Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy
Autor: | Vladimír Beneš, Jiri Vrana, Petr Hrabal, Filip Jiru, Daniel Horinek, Filip Kramar, Ondrej Bradac, Patricia de Lacy, David Netuka |
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Rok vydání: | 2014 |
Předmět: |
In vivo magnetic resonance spectroscopy
Adult Pathology medicine.medical_specialty Stereotactic biopsy Magnetic Resonance Spectroscopy Biopsy Creatine chemistry.chemical_compound Glioma medicine Choline Humans Aged medicine.diagnostic_test business.industry Brain Neoplasms Brain biopsy Histology General Medicine Middle Aged medicine.disease chemistry Surgery Neurology (clinical) Neoplasm Grading Nuclear medicine business |
Zdroj: | British journal of neurosurgery. 28(5) |
ISSN: | 1360-046X |
Popis: | The recognition of anaplastic foci within low-grade gliomas is of extreme importance in patients under follow-up for Grade II gliomas. We present the algorithm of MR spectroscopy (MRS)-guided brain biopsy and its correlation with tumour histology.Twenty-seven patients harbouring suspected Grade II/III glioma were examined on our 3T MR. 2D PRESS-CSI metabolite images of Choline/Creatine, Creatine/N-acetylaspartate and Choline/N-acetylaspartate were calculated and exported to the DICOM format. According to these maps, a stereobiopsy was performed at the point of maximum Choline/Creatine ratio prior to tumour resection. In the case of enhancing tumour, a subsequent biopsy was performed from the point of enhancement. Comparisons were made between the histology of the biopsied specimens and the resected tumours.Eleven tumours were diagnosed as high-grade and sixteen as low-grade lesions. The correlation between main spectroscopic ratios (Cho/Cr and Cho/NAA) was strongly positive at the points of maximum Cho/Cr. Similar results were obtained at the points of contrast enhancement. Comparison of histological parameters of biopsy samples at the points of maximum Cho/Cr and histological examination of the completely resected tumours gives a strong correlation of tumour grade, number of mitoses and Ki-67 expression. The diagnostic accuracy of MRS-guided biopsy was 84%. The absolute value of Cho/NAA was higher in high-grade compared to that of low-grade lesions. The value of Cho/NAA ratio of 0.9 using MRS produced a sensitivity and specificity of 78% in the differentiation between low-grade and high-grade lesions. Combining MRS with structural MR, the sensitivity increased to 86% and the specificity to 80%.Strong correlation was demonstrated between Cho/Cr and Ch/NAA ratios. Strong correlation was demonstrated between histological parameters of biopsy samples taken using Cho/Cr ratio and those from total tumour examination. Diagnostic accuracy of MRS-guided biopsy was 84%. Sensitivity and specificity of MRS combined with structural MR reaches 86% and 80%. |
Databáze: | OpenAIRE |
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