

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Matthias Philipp Lichy and Christian Plathow contributed equally to this work

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Lichy, M.P., Plathow, C., Schulz-Ertner, D. et al. Follow-up gliomas after radiotherapy: 1H MR spectroscopic imaging for increasing diagnostic accuracy. Neuroradiology 47, 826–834 (2005). https://doi.org/10.1007/s00234-005-1434-0

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  • DOI: https://doi.org/10.1007/s00234-005-1434-0

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