Spectroscopic increase in choline signal is a nonspecific marker for differentiation of infective/inflammatory from neoplastic lesions of the brain

Venkatesh, Sudhakar K.; Gupta, Rakesh K.; Pal, Lily; Husain, Nuzhat; Husain, Mazhar

doi:10.1002/jmri.1144

Cited by 62 publications

(46 citation statements)

References 21 publications

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“…Cho/NAA, Cho/Cr ratios were the valuable tools for determining the malignancy of cranial neoplasms, used by most of the authors (3-5, 9-12, 15). In most of the former studies, both ratios increased from lowgrade to high-grade gliomas, also extremely higher in metastases and Primitive neuroectodermal tumours (PNET) (3,5,8,9,11,15). In this research, Cho/Cr ratio more than 2.5 was presented as malignant (p < 0.05) .…”

Section: Discussionsupporting

confidence: 44%

“…disorders except for the cystic cranial masses, Perfusion MR and Diffusion Weighted MR imaging could also be added to MRS findings in order to get more beneficial results (2,4,7,10,16). When we look at the literature; Elevated Cho levels and reduced NAA levels had been reported in acute MS plaques and had been explained by reactive astrogliosis, inflammation and early axonal degeneration, MI at short TE was also a discriminating metabolite for the acute MS and also increased in cases of glial activation or gliosis, represented dominancy in low-grade astrocytomas related to abnormal astrocyte proliferation, nevertheless might also be seen in Encephalitis, Dementia, Epilepsy and SSPE-PML like brain disorders (1,7,10,13,14), but in high grade gliomas, metastases and more malignant tumours, its peak sharply declined (1,2,4,15,17). In our study, we had also elevated MI peaks in non-neoplastic demyelinating group.…”

Section: Resultsmentioning

confidence: 96%

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The value of proton mr-spectroscopy in the differentiation of brain tumours from non-neoplastic brain lesions

Aydın¹,

Sipahioğlu²,

Na³

et al. 2011

Journal of the Belgian Society of Radiology

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Section: Discussionsupporting

confidence: 44%

Section: Resultsmentioning

confidence: 96%

The value of proton mr-spectroscopy in the differentiation of brain tumours from non-neoplastic brain lesions

Aydın¹,

Sipahioğlu²,

Na³

et al. 2011

Journal of the Belgian Society of Radiology

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“…However, some studies have found high-grade tumors (GBM) to have lower levels of Cho than grade II or III astrocytoma (57). This may be due to the presence of necrosis in high-grade tumors, because necrosis is associated with low levels of all metabolites (72 figure 5.…”

Section: Assessment Of Glioma Gradementioning

confidence: 99%

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

et al. 2009

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Background: Conventional magnetic resonance (MR) imaging has a number of limitations in the diagnosis of the most common intracranial brain tumors, including tumor specification and the detection of tumoral infiltration in regions of peritumoral edema. Purpose: To prospectively assess if diffusion-weighted MR imaging (DWI) could be used to differentiate between different types of brain tumors and to distinguish between peritumoral infiltration in high-grade gliomas, lymphomas, and pure vasogenic edema in metastases and meningiomas. Material and Methods: MR imaging and DWI was performed on 93 patients with newly diagnosed brain tumors: 59 patients had histologically verified high-grade gliomas (37 glioblastomas multiforme, 22 anaplastic astrocytomas), 23 patients had metastatic brain tumors, five patients had primary cerebral lymphomas, and six patients had meningiomas. Apparent diffusion coefficient (ADC) values of tumor (enhancing regions or the solid portion of tumor) and peritumoral edema, and ADC ratios (ADC of tumor or peritumoral edema to ADC of contralateral white matter, ADC of tumor to ADC of peritumoral edema) were compared with the histologic diagnosis. ADC values and ratios of high-grade gliomas, primary cerebral lymphomas, metastases, and meningiomas were compared by using ANOVA and multiple comparisons. Optimal thresholds of ADC values and ADC ratios for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results: Statistically significant differences were found for minimum and mean of ADC tumor and ADC tumor ratio values between metastases and high-grade gliomas when including only one factor at a time. Including a combination of in total four parameters (mean ADC tumor, and minimum, maximum and mean ADC tumor ratio) resulted in sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 72.9, 82.6, 91.5, and 54.3% respectively. In the ROC curve analysis, the area under the curve of the combined four parameters was the largest (0.84), indicating a good test. Conclusion: Our results suggest that ADC values and ADC ratios (minimum and mean of ADC tumor and ADC tumor ratio) may be helpful in the differentiation of metastases from high-grade gliomas. It cannot distinguish high-grade gliomas from lymphomas, and lymphomas from metastases. ADC values and ADC ratios in peritumoral edema cannot be used to differentiate edema with infiltration of tumor cells from vasogenic edema when measurements for high-grade gliomas, lymphomas, metastases, and meningiomas were compared.

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“…89 Increases in Cho due to inflammation have also been reported. 90,91 These two observations may cause some overlap in interpreting results in lesions, such as tumefactive MS, [92][93][94][95] that may have both inflammation and demyelination present.…”

Section: Cholinementioning

confidence: 99%

Recent Advances in Magnetic Resonance Neurospectroscopy

Rosen

Lenkinski

2007

Neurotherapeutics

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Summary:Over the past two decades, proton magnetic resonance spectroscopy (proton MRS) of the brain has made the transition from research tool to a clinically useful modality. In this review, we first describe the localization methods currently used in MRS studies of the brain and discuss the technical and practical factors that determine the applicability of the methods to particular clinical studies. We also describe each of the resonances detected by localized solvent-suppressed proton MRS of the brain and discuss the metabolic and biochemical information that can be derived from an analysis of their concentrations. We discuss spectral quantitation and summarize the reproducibility of both single-voxel and multivoxel methods at 1.5 and 3-4 T. We have selected three clinical neurologic applications in which there has been a consensus as to the diagnostic value of MRS and summarize the information relevant to clinical applications. Finally, we speculate about some of the potential technical developments, either in progress or in the future, that may lead to improvements in the performance of proton MRS.

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Spectroscopic increase in choline signal is a nonspecific marker for differentiation of infective/inflammatory from neoplastic lesions of the brain

Cited by 62 publications

References 21 publications

The value of proton mr-spectroscopy in the differentiation of brain tumours from non-neoplastic brain lesions

The value of proton mr-spectroscopy in the differentiation of brain tumours from non-neoplastic brain lesions

Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema

Recent Advances in Magnetic Resonance Neurospectroscopy

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