Proton MR spectroscopy in predicting the increase of perfusion MR imaging for WHO grade II gliomas

Abstract

Purpose: To investigate the correlation between the metabolite ratios obtained from proton magnetic resonance (MR) spectroscopy and those obtained from MR perfusion parameters (relative cerebral blood volume [rCBV]) in a cohort of low-grade glioma (LGG). Materials and Methods:Patients underwent prospectively conventional MR, proton magnetic resonance spectroscopy ( 1 HMRS), and perfusion-weighted images (PWI). Statistical analyses were performed to determine the correlative and independent predictive factors of rCBVmax and the metabolite ratio thresholds with optimum sensitivity and specificity.Results: Thirty-one patients were included in this study. Linear correlations were observed between the metabolic ratios (lactate [Lac]/creatine [Cr], choline [Cho]/N-acetylaspartate [NAA], free-lipids/Cr) and rCBVmax (P < 0.05). These metabolic ratios were determined to be independent predictive factors of rCBVmax (P ¼ 0.027, 0.011 and 0.032, respectively). According to the receiver operating characteristic curves, the cutoff values of the metabolic ratios to discriminate between the two populations of rCBVmax (<1.7 versus ¼ 1.7) were 1.72, 1.54, and 1.40, respectively, with a sensitivity ¼ 75% and a specificity >95% for Lac/Cr. Conclusion:This study demonstrated consistent correlations between the data from 1 HMRS and PWI. The Lac/Cr ratio predicts regional hemodynamic changes, which are themselves a useful biomarker of clinical prognosis in patients with LGG. As such, this ratio may provide a new parameter for making improved clinical decisions.

Advanced MR Imaging Techniques in the Evaluation of Nonenhancing Gliomas: Perfusion-Weighted Imaging Compared with Proton Magnetic Resonance Spectroscopy and Tumor Grade

“…A recent study assumed that spectroscopy data including the Cho/NAA, Lac/Cr, and Lip/Cr ratios probabilistically supported rCBV, but the Cho/Cr ratio was not a predictive factor of rCBV 24 . These findings may explain our results that although a Cho/Cr ratio with a cutoff value 1.3 was correlated with the initial histopathological diagnosis of the tumors, the Cho/Cr ratio was not as helpful in predicting the outcome as the rCBV ratio.…”

Prediction of anaplastic transformation in low-grade oligodendrogliomas based on magnetic resonance spectroscopy and 1p/19q codeletion status

“…Previous studies [38] predicted LGG response to temozolomide using these markers with MR spectroscopy. Moreover, spectroscopy has been used to predict increases in MR perfusion in follow-ups of patients with LGG [39]. Proton MR spectroscopy may be superior for predicting LGG anaplastic transformation compared to diffusion or perfusion MRI but remains unable to characterize alone brain neoplasms [40].…”

Usefulness of 1H‐MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates

“…1 H‐MRS has been applied extensively in clinical research (), and 1 H‐MRS is recognized as a valuable tool for noninvasive monitoring of brain biochemistry in vivo for both animals and humans. The metabolites in the central nervous system most amenable for study with 1 H‐MRS are NAA, Cr, and Cho.…”

“…The pathological findings in kernicterus have been classically described as preferential yellow discolouration of basal ganglia with sparing of the cortex and the white matter (14). 1 H-MRS has been applied extensively in clinical research (16), and 1 H-MRS is recognized as a valuable tool for noninvasive monitoring of brain biochemistry in vivo for both animals and humans. The metabolites in the central nervous system most amenable for study with 1 H-MRS are NAA, Cr, and Cho.…”