American Journal of Neuroradiology 22:1316-1324 (8 2001)
© 2001 American Society of Neuroradiology
ARTICLE
Proton MR Spectroscopic Evaluation of Suspicious Brain Lesions After Stereotactic Radiotherapy
a From the Departments of Oncological Diagnostics and Therapy (H.–P.S., G.V.K.), Biophysics and Medical Radiation Physics (P.B.), and Radiooncology (I.Z.), German Cancer Research Center (dkfz), Heidelberg, Germany, and the Department of Radiooncology (K.K.H, J.D.), University of Heidelberg, Heidelberg, Germany.
BACKGROUND AND PURPOSE: The radiologic assessment of suspicious brain lesions after stereotactic radiotherapy of brain tumors is difficult. The purpose of our study was to define parameters from single-voxel proton MR spectroscopy that provide a probability measure for differentiating neoplastic from radiation-induced, nonneoplastic lesions.
METHODS: Seventy-two lesions in 56 patients were examined using a combined MR imaging and MR spectroscopy protocol (point-resolved spectroscopy, TE = 135 ms). Signal intensities of cholines, creatines, N-acetyl aspartate, and the presence of lactate and lipid resonances were correlated to final diagnoses established by clinical and MR imaging follow-up, positron emission tomography studies, or biopsy/surgery. Statistical analysis was performed using the t test, linear discriminant analysis, and k nearest-neighbor method.
RESULTS: Significantly increased signal intensity ratios ItCho/ItCr (P < .0001) and ItCho/INAA (P < .0001) were observed in neoplastic (n = 34) compared with nonneoplastic lesions (n = 32) and contralateral normal brain (n = 33). Analysis of ItCho/ItCr and ItCho/INAA data yielded correct retrospective classification as neoplastic and nonneoplastic in 82% and 81% of the lesions, respectively. Neither INAA/ItCr nor signal intensitities of lactate or lipids were useful for differential diagnosis.
CONCLUSION: Metabolic information provided by proton MR spectroscopy is useful for the differentiation of neoplastic and nonneoplastic brain lesions after stereotactic radiotherapy of brain tumors.
This article has been cited by other articles:
 |
|
 |
|
  A. A. Brandes, E. Franceschi, A. Tosoni, V. Blatt, A. Pession, G. Tallini, R. Bertorelle, S. Bartolini, F. Calbucci, A. Andreoli, et al. MGMT Promoter Methylation Status Can Predict the Incidence and Outcome of Pseudoprogression After Concomitant Radiochemotherapy in Newly Diagnosed Glioblastoma Patients J. Clin. Oncol., May 1, 2008; 26(13): 2192 - 2197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Panigrahy, M. D. Nelson Jr, J. L. Finlay, R. Sposto, M. D. Krieger, F. H. Gilles, and S. Bluml Metabolism of diffuse intrinsic brainstem gliomas in children Neuro-oncol, February 1, 2008; 10(1): 32 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Brandes, A. Tosoni, F. Spagnolli, G. Frezza, M. Leonardi, F. Calbucci, and E. Franceschi Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: Pitfalls in neurooncology Neuro-oncol, January 1, 2008; 10(3): 361 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Weber, S. Zoubaa, M. Schlieter, E. Juttler, H. B. Huttner, K. Geletneky, C. Ittrich, M. P. Lichy, A. Kroll, J. Debus, et al. Diagnostic performance of spectroscopic and perfusion MRI for distinction of brain tumors Neurology, June 27, 2006; 66(12): 1899 - 1906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Cao, P. C. Sundgren, C. I. Tsien, T. T. Chenevert, and L. Junck Physiologic and Metabolic Magnetic Resonance Imaging in Gliomas J. Clin. Oncol., March 10, 2006; 24(8): 1228 - 1235. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Weybright, P. C. Sundgren, P. Maly, D. G. Hassan, B. Nan, S. Rohrer, and L. Junck Differentiation Between Brain Tumor Recurrence and Radiation Injury Using MR Spectroscopy Am. J. Roentgenol., December 1, 2005; 185(6): 1471 - 1476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Henze, A. Mohammed, H. P. Schlemmer, K. K. Herfarth, S. Hoffner, S. Haufe, W. Mier, M. Eisenhut, J. Debus, and U. Haberkorn PET and SPECT for Detection of Tumor Progression in Irradiated Low-Grade Astrocytoma: A Receiver-Operating-Characteristic Analysis J. Nucl. Med., April 1, 2004; 45(4): 579 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Hein, C. J. Eskey, J. F. Dunn, and E. B. Hug Diffusion-Weighted Imaging in the Follow-up of Treated High-Grade Gliomas: Tumor Recurrence versus Radiation Injury AJNR Am. J. Neuroradiol., February 1, 2004; 25(2): 201 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Bulakbasi, M. Kocaoglu, F. Ors, C. Tayfun, and T. Ucoz Combination of Single-Voxel Proton MR Spectroscopy and Apparent Diffusion Coefficient Calculation in the Evaluation of Common Brain Tumors AJNR Am. J. Neuroradiol., February 1, 2003; 24(2): 225 - 233. [Abstract] [Full Text] [PDF]
|
|