Magnetic resonance spectroscopy guided brain tumor resection: differentiation between recurrent glioma and radiation change in two diagnostically difficult cases

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Mark C PreulD L Arnold

Abstract

It is often difficult to differentiate a recurrent glioma from the effects of post-operative radiotherapy by means of conventional neurodiagnostic imaging. Proton magnetic resonance spectroscopic imaging (1H-MRSI), that allows in vivo measurements of the concentration of brain metabolites such as choline-containing phospholipids (Cho), may provide in vivo biochemical information helpful in distinguishing areas of tumor recurrence from areas of radiation effect. Two patients who had undergone resection and post-operative radiotherapy for a cerebral glioma became newly symptomatic. Computed tomographic (CT) and magnetic resonance imaging (MRI) performed after the intravenous infusion of contrast material, and in one case, [18F]fluorodeoxyglucose positron emission tomography (PET), could not differentiate between the possibilities of recurrent glioma and radiation effect. The patients underwent 1H-MRSI prior to reoperation and the 1H-MRSI results were compared to histological findings originating from the same locations. A high Cho signal measured by 1H-MRSI was seen in areas of histologically-proven dense tumor recurrence, while low Cho signal was present where radiation changes predominated. The differentiation between the recur...Continue Reading

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Citations

May 15, 2015·Mathematical Biosciences and Engineering : MBE·Nikolay L MartirosyanMark C Preul
Feb 13, 2001·Journal of Magnetic Resonance Imaging : JMRI·T R McKnightS J Nelson
Sep 17, 2007·Optics Express·Conor L EvansGeoffrey S Young
Jun 1, 2004·The Oncologist·Katherine E Warren
Aug 11, 2006·Stereotactic and Functional Neurosurgery·J D RabinovR G Gonzalez
Nov 16, 2007·Neuro-oncology·Ashok PanigrahyStefan Blüml
Mar 10, 2012·Radiation Research·Dominick J O McIntyreJohn R Griffiths
Jun 16, 2005·Current Problems in Pediatric and Adolescent Health Care·Adam S Levy
Nov 25, 2004·Neurosurgery Clinics of North America·Stephen GruberEwald Moser

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