Brain tumours and their metabolic profiles by magnetic resonance spectroscopy (original) (raw)
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1H-MRS metabolic patterns for distinguishing between meningiomas and other brain tumors
Magnetic Resonance Imaging, 2003
Yet meningiomas have characteristic neuroimaging features, some other lesions are still confusing with meningiomas. The aim of this study was trying to find the typical 1 H-MRS metabolic factors of histologic subtyped meningiomas, schwannomas, metastases, and other brain tumors for differential diagnosis among them. 1 H-MRS using STEAM (TE/30 ms, TR/2 sec) and PRESS (TE/288 ms, TR/2 sec) sequences were performed on 44 untreated brain tumors. Obtained metabolic patterns from the typical spectra of meningioma, schwannoma, metastasis were compared with each other or other brain tumors to evaluate the usefulness for diagnosis between them. Alanine(Ala) was observed in 15 cases of the 19 meningiomas with a little variation to three histologic subtypes, while minimal lipids were observed in every 19 meningiomas. Elevated glutamate/glutamine(Glx) was detected in 12 cases of the meniningiomas. Increased myo-inositol(mI) was detected in 11 cases of the 13 schwannomas. Dominant lipids signals as well as long-T2 lipids were detected in every metastasis in conjunction with elevated choline (Cho). Enhanced Glx was observed in 4 cases of the 8 metastases without correlation of primary tumor site or types. Hemangiopericytoma showed different spectral patterns from typical meningiomas: only dominant Cho, minimal lipids and absence of Ala or Glx signals. These metabolic patterns in typical tumors may provide a basis for differential diagnosis (average value of 2 ϭ 23.33, p Ͻ 0.01) between meningiomas and schwannomas as well as metastases. However proton spectral distinction among the different histologic subtypes of meningiomas was not definite.
Nuclear magnetic resonance (NMR) has been used to detect the chemicals earlier before the clinical application of magnetic resonance imaging (MRI). Since late 1980s, magnetic resonance spectroscopy (MRS) became popular with the advancement of MRI. Previous studies on in vitro NMR and in vivo MRS elucidate the effectiveness of its clinical application in different areas. We performed this study, which combines MRI and in vivo MRS, to evaluate the metabolic status of different brain tumors. We prospectively evaluated the patients with brain tumor by Single-Voxel Proton Brain Spectroscopy Exam (PROBE / SV) in 2000 and 2001. Eight glioblastoma multiformes, 5 astrocytomas, 3 meningiomas, 4 lung carcinomas with brain metastases, and 15 normal brains as the control group were included in this study. The spectra of metabolite peaks of the N-acetylaspartate (NAA), Creatine (Cr) and Choline (Cho) of the brain tumors were evaluated and compared with that of the control group. As compared with the control group, the quantitative peak ratio of NAA/Cho was significantly decreased in lesions of glioblastoma, astrocytoma, meningioma, and metastasis. The NAA/Cr and Cr/Cho peak ratios were also significantly decreased in glioblastoma and astrocytoma; on the contrary, the Cho/Cr peak ratio was increased. In patients with carcinoma of lung with brain metastasis, the NAA/Cho was significantly higher than the glioblastoma. When a focal mass lesion was detected on MRI, and the spectroscopy showed marked decrease of NAA/Cho, NAA/Cr and Cr/Cho ratios, either astrocytoma or glioblastoma should be highly considered. If the mass lesion showed higher NAA/Cho peak ratio, and the patient already had a primary malignancy, metastasis was the most likely diagnosis as compared with glioblastoma, astrocytoma and meningioma.
Metabolic Profiles of Brain Metastases
International Journal of Molecular Sciences, 2013
Metastasis to the brain is a feared complication of systemic cancer, associated with significant morbidity and poor prognosis. A better understanding of the tumor metabolism might help us meet the challenges in controlling brain metastases. The study aims to characterize the metabolic profile of brain metastases of different origin using high resolution magic angle spinning (HR-MAS) magnetic resonance spectroscopy (MRS) to correlate the metabolic profiles to clinical and pathological information. Biopsy samples of human brain metastases (n = 49) were investigated. A significant correlation between lipid signals and necrosis in brain metastases was observed (p < 0.01), irrespective of their OPEN ACCESS primary origin. The principal component analysis (PCA) showed that brain metastases from malignant melanomas cluster together, while lung carcinomas were metabolically heterogeneous and overlap with other subtypes. Metastatic melanomas have higher amounts of glycerophosphocholine than other brain metastases. A significant correlation between microscopically visible lipid droplets estimated by Nile Red staining and MR visible lipid signals was observed in metastatic lung carcinomas (p = 0.01), indicating that the proton MR visible lipid signals arise from cytoplasmic lipid droplets. MRS-based metabolomic profiling is a useful tool for exploring the metabolic profiles of metastatic brain tumors.
