Clinicopathological examination of glioma by proton magnetic resonance spectroscopy background

Abstract

Automation of proton magnetic resonance spectroscopy (MRS) in recent years has made it possible for MRS measurement to be performed in a shorter time than before, and the number of reports of its usefulness for the assessment of glioma malignancy has been increasing in the past several years. We studied the efficacy of proton MRS when used for glioma and conducted clinicopathological examination of glioma. The subjects were 15 patients who had received a pathological diagnosis of glioma at our hospital (6 cases of glioblastoma, 1 case of anaplastic astrocytoma, 4 cases of low-grade astrocytoma, and 4 cases of radiation necrosis); Siemens Magnetom Vision 1.5T was used for the study. Regions of interest (ROIs) were defined as the areas where abnormal signals were found on magnetic resonance imaging (MRI). Areas of primary peaks, such as choline (Cho), N-acetylaspartate (NAA), and lactate (Lac), were measured, and the ratios to normal brain tissue were examined. This study revealed a tendency of increased malignancy of glioma with a decrease in NAA. Some cases also displayed a decrease in Cho with an increase in malignancy. Assessment of malignancy must not be based on a single ROI alone, but several ROIs should be assessed comprehensively. Measurement was difficult when the tumor volume was small. Because diagnosis of very early glioma by MRS seemed difficult, other adjunctive diagnoses may be necessary. Proton MRS is very useful for diagnosis of glioblastoma.

Preoperative assessment using multimodal functional magnetic resonance imaging techniques in patients with brain gliomas

“…In our experiences, the MRS data can provide unique information that when combined with BOLD and DTI has implications for defining tumor type and grade, directing biopsy or surgical resection. To review the findings of this study and relative literatures (1,3,4,(6)(7)(8)(15)(16)(17)(18)19,28,31,38), typical changes of various metabolites among different types of lesions were summarized in Table II. The value of proton MRS for predicting tumor malignancy which was known as an important branch of clinical application has been reported in several prior clinical studies (5,(12)(13)(14)19,22,27). Similar to our results, the ratio of Cho/Cr and Cho/NAA in high grade gliomas were found significantly higher than in low grade gliomas, and lipid peak was usually defined in high grade gliomas, which was strongly associated with the presence and amount of necrosis in glioma.…”

Role of magnetic resonance imaging, diffusion study versus spectroscopy in grading of gliomas correlated with pathology

“…According to Izumiyama et al ( 2004), glioma malignancy is likely to increase when NAA levels decrease. In the current study, declines in NAA in all gliomas demonstrated that the neurons had been invaded and substituted for neoplasia, resulting in a significant reduction in the number of neurons and a drop in signal intensity [29]. According to Liu et al (2012), none of the diagnosed lowgrade gliomas had a lipid peak, whereas most high-grade gliomas, particularly glioblastoma multiformis, had higher lipid peaks [30].…”

Differentiation of Glioma and Radiation Injury in Rats Using In Vitro Produce Magnetically Labeled Cytotoxic T-Cells and MRI

“…Investigators have already used magnetically labeled cells in a different clinical setting to target the migration of dendritic cells, neural stem cells, bone marrow derived CD34+ cells and islet grafts [41]–[44]. Despite the advancement in imaging modalities, the early detection of residual tumor or metastatic foci in glioblastoma multiforme patients is still controversial, especially in the areas with a mixture of inflammation and malignancy [9], [10], [45], [46]. Since magnetic labeling of cells does not interfere with radionuclide or PET tracer accumulation in genetically engineered cells [47], it will be possible to combine these two approaches to clinically monitor and functionally assess the temporal and spatial migration of cells using the recently introduced PET/MRI systems [48].…”