Role of short TE 1H-MR spectroscopy in monitoring of post-operation irradiated patients

Walecki, Jerzy; Sokół, Maria; Pienia̦żek, Piotr; Maciejewski, B.; Tarnawski, Rafał; Krupska, Teresa; Wydmański, Jerzy; Brzeziński, J; Grieb, Paweł

doi:10.1016/s0720-048x(99)00053-4

Cited by 37 publications

(31 citation statements)

References 25 publications

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“…Cr is a marker of energy metabolism and is commonly considered to be fairly stable under most conditions and, therefore, is often used as the denominator in metabolic ratio calculations, even if some reports question the stability of Cr in tumors, hypoxia, and other confounding factors. 41,44 Injury to the white matter outside the area of the initial brain lesion has not only been demonstrated with MR spectroscopy but is also supported by findings with DTI. For example, a recent study showed that the mean FA value decreased and the average of the mean isotropic ADC value increased significantly in normal-appearing white matter in patients treated with radiation compared with values found in normal white matter in control subjects.…”

Section: Effects Of Radiation On Normal Brainmentioning

confidence: 82%

MR Spectroscopy in Radiation Injury

Sundgren¹

2009

AJNR Am J Neuroradiol

120

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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: Effects Of Radiation On Normal Brainmentioning

confidence: 82%

MR Spectroscopy in Radiation Injury

Sundgren¹

2009

AJNR Am J Neuroradiol

120

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“…Moreover, in case of in vivo proton spectra acquired from the pathological brain areas spectroscopic evaluations are usually based on the analysis of metabolite ratios thus making it difficult for individual metabolite concentration changes to be observed. In our previous work we studied the early response to treatment of the irradiated human brain [15]. Though, the explanation of the observed changes requires some model animal studies.…”

Section: Introductionmentioning

confidence: 99%

Investigation of metabolic changes in irradiated rat brain tissue by means of 1H NMR in vitro relaxation study

Sokół¹,

Przybyszewski²,

Matlas³

2004

Solid State Nuclear Magnetic Resonance

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“…Proton MRS is a noninvasive technique to, (i) interrogate metabolic distributions in the brain (Gillies and Morse 2005;Hoehn et al 2001), (ii) differentiate radiation necrosis from brain tumor progression (Chong et al 2002;Schlemmer et al 2002), and (iii) serve as a indicator of neurotoxicity following experimental (Chan et al 2009;Herynek et al 2004) and clinical brain irradiation (Chan et al 2001;Esteve et al 1998;Lee et al 2004;Virta et al 2000;Walecki et al 1999). Metabolites detected in brain tissue include choline-containing compounds, creatine, glutamate, lactate, N-acetylaspartate (NAA), myoinositol (mI), and taurine.…”

Section: Mr Proton Spectroscopymentioning

confidence: 99%