Magnetic resonance spectroscopy suggests key differences in the metastatic behaviour of medulloblastoma

Peet, Andrew C.; Davies, Nigel P.; Ridley, Lee; Bründler, Marie-Anne; Kombogiorgas, Dimitris; Lateef, Shaheen; Natarajan, K.; Sgouros, Spyros; MacPherson, Lesley; Grundy, Richard G.

doi:10.1016/j.ejca.2007.01.019

Cited by 33 publications

(21 citation statements)

References 24 publications

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“…Advances in imaging have allowed tissue properties to be probed non-invasively giving important insights into in vivo tumour biology [7]. The aims of modern imaging are therefore not just to give a non-invasive histological diagnosis but rather to improve the classification of tumours.…”

Section: Introductionmentioning

confidence: 99%

Accurate classification of childhood brain tumours by in vivo 1H MRS – A multi-centre study

Vicente

Fuster–Garcia

Tortajada

et al. 2013

European Journal of Cancer

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ElsevierVicente Robledo, J.; Fuster Garcia, E.; Tortajada Velert, S.; García Gómez, JM.; Davies, N.; Natarajan, K.; Wilson, M.... (2013) Integration. Linear Discriminant Analysis was applied to this data to produce diagnostic classifiers. An evaluation of the diagnostic accuracy was performed based on resampling to measure the Balanced Accuracy Rate (BAR). Results:The accuracy of the diagnostic classifiers for discriminating the three tumour types was found to be high (BAR 0.98) when a combination of TE was used. The combination of both TE significantly improved the classification performance (p < 0.01, Tukeyʼs test) compared with the use of one TE alone. 3Other tumour types were classified accurately as glial or primitive neuroectodermal (BAR 1.00). 12 cases failed the inclusion criteria for QC mainly due to poor SNR. Conclusions Classification and evaluation 9The diagnostic classification problem of discriminating between EPEN, PILOA and MED, the three most common pediatric tumour types, is addressed in this study. Since EPEN and PILOA tumours can be found in brain locations other than the PF whereas MED are found only in the PF, training was undertaken twice, once using the tumour cases located in the PF and then with those in any brain location. Classifiers were designed and evaluated using features from Short-TE and Long-TE alone and a combination of both TEs, ShortTE+Long-TE. Our results were compared with those in previous studies [27][28][29][30].Based on the results of previous studies [15,20,26,29 Results Spectral featuresSeveral key features allow visual discrimination of PILOA, EPEN and MED. Figures 1 and 2 show the Short-TE and Long-TE mean spectra of the tumour types. Minimum differences are found between the mean spectra of the tumours in the PF and those in any location. All tumour spectra display an increase in Cho peak (3.2ppm) with respect to Cr peak (3.0ppm). NAA (2.0ppm) presents a less prominent peak in MED and EPEN compared with 10 PILOA. Elevation of macromolecules and lipids (0.9ppm and 1.3ppm) is observed in Short-TE. Regarding Long-TE, the inverted peak of Lac at 1.3ppm is distinguished in PILOA and EPEN but not in MED. Tables 2 and 3 show the metabolite concentrations estimated with TARQUIN in Short-TE and Long-TE for the three tumour types found in any brain location. The Kruskal-Wallis test for the analysis of the variance (α=0.05) was applied to determine the significant differences in metabolite concentrations of PILOA, EPEN and MED. Both Cho components, Glycerophosphocholine (GPC) and Phosphocholine (PCh) (p≤0.01) showed significant differences. Cr and Tau concentrations were significantly different in both TEs (p≤0.01). Univariate metabolite comparisonDifferences in the mI concentrations (p≤0.01) were significant in Short-TE.Macromolecules and lipids at 0.9, 1.3 and 2.0ppm (p≤0.05, p≤0.01 and p≤0.01, respectively) exhibited statistical differences in Short-TE MRS. Classification DiscussionThis is the first study of MRS as a non-invasive diagnostic aid in childhood brain tumo...

