In Vivo Differentiation of Aerobic Brain Abscesses and Necrotic Glioblastomas Multiforme Using Proton MR Spectroscopic Imaging

Lai, Ping-Hong; Weng, Hsu–Huei; Chen, C.Y.; Hsu, Shu-Shong; Ding, Shang Wu; Ko, Chung‐Wen; Fu, Jui-Hsun; Liang, Huei‐Lung; Chen, K.H.

doi:10.3174/ajnr.a1130

Cited by 42 publications

(32 citation statements)

References 31 publications

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“…However, the middle part of glioblastomas had in general lower values of tNAA/tCr compared to its solid or peritumoral regions, they did not differ significantly from each other. This indicated an infiltrating character of the tumor cells, which is in compliance with the published characteristics of glioblastomas (Lai et al 2008;Law 2009;Wright et al 2009). Using this clinically feasible 1 H MRSI evaluated at 1.5 Tesla it was possible to demonstrate high heterogeneity of glioblastomas, with necrotic middle part, highly proliferating solid part, metabolically influenced surrounding tissue with infiltrating tumorous cells (Fig.…”

Section: Discussionsupporting

confidence: 67%

“…There is a theory suggesting that due to the growing tumor the neovasculature could not sufficiently supply the more distant cells, resulting in hypoxic or almost necrotic regions, particularly in the central part of tumors (Lupo et al 2007;Garett and Grisham 2008;Ganapathy et al 2009). As a consequence spectroscopically detectable lipids could be present in these regions (Lai et al 2008;Delikatny et al 2011). In this study increased value of lip/Lac ratio was found suggesting the central tumor necrosis.…”

Section: Discussionmentioning

confidence: 63%

“…However, the considerable variance of this ratio, esspecially in the middle part of the glioblastomas, suggested a diverse range of necrosis in individual tumors. As mentioned in literature, the high tissue heterogeneity is typical for glioblastomas, with the occurrence of low-aggressive even high-proliferating zones and central necrosis (Lai et al 2008;Laprie et al 2008;Schneider et al 2010). The high-grade of malignancy in glioblastomas is further associated with significant changes at the cellular level.…”

Section: Discussionmentioning

confidence: 92%

“…It was declared, that in a necrotic part of glioblastomas in addition to the significant neuronal loss (Kornienko and Pronin 2009;McKnight and Wladman 2010;Kumar et al 2012) also the process of tumor cell proliferation inhibited (Laprie et al 2008;Wright et al 2009), leading to the decreased concentration of tCho compared to the tumor mass (Callot et al 2008;Pinker et al 2012). Furthermore, it appears that the decrease of tNAA concentration correlates with the extent of tisue necrosis (Lai et al 2008;Kornienko and Pronin 2009). There is a theory suggesting that due to the growing tumor the neovasculature could not sufficiently supply the more distant cells, resulting in hypoxic or almost necrotic regions, particularly in the central part of tumors (Lupo et al 2007;Garett and Grisham 2008;Ganapathy et al 2009).…”

Section: Discussionmentioning

confidence: 99%

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Proton MR spectroscopic imaging of human glioblastomas at 1.5 Tesla

Hnilicová

Richterová²,

Kantorová³

et al. 2017

gpb

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Abstract. In this study we evaluated clinical feasibility of proton magnetic resonance spectroscopy metabolite mapping ( 1 H MRSI) by using 1.5 Tesla MR-scanner in 10 patients with high-grade glioblastoma. In vivo 1 H MRSI performed with a relatively short scan time of 20 minutes enabled to obtain comprehensive information about metabolic changes in glioblastoma and adjacent tissues namely in the peritumoral edema, in the middle and solid part of the tumor, and in the normal-appearing brain tissue. Spectroscopically it was possible to identify initiation of neuronal cell death in the solid tumorous tissue via decreased N-acetyl-aspartate to creatine ratio (↓ tNAA/tCr) and expanding carcinogenesis reflected in elevated choline ratios (↑ tCho/tCr and tCho/tNAA). We showed also the central necrosis of glioblastoma accompanied by the tissue hypoxia, which were apparent as increased lactate and lipids ratios (↑ Lac/tCr and lip/Lac). Metabolic changes were noticeable also in the peritumoral area, showing the glioblastoma infiltration into the surrounding tissues. In intracranial tumors, 1 H MRSI performed on 1.5 Tesla field strength was sufficient to provide information about the stage of carcinogenesis, tumor expansion or necrotization and thus it could be considered as a useful diagnostic tool in oncology.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Proton MR spectroscopic imaging of human glioblastomas at 1.5 Tesla