NMR in Biomedicine, 2005
High-resolution proton magnetic resonance spectroscopy was performed on tissue specimens from 33 patients with astrocytic tumors (22 astrocytomas, 11 glioblastomas) and 13 patients with meningiomas. For all patients, samples of primary tumors and their first recurrences were examined. Increased anaplasia, with respect to malignant transformation, resulting in a higher malignancy grade, was present in 11 recurrences of 22 astrocytoma patients. Spectroscopic features of tumor types, as determined on samples of the primary occurrences, were in good agreement with previous studies. Compared with the respective primary astrocytomas, characteristic features of glioblastomas were significantly increased concentrations of alanine (Ala) (p ¼ 0.005), increased metabolite ratios of glycine (Gly)/total creatine (tCr) (p ¼ 0.0001) and glutamate (Glu)/glutamine (Gln) (p ¼ 0.004). Meningiomas showed increased Ala (p ¼ 0.02) and metabolite ratios [Gly, total choline (tCho), Ala] over tCr (p ¼ 0.001) relative to astrocytomas, and N-acetylaspartate and myo-inositol were absent. Metabolic changes of an evolving tumor were observed in recurrent astrocytomas: owing to their consecutive assessments, more indicators of malignant degeneration were detected in astrocytoma recurrences (e.g. Gly, p ¼ 0.029; tCho, p ¼ 0.034; Glu, p ¼ 0.015; tCho/tCr, p ¼ 0.001) in contrast to the comparison of primary astrocytomas with primary glioblastomas. The present investigation demonstrated a correlation of the tCho-signal with tumor progression. Significantly elevated concentrations of Ala (p ¼ 0.037) and Glu (p ¼ 0.003) and metabolite ratio tCho/tCr (p ¼ 0.005) were even found in recurrent low-grade astrocytomas with unchanged histopathological grading (n ¼ 11). This may be related to an early stage of malignant transformation, not yet detectable morphologically, and emphasizes the high sensitivity of 1 H NMR spectroscopy in elucidating characteristics of brain tumor metabolism.
NMR in Biomedicine, 1997
Water-soluble metabolites extracted from 60 surgically excised samples of various brain tumors and four nontumorous lobectomized brains were measured quantitatively using in vitro high-resolution magnetic resonance spectroscopy. A detailed MR spectrum-histology correlation study in a glioblastoma was made, to reveal MR spectral changes in accordance with the density of glioma cells. Furthermore, three cases that had difficult preoperative diagnoses are discussed. MR spectra from gliomas exhibited characteristic patterns according to malignancy, presumably reflecting its metabolic effects. Concentrations of choline-containing compounds, inositol, alanine, glycine and phosphorylethanolamine (PEA) increased according to the degree of malignancy, but it was noteworthy that in glioblastoma the choline-containing compounds, inositol, alanine, glycine and phosphorylethanolamine increased according to the degree of malignancy. In particular, the glycine concentration was very high in glioblastoma. We also detected a large amount of taurine in medulloblastoma. Although the total creatine concentrations decreased according to the malignancy, the concentration of total creatine was relatively preserved in neuroectodermal tumors but was low in nonneuroectodermal tumors. N-acetyl-aspartate was unequivocally demonstrated in normal tissues, but could not be detected in nonneuroectodermal brain tumors such as metastatic brain tumor, meningioma, neurinoma and chordoma. In meningioma, although a high peak of choline-containing compounds has been reported uniquely by in vitro and in vivo 1 H-MRS, we demonstrated that its concentration was not increased in meningioma; instead, there was an increased alanine content. 1 H-MRS of neurinoma demonstrated high inositol peaks, and a large amount of inositol. The reason for the high inositol content in neurinoma is unknown, but the prominent peak of inositol on MR spectra should be useful for the differential diagnosis of neurinoma from meningioma. PEA concentration was increased four to five times in pituitary adenoma, malignant lymphoma, and medulloblastoma as compared with normal brain. Thus 1 H-MRS might provide clinically useful information on tumor malignancy and characteristic tumor metabolism. Although excellent anatomical information of tumors can be readily obtained by magnetic resonance imaging, MRS provides metabolic information. MRS may provide additional information in cases in which the differential diagnosis of tumors by neuroimaging is difficult.
