Analysis of brain tumors using 1H magnetic resonance spectroscopy

McBride, Duncan Q.; Miller, Bruce L.; Nikas, Diana L.; Buchthal, Steven; Chang, Linda; Chiang, Frances; Booth, Ruth A.

doi:10.1016/0090-3019(95)00139-5

Cited by 72 publications

(28 citation statements)

References 20 publications

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“…In 10% of patients, there was clear improvement in T staging on PET/MR imaging, where T2 HASTE and DWI were most useful and showed the degree of tumor extension into adjacent tissue because of the superior soft-tissue contrast and anatomic detail. It is speculated that any clinical impact will be driven by the MR imaging and CT components of PET/MR imaging and PET/CT and that newer PET radiopharmaceuticals and the addition of dynamic contrast-enhanced MR imaging, DWI, and MR spectroscopy will increase the sensitivity and specificity (23)(24)(25) and may also have a clinical impact. PET/CT is likely to remain the preferred imaging modality for lung and mediastinal nodal disease.…”

Section: Discussionmentioning

confidence: 99%

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

et al. 2013

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The aim of this study was to prospectively compare whole-body PET/MR imaging and PET/CT, qualitatively and quantitatively, in oncologic patients and assess the confidence and degree of inter-and intraobserver agreement in anatomic lesion localization. Methods: Fifty patients referred for staging with known cancers underwent PET/CT with low-dose CT for attenuation correction immediately followed by PET/MR imaging with 2-point Dixon attenuation correction. PET/CT scans were obtained according to standard protocols (56 6 20 min after injection of an average 367 MBq of 18 F-FDG, 150 MBq of 68 Ga-DOTATATE, or 333.8 MBq of 18 F-fluoro-ethyl-choline; 2.5 min/bed position). PET/MR was performed with 5 min/bed position. Three dual-accredited nuclear medicine physicians/radiologists identified the lesions and assigned each to an exact anatomic location. The image quality, alignment, and confidence in anatomic localization of lesions were scored on a scale of 1-3 for PET/CT and PET/MR imaging. Quantitative analysis was performed by comparing the standardized uptake values. Intraclass correlation coefficients and the Wilcoxon signed-rank test were used to assess intra-and interobserver agreement in image quality, alignment, and confidence in lesion localization for the 2 modalities. Results: Two hundred twenty-seven tracer-avid lesions were identified in 50 patients. Of these, 225 were correctly identified on PET/CT and 227 on PET/MR imaging by all 3 observers. The confidence in anatomic localization improved by 5.1% when using PET/MR imaging, compared with PET/CT. The mean percentage interobserver agreement was 96% for PET/CT and 99% for PET/MR imaging, and intraobserver agreement in lesion localization across the 2 modalities was 93%. There was 10% (5/50 patients) improvement in local staging with PET/MR imaging, compared with PET/CT. Conclusion: In this first study, we show the effectiveness of whole-body PET/MR imaging in oncology. There is no statistically significant difference between PET/MR imaging and PET/CT in respect of confidence and degree of inter-and intraobserver agreement in anatomic lesion localization. The PET data on both modalities were similar; however, the observed superior soft-tissue resolution of MR imaging in head and neck, pelvis, and colorectal cancers and of CT in lung and mediastinal nodal disease points to future tailored use in these locations.

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Section: Discussionmentioning

confidence: 99%

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

et al. 2013

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“…Third, conventional MRI is often insensitive to changes after treatment (1). Advanced MRI techniques such as diffusion-weighted imaging (6), perfusion-weighted imaging (7), and MR spectroscopy (8,9) may provide a better estimation of tumor extension and potentially higher accuracy in tumor grading.…”

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Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT