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Section: Introductionmentioning

confidence: 99%

Accurate classification of childhood brain tumours by in vivo 1H MRS – A multi-centre study

Vicente

Fuster–Garcia

Tortajada

et al. 2013

European Journal of Cancer

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“…Total choline elevation is thought to be a marker of malignant transformation and rapid cellular proliferation as a result of increased mitosis, leading to an abnormal increase in metabolism [17,18,43,44]. Previous studies have identified a correlation between Ki67 and total choline in a variety of tumours including grade II-IV astrocytomas in adults [19], medulloblastomas in children [23,45], and homogeneous, but not heterogeneous, gliomas in adults [18]. Two other studies in adult gliomas did not find a correlation between total choline and Ki67 [27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps the most evidence for an association between MRS and histology is constituted by the choline metabolites, which have been linked to cell density [27,28], the Ki67 proliferation index [18,19], and nuclear shape [17,27], as well as being suggested as a marker of rapid cellular proliferation and tumour aggressiveness [23,29,30]. There is also substantial literature on lipid levels detected by MRS in tumours.…”

Section: Introductionmentioning

confidence: 99%

“…However, whilst some studies have correlated clinical information such as tumour grade with MRS features, there are relatively few studies that have directly examined the relationship between in vivo metabolite markers and traditional histopathological measures [17][18][19][20][21]. Even fewer studies have been undertaken in paediatric brain tumour patients [22,23]. There is also an increasing trend in clinical studies towards the use of short echo time MRS data that can measure a larger number of metabolites, increasing the information available and allowing detailed laboratory findings to be investigated [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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Metabolite Levels in Paediatric Brain Tumours Correlate with Histological Features

Orphanidou-Vlachou

Kohe²,

Bründler³

et al. 2018

Pathobiology

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Aims: Metabolite levels can be measured non-invasively using in vivo ¹H magnetic resonance spectroscopy (MRS). These tumour metabolite profiles are highly characteristic for tumour type in childhood brain tumours; however, the relationship between metabolite values and conventional histopathological characteristics has not yet been fully established. This study systematically tests the relationship between metabolite levels detected by MRS and specific histological features in a range of paediatric brain tumours. Methods: Single-voxel MRS was performed routinely in children with brain tumours along with the clinical imaging prior to treatment. Metabolites were quantified using LCModel. Histological features were assessed semi-quantitatively for 27 children on H&E and immunostained slides, blind to the metabolite values. Statistical analysis included 2-tailed independent-samples t tests and 2-tailed Spearman rank correlation tests. Results: Ki67, cellular atypia, and mitosis correlated positively with choline metabolites, and phosphocholine in particular. Apoptosis and necrosis were both associated with lipid levels, with the relationship dependent on the use of long or short echo time MRS acquisitions. Neuronal components correlated negatively and glial components positively with N-acetyl-aspartate. Glial components correlated positively with myoinositol. Conclusion: Metabolite levels in children's brain tumours measured by MRS are closely associated with key histological features routinely assessed by histopathologists in the diagnostic process. This further elucidates our understanding of this important non-invasive diagnostic tool and strengthens our understanding of the relationship between metabolites and histological features.

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“…106 Differences have also been found in the primary tumors of medulloblastomas with and without metastatic disease at diagnosis. 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%

Using magnetic resonance imaging and spectroscopy in cancer diagnostics and monitoring

Kauppinen

Peet

2011

Cancer Biology & Therapy

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Magnetic resonance spectroscopy suggests key differences in the metastatic behaviour of medulloblastoma

Cited by 33 publications

References 24 publications

Accurate classification of childhood brain tumours by in vivo 1H MRS – A multi-centre study

Accurate classification of childhood brain tumours by in vivo 1H MRS – A multi-centre study

Metabolite Levels in Paediatric Brain Tumours Correlate with Histological Features

Using magnetic resonance imaging and spectroscopy in cancer diagnostics and monitoring

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