Revealing the metabolic profile of brain tumors for diagnosis purposes
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2009
The metabolic behavior of complex brain tumors, like Gliomas and Meningiomas, with respect to their type and grade was investigated in this paper. Towards this direction the smallest set of the most representative metabolic markers for each brain tumor type was identified, using ratios of peak areas of well established metabolites, from (1)H-MRSI (Proton Magnetic Resonance Spectroscopy Imaging) data of 24 patients and 4 healthy volunteers. A feature selection method that embeds Fisher's filter criterion into a wrapper selection scheme was applied; Support Vector Machine (SVM) and Least Squares-SVM (LS-SVM) classifiers were used to evaluate the ratio markers classification significance. The area under the Receiver Operating Characteristic curve (AUROC) was adopted to evaluate the classification significance. It is found that the NAA/CHO, CHO/S, MI/S ratios can be used to discriminate Gliomas and Meningiomas from Healthy tissue with AUROC greater than 0.98. Ratios CHO/S, CRE/S, MI...
Study of Correlation between Magnetic Resonance Spectroscopy Metabolites and Glioma Grading
International Journal of Contemporary Medicine, Surgery and Radiology, 2019
Gliomas are among the most common primary neoplasms in children and adults. Management plan for gliomas greatly depends on their grade. Based on their grade, pre or post-surgical radiation or chemotherapy may be advocated. The objective of our study was to evaluate the role of Magnetic Resonance Spectroscopy in differentiating grades of glioma and to assess the relationship of brain metabolite ratios. Material and methods: Magnetic Resonance Spectroscopy was performed in 27 patients with gliomas which were histologically proven. Brain metabolite ratios were calculated at intermediate / long Echo Time. Tumours were graded as low grade or high grade gliomas by experienced radiologist based on Magnetic resonance imaging and Magnetic Resonance Spectroscopy findings. Post-surgery, the histologic grade of glioma was correlated with that of imaging grade. Results: Overall sensitivity, specificity, positive and negative predictive values for classifying glioma into grades using Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy was found to be 83%, 66%, 66% and 83% respectively. Among the metabolite ratios, Choline-to-Creatine was found to be most useful in grading gliomas as low and high grade. Conclusion: Magnetic Resonance Spectroscopy is a useful tool in diagnosing gliomas. Various metabolite ratios can be used in grading gliomas by considering the peri tumoral spread and nature of tumour composition. Further studies on Magnetic Resonance Spectroscopy metabolites are required to improve the sensitivity and specificity of the diagnosing tools in grading gliomas.
Molecular medicine reports, 2012
The purpose of the present study was to evaluate distinct metabolic features of meningiomas to distinguish them from other brain lesions using proton magnetic resonance spectroscopy. The study was performed on 17 meningiomas, 24 high-grade gliomas and 9 metastases. Elevated signal intensity at 3.8 ppm observed in low TE spectra adequately differentiated meningioma from other brain tumors while alanine was not indicative of meningioma occurrence; the presence of lipids and lactate did not provide a strong index for meningioma malignancy.
2020
Background: Glioblastoma Multiforme (GBM) is the most common and deadly type of primary brain tumor in adults. Magnetic Resonance Spectroscopy (MRS) is a noninvasive imaging technique used to study metabolic changes in the brain tumors. Some metabolites such as Phosphocholine, Creatine, NAA/Cr, and Pcho/Cr have been proven to show a diagnostic role in GBM. The present study was conducted to analyze important metabolites using MRS multivoxel in GBM tumor. Methods: In this study, information was collected from 8 individuals diagnosed with GBM using Siemens multivoxel MRS with a magnetic field strength of 3 T. Data were obtained by Point-Resolved Spectroscopy (PRESS) protocol with TE=135 ms and TR=1570 ms. NAA, Pcho, Cr, Ala, Gln, Gly, Glu, Lac, NAAG, and Tau metabolites were extracted and evaluated statistically. Results: Given total number of normal voxels and total number of all voxels, levels of Cr, Glu, NAA, NAAG, and Gly/Tau ratio in healthy voxels were significantly higher than ...