1h-mr spectroscopy of normal brain tissue before and after postoperative radiotherapy because of primary brain tumors

Rutkowski, T.; Tarnawski, Rafał; Sokół, Maria; Maciejewski, B.

doi:10.1016/s0360-3016(03)00327-4

Cited by 33 publications

(36 citation statements)

References 16 publications

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“…[41][42][43]47,48,50,51,59 Measurements of Metabolites and Ratio Calculations One of the major problems when reviewing the literature and comparing existing MR spectroscopy data is the use of various ways of calculating metabolite ratios. Several different methods have been used when trying to differentiate recurrent tumor from radiation-induced injury, and there is currently no consensus in the literature on which type of differently calculated ratios can best differentiate tumor recurrence from radiation change.…”

Section: Mr Spectroscopy In Radiation Injurymentioning

confidence: 99%

MR Spectroscopy in Radiation Injury

Sundgren¹

2009

AJNR Am J Neuroradiol

117

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SUMMARY:Detecting a new area of contrast enhancement in or in the vicinity of a previously treated brain tumor always causes concern for both the patient and the physician. The question that immediately arises is whether this new lesion is recurrent tumor or a treatment effect. The differentiation of recurrent tumor or progressive tumor from radiation injury after radiation therapy is often a radiologic dilemma regardless the technique used, CT or MR imaging. The purpose of this article was to review the utility of one of the newer MR imaging techniques, MR spectroscopy, to distinguish recurrent tumor from radiation necrosis or radiation injury. N ew contrast enhancing lesions discovered on routine follow-up brain imaging at or near the site of previously treated primary brain tumor present a diagnostic dilemma. Posttreatment imaging features are often non-specific and the differentiation between recurrent tumor and radiation injury is often difficult. In attempts by investigators to improve local tumor control and the overall clinical outcome and survival for patients with primary brain tumor, new, more aggressive treatment protocols are implemented or tested. These protocols include different schemes of dosages of various chemotherapeutic agents but also different schemes of locally administered high doses of radiation.Although these new radiation schemes have resulted in improved outcome, they have also been associated with a significant incidence of radiation injury to the brain. It is well documented that there is a relationship between increased survival and increased total dose. 1 The risk of late effects that can lead to devastating functional deficits several months to years after brain irradiation limits the total dose that can safely be administrated to patients. Recent data suggest that progressive dementia occurs in approximately 20%-50% of patients with brain tumor who are long-term survivors after treatment with large-field partial-or whole-brain irradiation. 2The differentiation of recurrent tumor or progressive tumor from radiation injury after radiation therapy is often a radiologic dilemma, regardless of the technique used, CT or MR imaging. Most of these brain neoplasms have been subjected to radiation and/or chemotherapy, and many of the tumors do not have specific imaging characteristics that will enable the neuroradiologist to discriminate tumor recurrence from the inflammatory or necrotic change that can result from treatment with radiation and/or chemotherapy. Both entities typically demonstrate contrast enhancement. It is, therefore, often the clinical course, a brain biopsy, or imaging over a lengthy follow-up interval that enables the distinction of recurrent tumor from a treatment-related lesion, not the specific imaging itself.3 A noninvasive tool that could differentiate these entities when a new enhancing lesion is first identified would be invaluable. MR spectroscopy might be well suited for this purpose, provided that spectra of diagnostic quality can be obtained. This noninvasi...

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Section: Mr Spectroscopy In Radiation Injurymentioning

confidence: 99%

MR Spectroscopy in Radiation Injury

Sundgren¹

2009

AJNR Am J Neuroradiol

117

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“…Chan et al[ 29] showed a difference between NAA/Cho after radiotherapy and NAA/Cho of the tumour. Many other authors found a trend, which, however, was not statistically significant [12, 13, 16, 29, 30]. …”

Section: Discussionmentioning

confidence: 87%

“…Using long-echo single-voxel spectroscopy, there was a correlation between Cho/Cr and tumour grade [33]. However, others found no correlation between Cho and Cho/Cr and tumour grade [12, 19, 30, 36, 39,46,47,48,49]. In this study, Cho alone in 14/17 voxels was stable in groups A and C, and only showed changes in 1/18 voxels in the combined groups B and D (the groups where progression must be visible).…”

