Sudden Unexpected Death From Oligodendroglioma

Prolonged spin-spin relaxation times in tumour tissue have been observed since some of the earliest nuclear magnetic resonance investigations of the brain. Over the last three decades, numerous studies have sought to characterize tumour morphology and malignancy using quantitative assessment of T relaxation times, although attempts to categorize and differentiate tumours have had limited success. However, previous work must be interpreted with caution as relaxation data were typically acquired using a variety of multiple echo sequences with a range of echoes and T decay curves and were frequently fit with monoexponential analysis. We defined the distribution of T components in three different human brain tumours (glioblastoma, oligodendroglioma, meningioma) using a multi-echo sequence with a greater number of echoes and a longer acquisition window than previously used (48 echoes, data collection out to 1120 ms) with no a priori assumptions about the number of exponential components contributing to the T decay. T relaxation times were increased in tumour tissue and each tumour showed a distinct T distribution profile. Tumours have complex and unique compartmentalization characteristics. Quantitative assessment of T relaxation in brain cancer may be useful in evaluating different grades of brain tumours on the basis of their T distribution profile, and has the potential to be a non-invasive diagnostic tool which may also be useful in monitoring therapy. Further study with a larger sample size and varying grades of tumours is warranted.

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