Clinical Research Papers:
Dynamic 1H-MRS assessment of brain tumors: a novel approach for differential diagnosis of glioma
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Tong Tong1, Zhong Yang2, John W. Chen3, Jianming Zhu4, Zhenwei Yao2
1Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
2Department of Radiology, Fudan University Huashan Hospital, Shanghai, China
3Institute for Innovation in Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
4Department of Radiation Oncology, The University of North Carolina, Chapel Hill, NC, USA
Zhenwei Yao, e-mail: email@example.com
John W. Chen, e-mail: firstname.lastname@example.org
Keywords: clinical paper, magnetic resonance imaging, magnetic resonance spectroscopy, glioma, differential diagnosis
Received: May 18, 2015 Accepted: August 07, 2015 Published: August 20, 2015
Purpose: To determine whether the changes of [Cho/NAA] ratio in patients with glioma, measured by dynamic 1H-MRS can be used to differentiate between high-grade and low-grade gliomas.
Materials and Methods: This prospective study was approved by the institutional ethics committee. Written informed consent was obtained. Forty-nine patients with biopsy-proven glioma and 20 normal control subjects were recruited in this study. The maximum [Cho/NAA] ratios, acquired at 0 min, and at 6 min, were calculated and assessed from volume of interests (VOI) in the tumor areas and in the surrounding normal tissue for each patient. Absolute difference in the [Cho/NAA] ratios, from MRS acquired at 0 and 6 min, in high-grade glioma, low-grade glioma, and control subjects were compared.
Results: The maximum [Cho/NAA] ratio acquired from the tumor area at the 0 min is 6.08 ± 2.02, which was significantly different (p = .017) from that acquired after 6 min, 4.87 ± 2.13. The [Cho/NAA] ratio from the surrounding normal tissue area did not change significantly from spectra acquired at different times (0 min, 6 min). Absolute difference in [Cho/NAA] ratios acquired at 0 and 6 min time points were significantly higher (P < 0.001) in high-grade glioma (= 3.86 ± 3.31) than in low-grade glioma (= 0.81 ± 0.90), and control subjects (0.061 ± 0.026, P = 0.000), while there was no significantly difference in low-grade glioma and control subjects.
Conclusions: Dynamic 1H-MRS can be useful for differential diagnosis between high-grade and low-grade gliomas as well as insight into the heterogeneity within the tumor.
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