Section: Discussionmentioning

confidence: 99%

“…Comparing cerebral tumours, various authors observed a diminution of the ratio Myo/Cr with an augmentation of the tumour grade [5, 33, 52, 56]. There have been contradictory results, showing an increase in Myo or Myo/Cr with an augmentation of the tumour grade, but without a significant correlation [19, 20, 30]. In particular, Fountas et al [17] found inconstant variations of Myo values, and were not able to reproduce the results of Castillo et al [5].…”

Section: Discussionmentioning

confidence: 99%

“…Many authors find it constant throughout tumour grades [19, 30, 33, 57, 58], and even after radiotherapy [26], using it sometimes as a denominator in different ratios (NAA/Cr, Cho/Cr, Myo/Cr). Tartaglia et al [34 ]also found stability of Cr in multiple sclerosis lesions.…”

Section: Discussionmentioning

confidence: 99%

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Monovoxel <sup>1</sup>H Magnetic Resonance Spectroscopy in the Progression of Gliomas

et al. 2007

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Aim: Can monovoxel magnetic resonance spectroscopy (MRS) reliably follow tumour progression in low-grade glioma? Materials and Methods: 21 patients with low-grade glioma underwent at least 3 MRS. Results: For progression from a grade II to grade III tumour, a sensitivity of 57.1% and specificity of 60% were observed, with a positive predictive value (PPV) of 48.8% and a negative predictive value (NPV) of 54.5%. For progression under treatment, we obtained a sensitivity of 57.1% by N-acetylaspartate (NAA)/choline (Cho) and myoinositol/creatine (Cr) and a specificity of 100% by Cho/Cr and lipids, with a PPV of 80% and a NPV of 63.6%. Conclusion: We found that NAA/Cho is the best marker of tumour progression before therapy, with a sensitivity of 53.9%. For the therapeutic response, sensitivity was only 28.2%.

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Incense use and respiratory tract carcinomas

Friborg

Yuan

Wang

et al. 2008

Cancer

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BACKGROUND.Incense use is an integral part of daily life in large parts of Asia. The burning of incense is a powerful producer of particulate matter and the smoke contains a multitude of well‐characterized carcinogens. However, to the authors' knowledge, no convincing association has been reported between exposure to incense smoke and the development of cancer. Therefore, the relation between incense use and the risk of respiratory tract carcinomas was analyzed in a prospective cohort study.METHODS.Between 1993 and 1998, a population‐based cohort of 61,320 Singapore Chinese who were free of cancer and ages 45 to 74 years completed a comprehensive interview regarding living conditions and dietary and lifestyle factors. Through linkage to population‐based registries, the cohort was followed through 2005 and cancer occurrence determined. The relative risk for these cancers associated with incense use was estimated using a Cox proportional hazards model.RESULTS.A total of 325 upper respiratory tract (UPT) carcinomas and 821 lung carcinomas were observed during follow‐up. Incense use was associated with a significantly increased risk of UPT carcinomas other than nasopharyngeal, whereas no overall effect was observed on lung cancer. The duration and intensity of incense use were associated with an increased risk of squamous cell carcinomas in the entire respiratory tract (P for trend = .004), whereas there was no significant association noted between incense use and nonsquamous cell carcinomas. The relative risk of squamous cell carcinomas among long‐term incense users was 1.8 (95% confidence interval [95% CI], 1.2‐2.6; P = .004) in the entire respiratory tract.CONCLUSIONS.The results of the current study indicate that long‐term use of incense is associated with an increased risk of squamous cell carcinoma of the respiratory tract. Cancer 2008. © 2008 American Cancer Society.

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1h-mr spectroscopy of normal brain tissue before and after postoperative radiotherapy because of primary brain tumors

Cited by 33 publications

References 16 publications

MR Spectroscopy in Radiation Injury

MR Spectroscopy in Radiation Injury

Monovoxel <sup>1</sup>H Magnetic Resonance Spectroscopy in the Progression of Gliomas

Incense use and respiratory tract carcinomas

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