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Research ArticleBRAIN

Proton MR Spectroscopic Evaluation of Suspicious Brain Lesions After Stereotactic Radiotherapy

Heinz–Peter Schlemmer, Peter Bachert, Klaus K. Herfarth, Ivan Zuna, Jürgen Debus and Gerhard van Kaick
American Journal of Neuroradiology August 2001, 22 (7) 1316-1324;
Heinz–Peter Schlemmer
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Peter Bachert
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Klaus K. Herfarth
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Ivan Zuna
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Jürgen Debus
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Gerhard van Kaick
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Abstract

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.

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American Journal of Neuroradiology: 22 (7)
American Journal of Neuroradiology
Vol. 22, Issue 7
1 Aug 2001
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Proton MR Spectroscopic Evaluation of Suspicious Brain Lesions After Stereotactic Radiotherapy
Heinz–Peter Schlemmer, Peter Bachert, Klaus K. Herfarth, Ivan Zuna, Jürgen Debus, Gerhard van Kaick
American Journal of Neuroradiology Aug 2001, 22 (7) 1316-1324;

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Proton MR Spectroscopic Evaluation of Suspicious Brain Lesions After Stereotactic Radiotherapy
Heinz–Peter Schlemmer, Peter Bachert, Klaus K. Herfarth, Ivan Zuna, Jürgen Debus, Gerhard van Kaick
American Journal of Neuroradiology Aug 2001, 22 (7) 1316-1324;
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