Magnetic resonance spectroscopy in the assessment of pilocytic astrocytomas

Harris, Lisa M.; Davies, Nigel P.; MacPherson, Lesley; Lateef, Shaheen; Natarajan, K.; Bründler, Marie-Anne; Sgouros, Spyros; English, Martin; Arvanitis, Theodoros N.; Grundy, Richard G.; Peet, Andrew C.

doi:10.1016/j.ejca.2008.08.012

Cited by 40 publications

(17 citation statements)

References 28 publications

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“…[13] Tumors that arose primarily in the cerebellum and infiltrated the brain stem were called “transitional.”[13] Studies show that (1)H magnetic resonance spectroscopy detects key differences in the metabolites of the main types of cerebellar tumors and yields potential non-invasive biomarkers of prognosis. [1415] In the series of Desai et al ., 74.6% of the tumors were in the cerebellar hemispheres, while only 25.4% involved the vermis. [6] Brain stem involvement was seen in 19.6% of patients.…”

Section: Cerebellar Astrocytomasmentioning

confidence: 99%

Management of posterior fossa gliomas in children

Sridhar

Venkatprasanna

2011

J Pediatr Neurosci

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Brain tumours form the most common type of solid tumour in children and more that 50% of these are infratentorial. Cerebellar astrocytomas and brain stem gliomas are the commonest posterior fossa glial tumours in children. Cerebellar astrocytomas represent up to 10% of all primary brain tumours and up to 25% of posterior fossa tumors in children, with Low grade gliomas forming the commonest of the cerebellar gliomas. They commonly present with symptoms and signs of raised intracranial pressure due to obstructive hydrocephalus. Radiologically they may be solid or cystic with or without a mural nodule. Surgical excision is the mainstay of treatment and forms the most consistent factor influencing progression free and long term survival. While majority of the tumours are pilocytic astrocytomas, they may also be fibrillary astrocytomas or even high grade tumours. Tumour histology does not appear to be an independent factor in the prognosis of these children, and therefore no palliative treatment after surgery is advocated. Brain stem gliomas account for approximately 10% of all pediatric brain tumours. Cranial nerve signs, ataxia and cerebellar signs with or without symptoms and signs of raised intracranial pressure are classically described symptoms and signs. Radiographic findings and clinical correlates can be used to categorize brain stem tumours into four types: diffuse, focal, exophytic and cervicomedullary. Histologically most brain stem gliomas are fibrillary astrocytomas. Diffuse brain stem gliomas are the most commonly seen tumour in the brain stem. These lesions are malignant high grade fibrillary astrocytomas. Focal tumours of the brain stem are demarcated lesions generally less than 2 cms in size, without associated edema. Most commonly seen in the midbrain or medulla, they form a heterogeneous pathological group, showing indolent growth except when the lesion is a PNET. Dorsally exophytic tumours lie in the fourth ventricle, while cervicomedullary lesions are similar to spinal intramedullary tumours. Expanding lesions are the only lesions amenable for excision while infiltrative and ventral lesions are not.

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Section: Cerebellar Astrocytomasmentioning

confidence: 99%

Management of posterior fossa gliomas in children

Sridhar

Venkatprasanna

2011

J Pediatr Neurosci

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“…Variations in Cho, mobile lipids and myoinositol (MIns) are potential early non-invasive biomarkers of response15 allowing treatment adaptation as disease evolves 11. Pseudoprogression (treatment-related increase in size simulating relapse or progression) can be identified through comparing MRS profiles at different time points 16…”

Section: Introductionmentioning

confidence: 99%

What is MR spectroscopy?

Manias

Peet²

2017

Arch Dis Child Educ Pract Ed

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H-Magnetic Resonance Spectroscopy (MRS) is a novel advanced imaging technique used as an adjunct to MRI to reveal complementary non-invasive information about the biochemical composition of imaged tissue. Clinical uses in paediatrics include aiding diagnosis of brain tumours, neonatal disorders such as hypoxic-ischaemic encephalopathy, inherited metabolic diseases, traumatic brain injury, demyelinating conditions and infectious brain lesions. MRS has potential to improve diagnosis and treatment monitoring of childhood brain tumours and other CNS diseases, facilitate biopsy and surgical planning, and provide prognostic biomarkers. MRS is employed as a research tool outside the brain in liver disease and disorders of muscle metabolism. The range of clinical uses is likely to increase with growing evidence for added value. Multicentre trials are needed to definitively establish the benefits of MRS in specific clinical scenarios and integrate this promising new technique into routine practice to improve patient care. This article gives a brief overview of MRS and its potential clinical applications, and addresses challenges surrounding translation into practice.

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“…107 High total choline and lipids have been identified as biomarkers of poor survival in pediatric tumors. 108 Biomarkers of early response to treatment are also important to identify and there is some indication that MRS can provide this under some circumstances, 109 however, the promising results seen in animal and cell line studies have yet to be mirrored in the clinical arena.…”

Section: Multinuclear Mrs For Cancer Imagingmentioning

confidence: 99%