Boss¹,

Bisdas²,

Kolb³

et al. 2010

J Nucl Med

228

129

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Simultaneous PET and MRI using new hybrid PET/MRI systems promises optimal spatial and temporal coregistration of structural, functional, and molecular image data. In a pilot study of 10 patients with intracranial masses, the feasibility of tumor assessment using a PET/MRI system comprising lutetium oxyorthosilicate scintillators coupled to avalanche photodiodes was evaluated, and quantification accuracy was compared with conventional PET/CT datasets. Methods: All measurements were performed with a hybrid PET/MRI scanner consisting of a conventional 3-T MRI scanner in combination with an inserted MRI-compatible PET system. Attenuation correction of PET/MR images was computed from MRI datasets. Diagnoses at the time of referral were low-grade astrocytoma (n 5 2), suspicion of low-grade astrocytoma (n 5 1), anaplastic astrocytoma (World Health Organization grade III; n 5 1), glioblastoma (n 5 2), atypical neurocytoma (n 5 1), and meningioma (n 5 3). In the glial tumors, 11 C-methionine was used for PET; in the meningiomas, 68 Ga-DOTATOC was administered. Tumor-togray matter and tumor-to-white matter ratios were calculated for gliomas, and tracer uptake of meningiomas was referenced to nasal mucosa. PET/MRI was performed directly after clinically indicated PET/CT examination. Results: In all patients, the PET datasets showed similar diagnostic image quality on the hybrid PET/MRI and the PET/CT studies; however, slight streak artifacts were visible in coronal and sagittal sections when using the higher intrinsic resolution of the PET/MRI insert. Prefiltering of images with a 4-mm gaussian filter at a resolution comparable to that of the PET/CT system virtually eliminated these artifacts. Although acquisition of the PET/MR images started at 30-60 min after PET/CT (20.4-min half-life of 11 C) acquisition, the signal-to-noise ratio was good enough, thus underlining the high sensitivity of the PET insert, compared with whole-body PET systems. The computed tumor-to-reference tissue ratios exhibited an excellent accordance between the PET/MRI and PET/CT systems, with a Pearson correlation coefficient of 0.98. Mean paired relative error was 7.9% 6 12.2%. No significant artifacts or distortions were detected in the simultaneously acquired MR images using the PET/MRI scanner. Conclusion: Structural, functional, and molecular imaging in patients with brain tumors is feasible with diagnostic imaging quality using simultaneous hybrid PET/MR image acquisition.

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“…ALTHOUGH MAGNETIC RESONANCE IMAGING (MRI) examinations are the current standard for evaluating brain-tumor patients, there are circumstances in which interpretation of the images is complicated by difficulties in identifying the true extent of the lesion and distinguishing treatment effects from tumor progression (1,2). Since morphologic images are unable to provide information about tissue function, there has recently been an increased demand for alternative imaging techniques that reflect functional rather than morphologic properties of the tissue.…”

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confidence: 99%

3D ¹H MRSI of brain tumors at 3.0 tesla using an eight‐channel phased‐array head coil

Osorio

Öztürk-Işık

et al. 2007

Magnetic Resonance Imaging

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Purpose: To implement proton magnetic resonance spectroscopic imaging ( 1 H MRSI) at 3 Tesla (3T) using an eightchannel phased-array head coil in a population of braintumor patients. Materials and Methods:A total of 49 MRI/MRSI examinations were performed on seven volunteers and 34 patients on a 3T GE Signa EXCITE scanner using body coil excitation and reception with an eight-channel phased-array head coil.1 H MRSI was acquired using point-resolved spectroscopy (PRESS) volume selection and three-dimensional (3D) phase encoding using a 144-msec echo time (TE). Results:The mean choline to N-acetyl aspartate ratio (Cho/ NAA) was similar within regions of normal-appearing white matter (NAWM) in volunteers (0.5 Ϯ 0.04) and patients (0.6 Ϯ 0.1, P ϭ 0.15). This ratio was significantly higher in regions of T2-hyperintensity lesion (T2L) relative to NAWM for patients (1.4 Ϯ 0.7, P ϭ 0.001). The differences between metabolite intensities in lesions and NAWM were similar, but there was an increase in SNR of 1.95 when an eight-channel head coil was used at 3T vs. previous results at 1.5T. Conclusion:The realized increase in SNR means that clinically relevant data can be obtained in five to 10 minutes at 3T and used to predict the spatial extent of tumor in a manner similar to that previously used to acquire 1.5T data in 17 minutes.

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Analysis of brain tumors using 1H magnetic resonance spectroscopy

Cited by 72 publications

References 20 publications

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT

3D ¹H MRSI of brain tumors at 3.0 tesla using an eight‐channel phased‐array head coil

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Analysis of brain tumors using 1H magnetic resonance spectroscopy

Cited by 72 publications

References 20 publications

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

Qualitative and Quantitative Comparison of PET/CT and PET/MR Imaging in Clinical Practice

Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT

3D 1H MRSI of brain tumors at 3.0 tesla using an eight‐channel phased‐array head coil

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3D ¹H MRSI of brain tumors at 3.0 tesla using an eight‐channel phased‐array head coil