In Vivo 3-T MR Spectroscopy in the Distinction of Recurrent Glioma versus Radiation Effects: Initial Experience
| Autor: | John W. Henson, Allan F. Thornton, G. Rees Cosgrove, David N. Louis, E. Antonio Chiocca, Patricia Lani Lee, James D. Rabinov, Jay S. Loeffler, Fred G. Barker, R. Gilberto Gonzalez, Griffith R. Harsh |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male In vivo magnetic resonance spectroscopy medicine.medical_specialty Magnetic Resonance Spectroscopy Stereotactic biopsy Biopsy medicine.medical_treatment Astrocytoma Recurrent Glioma Choline Diagnosis Differential Biopsy Site Glioma Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies medicine.diagnostic_test Brain Neoplasms business.industry Brain biopsy Brain Middle Aged medicine.disease Radiation therapy Female Radiology Neoplasm Recurrence Local Glioblastoma business |
| Zdroj: | Radiology. 225:871-879 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2253010997 |
| Popis: | To determine if 3-T magnetic resonance (MR) spectroscopy allows accurate distinction of recurrent tumor from radiation effects in patients with gliomas of grade II or higher.This blinded prospective study included 14 patients who underwent in vivo 3-T MR spectroscopy prior to stereotactic biopsy. All patients received a previous diagnosis of glioma (grade II or higher) and high-dose radiation therapy (54 Gy). Prior to MR spectroscopy, conventional MR imaging was performed at 1.5 T to identify a gadolinium-enhanced region within the irradiated volume. Diagnosis was assigned by means of histopathologic analysis of the biopsy samples.Sixteen of 17 biopsy locations could be classified as predominantly tumor or predominantly radiation effect on the basis of the ratio of choline at the biopsy site to normal creatine level by using a value greater than 1.3 as the criterion for tumor. The remaining case, classified as recurrent tumor on the basis of MR spectroscopy results, was diagnosed as predominantly radiation effect on the basis of histopathologic findings. Disease in this patient progressed to biopsy-proven recurrence within 3 months. Overall, the ratio of choline at the biopsy site to normal creatine level was significantly elevated (unpaired two-tailed Student t test, P.002) in those biopsy samples composed predominantly of tumor (n = 9) compared with those containing predominantly radiation effects (n = 8). The ratio was not significantly different between the two histopathologic groups.In vivo 3-T MR spectroscopy has sufficient spatial resolution and chemical specificity to allow distinction of recurrent tumor from radiation effects in patients with treated gliomas. |
| Databáze: | OpenAIRE |
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