Abstract
Purpose
Desmoplastic infantile gangliogliomas (DIG) are rare benign intracranial neoplasms of early childhood with involvement of superficial cerebral cortex and leptomeninges. The purpose of the study was to determine the alterations in metabolite ratios occurring in the neoplasm and combine with magnetic resonance (MR) imaging features to narrow down the diagnosis.
Methods
MR imaging sequences include T1- and T2-weighted sequences, fluid-attenuated inversion recovery sequences, and post-gadolinium-contrast T1-weighted imaging. Single-voxel short TE 1H MR spectroscopy was used to study the changes in metabolite ratios in the tumor.
Results
Comparison of metabolite ratios between normal brain tissue and tumor-affected region showed lower N-acetyl aspartate to creatine (Cr; 1.58 vs.1.28), higher choline to Cr (0.82 vs.2.03), and no significant change in myo-inositol to Cr (0.42 vs.0.39).
Conclusion
MR spectroscopy and imaging provide valuable information in the diagnosis of DIG.
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References
Berridge MJ (1987) Inositol lipids and cell proliferation. Biochim Biophys Acta 907:33–45
Cepeda C, Andre VM, Flores-Hernandez J, Nguyen OK, Wu N, Klapstein GJ, Nguyen S, Koh S, Vinters HV, Levine MS, Mathern GW (2005) Pediatric cortical dysplasia: correlations between neuroimaging and electrophysiology and location of cytomegalic neurons and balloon cells, and glutamate/GABA synaptic circuits. Dev neurosci 27:59–76
Cheng LL, Chang IW, Louis DN, Gonzalez RG (1998) Correlation of high-resolution magic angle spinning proton magnetic resonance spectroscopy with histopathology of intact human brain tumor specimen. Cancer Research 58:1825–1832
Duffner PK, Burger PC, Cohen ME, Stanford RA, Krischer JP, Elterman R, Aronin PA, Pullen J, Horowitz ME, Parent A, Martin P, Kun LE (1994) Desmoplastic infantile ganglioglioma: an approach to therapy. Neurosurgery 34:583–589
Ganesan K, Desai S, Udwadia-Hegde A (2006) Non-infantile variant of desmoplastic ganglioglioma: a report of 2 cases. Pediatr Radiol 36:541–545
Jackson EF, Doyle TJ, Wolinsky JS, Narayana PA (1994) Short TE hydrogen-1 spectroscopic MR imaging of normal human brain: reproducibility studies. J Magn Reson Imaging 4:545–551
Kesavadas C, Sonwalker H, Thomas B, Gupta AK, Radhakrishnan VV (2005) Atypical MRI appearance of desmoplastic infantile ganglioglioma. Pediatr Radiol 35:1024–1026
Koeller KK, Henry JM (2001) Superficial gliomas: radiologic–pathologic correlation. Radiographics 21:1533–1536
Kuchelmeister K, Bergmann M, von Wild K, Hochreuther D, Bush G, Gullota F (1993) Desmoplastic ganglioglioma: report of two non-infantile cases. Acta Neuropathol 85:199–204
Negendank W (1992) Studies of human tumors by MRS: a review. NMR Biomed 5:303–324
Norfray JF, Tomita T, Byrd SE, Ross BD, Berger PA, Miller RS (1999) Clinical impact of MR spectroscopy when MR imaging is indeterminate for pediatric brain tumors. AJR 173:119–125
Pommepuy I, Delage-Corre M, Moreau JJ, Labrousse F (2006) A report of a desmoplastic ganglioglioma in a 12-year-old girl with review of the literature. J Neurooncol 76:271–275
Raybaud C, Shroff M, Rutka JT, Chuang SH (2006) Imaging surgical epilepsy in children. Childs Nerv Syst 22:786–809
Ross BD (1991) Biochemical considerations in IH spectroscopy: glutamate and glutamine: myo-inositol and related metabolites. NMR Biomed 4:59–63
Ross B, Michaelis T (1994) Clinical application of magnetic resonance spectroscopy. Magn Reson Q 10:191–247
Ruiz-Cabello J, Cohen JS (1992) Phospholipid metabolites as indicators of cancer cell function. NMR Biomed 5:226–233
Salamon N, Andres M, Chute DJ, Nguyen ST, Chang JW, Huynh MN, Chandra PS, Andre VM, Cepeda C, Levine MS, Leite JP, Neder L, Vinters HV, Mathern GW (2006) Contralateral hemimicrencephaly and clinical–pathological correlations in children with hemimegalencephaly. Brain 129:352–365
Sutton LN, Wang Z, Gusnard D, Lange B, Perilongo G, Bogdan AR, Detre JA, Rorke L, Zimmerman RA (1992) Proton magnetic resonance spectroscopy of pediatric brain tumor. Neurosurgery 31:195–202
Tamburrini G, Colosimo C Jr, Giangaspero F, Riccardi R, Di Ricco C (2003) Desmoplastic infantile ganglioglioma. Childs Nerv Syst 19:292–297
Trehan G, Bruge H, Vinchon M, Khalil C, Ruchoux MM, Dhellemmes P, Ares GS (2004) MR imaging in the diagnosis of desmoplastic infantile tumor: retrospective study of six cases. AJNR Am J Neuroradiol 25:1028–1033
Vandenberg SR, Estelle EM, Rubinstein LJ (1987) Desmoplastic supratentorial intraepithelial tumors of infancy with divergent differentiation potential (desmoplastic infantile gangliogliomas). Report of 11 cases of a distinctive embryonal tumor with favorable prognosis. J Neurosurg 66:58–71
van Zihl PCM, Barker PB (1997) Magnetic resonance spectroscopy and spectroscopic imaging for the study of brain metabolism. Ann N Y Acad Sci 820:75–96
Wang Z, Sutton LN, Cnaan A, Haselgrove JC, Rorke LB, Zhao H, Bilaniuk LT, Zimmerman RA (1995) Proton MR spectroscopy of pediatric cerebellar tumors. AJNR Am J Neuroradiol 16:1821–1833
Woesler B, Kuwert T, Kurlemann G, Morgenroth C, Probst-Cousin S, Lerch H, Gullotta F, Wassmann H, Schober O (1998) High amino acid uptake in a low-grade desmoplastic infantile ganglioglioma in a 14-year-old patient. Neurosurg Rev 21:31–35
Acknowledgment
The authors would like to acknowledge Dr. M. Kanakavel, Phd, Senior NMR Consultant for his valuable inputs.
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Balaji, R., Ramachandran, K. Imaging of desmoplastic infantile ganglioglioma: a spectroscopic viewpoint. Childs Nerv Syst 25, 497–501 (2009). https://doi.org/10.1007/s00381-008-0786-2
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DOI: https://doi.org/10.1007/s00381-008-0786-2