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Longitudinal MR Spectroscopic Imaging of Pediatric Diffuse Pontine Tumors to Assess Tumor Aggression and Progression

S.B. Thakura, S. Karimib, I.J. Dunkelc, J.A. Koutchera,b,d and W. Huanga,b

a Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY
b Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
c Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY
d Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY


Figure 1
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  		Fig 1. Postcontrast axial T1-weighted MR image of patient 1 at baseline (A), showing no enhancement, and at follow-up 1 (B), revealing contrast enhancement in the tumor region.


Figure 2
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  		Fig 2. (A) The region of excitation or PRESS box (white) and the phase-encoding matrix (green) for the MR spectroscopic imaging data acquisition are superimposed on an axial FLAIR MR image of patient 1 at baseline. The region of excitation encompasses the lesion (region of hyperintensity on the FLAIR image) and surrounding normal-appearing tissue. (B) Proton spectrum from a voxel in the tumor area (red box) of patient 1 at baseline. (C) Proton spectrum from a voxel in the normal-appearing tissue area (blue box) of patient 1 at baseline. (D) Proton spectrum obtained at follow-up 1 from the same voxel of origin for the spectrum shown in B.


Figure 3
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  		Fig 3. Zoomed 2 x 3 array of proton spectra (A) collected at follow-up 1 from the tumor region of patient 1, where MR imaging contrast enhancement was observed (B).


Figure 4
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  		Fig 4. Scatterplots of Cho/Cr and Cho/NAA (left vertical axis) in the lesion region of interest and NAROI, and CEV (right vertical axis) at baseline, follow-up 1, and follow-up 2 for patients 1 (A) and 2 (B).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X