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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:560-572, March 2006
© 2006 American Society of Neuroradiology

PEDIATRICS

Quantitative Short Echo Time ¹H-MR Spectroscopy of Untreated Pediatric Brain Tumors: Preoperative Diagnosis and Characterization

A. Panigrahy^a, M.D. Krieger^a, I. Gonzalez-Gomez^a, X. Liu^a, J.G. McComb^a, J.L. Finlay^a, M.D. Nelson, Jr.^a, F.H. Gilles^a and S. Blüml^a

^a From the Department of Radiology, the Division of Neurosurgery, the Department of Neuropathology, and the Childrens Center for Cancer and Blood Diseases, Childrens Hospital Los Angeles, Los Angeles, Calif; and the Rudi Schulte Research Institute, Santa Barbara, Calif

Address correspondence to: Stefan Blüml, PhD, Department of Radiology, Childrens Hospital Los Angeles, MS 81, 4650 Sunset Blvd, Los Angeles, CA 90027

PURPOSE: Our aims were to evaluate the metabolic profiles of pediatric brain tumors with short echo time (TE) MR spectroscopy and absolute quantitation of metabolite concentrations (in mmol/kg of tissue) and to describe metabolic features that distinguish individual tumor types and that may help to improve preoperative diagnosis of specific tumors.

METHODS: MR imaging examinations of 60 patients with untreated brain tumors (14 medulloblastomas, 5 anaplastic astrocytomas, 3 low-grade astrocytomas, 17 pilocytic astrocytomas, 4 anaplastic ependymomas, 5 ependymomas, 3 choroid plexus papillomas, 3 choroid plexus carcinomas, and 6 pineal germinomas) were reviewed. Single-voxel proton MR spectroscopy with a TE of 35 ms was performed and absolute metabolite concentrations were determined by using fully automated quantitation.

RESULTS: Taurine (Tau) was significantly elevated in medulloblastomas (P < .00001) compared with all other tumors pooled (All Other). Tau was also observed consistently, at lower concentration, in pineal germinomas. Creatine (Cr) was significantly reduced in pilocytic astrocytomas, distinguishing them from All Other (P < .000001). The MR spectra of choroid plexus papillomas exhibited low Cr (P < .01) concentrations; however, myoinositol was elevated (P < .01) and total choline (tCho) (P < .0001) was reduced relative to All Other. Choroid plexus carcinomas had low Cr (P < .01 versus All Other) and the lowest Cr/tCho ratio (P < .0001 versus All Other) among all tumors studied. Guanidinoacetate was reduced in low-grade astrocytomas and anaplastic astrocytomas (P < .00001) versus All Other, whereas ependymoma and anaplastic ependymomas exhibited particularly low N-acetylaspartate (P < .00001 versus All Other).

CONCLUSION: Quantitative proton MR spectroscopy reveals features of pediatric brain tumors that are likely to improve preoperative diagnoses.

This article has been cited by other articles:

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