Hnilicová

Richterová²,

Kantorová³

et al. 2017

gpb

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show abstract

“…Various MRI sequences were used including GRE and DWI, however, main limitation of this study was lack of use of advanced MRI tools like perfusion weighted imaging and MR spectroscopy that can be of help for accurate tissue characterisation. (17) CONCLUSION MRI proves to be a valuable modality of imaging in accurately evaluating the morphologic distribution of various intra-and extra-axial tumours in the posterior fossa.…”

Section: Discussionmentioning

confidence: 99%

Role of Mri in Evaluation of Posterior Fossa Tumours With Histopathological Correlation

Durai¹,

Ganesan²,

Selvaganapathy³

et al. 2016

jemds

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Posterior fossa extends from tentorium cerebelli to foramen magnum and posterior fossa tumours are more common in children than in adults. Since posterior fossa is a critical location with limited space, even small tumours produce significant morbidity and mortality. The advent of Magnetic Resonance Imaging (MRI) has revolutionised the diagnosis and management of brain tumours. OBJECTIVESTo study the demographic profile and assess the distribution, features, localisation, and extent of posterior fossa neoplasms by MRI and to correlate the tissue characterisation by MRI with that of histopathological examination. MATERIALS AND METHODSA prospective study was done on 90 patients who were diagnosed to have posterior fossa neoplasm by magnetic resonance imaging from January 2014 to November 2015. They were followed up till surgery or biopsy for confirmatory histopathological diagnosis. The final diagnosis were correlated followed by analysis of the present study by comparing with previous similar studies from various literature. RESULTSThere was an overall male predominance with Male: Female ratio of 1.5:1. Among adults, extra-axial tumours (68%) were more frequent than intra-axial ones (32%) with vestibular schwannoma (37%) being the commonest lesion. Most common intra-axial tumour was metastasis (13%) and most common primary intra-axial tumour was haemangioblastoma (8%). Among paediatric age group, intra-axial tumours (83%) were commoner than extra-axial ones (17%) with low-grade astrocytoma (38%) as the commonest lesion followed by medulloblastoma (29%) and ependymoma (17%). Overall, 6 cases were misdiagnosed by MRI as glioma and turned out to be tuberculoma CONCLUSIONMRI proves to be a valuable modality of imaging in accurately evaluating the morphologic distribution of various intra-and extra-axial tumours in the posterior fossa. MRI can correctly diagnose 100% of extra-axial tumours and 85% of intra-axial lesions. Main tumour mimics of posterior fossa are tuberculoma and pyogenic abscess.

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Early prediction of response to Vorinostat in an orthotopic rat glioma model

Hong

Yoon

et al. 2012

NMR in Biomedicine

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Glioblastoma (GBM) is the most common primary brain tumor and is uniformly fatal despite aggressive surgical and adjuvant therapy. Since survival is short, it is critical to determine the value of therapy early on in treatment. Improved early predictive assessment would allow neuro-oncologists to personalize and adjust or change treatment sooner to maximize use of efficacious therapy. During carcinogenesis, tumor suppressor genes can be silenced by aberrant histone deacetylation. This epigenetic modification has become an important target for tumor therapy. Suberoylanilide hydroxamic acid (SAHA, Vorinostat, Zolinza; Merck & Co., Inc.) is an orally active, potent inhibitor of histone deacetylase (HDAC) activity. A major shortcoming of the use of HDAC inhibitors in treating brain tumor patients is the lack of reliable biomarkers to predict and determine response. Histological evaluation may reflect tumor viability following treatment but it is an invasive procedure and impractical for GBM. Another problem is that response to SAHA therapy is associated with tumor redifferentiation and cytostasis rather than tumor size reduction, thus limiting the use of traditional imaging methods. A noninvasive method to assess drug delivery and efficacy is needed. Here, we investigated whether changes in 1H MRS metabolites could render reliable biomarkers for an early response to SAHA treatment in an orthotopic animal model for glioma. Untreated tumors exhibited significantly elevated alanine and lactate levels and reduced inositol, NAA and creatine, typical changes reported in GBM compared to normal brain tissues. The proton MRS-detectable metabolites of SAHA treated tumors were restored toward those of normal-like brain tissues. In addition, reduced inositol and NAA were found to be potential biomarkers for mood alteration and depression, which may also be alleviated with SAHA treatment. Our study suggests that 1H MRS can provide reliable metabolic biomarkers at the earliest stage of SAHA treatment to predict the therapeutic response.

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In Vivo Differentiation of Aerobic Brain Abscesses and Necrotic Glioblastomas Multiforme Using Proton MR Spectroscopic Imaging

Cited by 42 publications

References 31 publications

Proton MR spectroscopic imaging of human glioblastomas at 1.5 Tesla

Proton MR spectroscopic imaging of human glioblastomas at 1.5 Tesla

Role of Mri in Evaluation of Posterior Fossa Tumours With Histopathological Correlation

Early prediction of response to Vorinostat in an orthotopic rat glioma model

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