PT - JOURNAL ARTICLE AU - B. Tamrazi AU - S. Venneti AU - A. Margol AU - D. Hawes AU - S.Y. Cen AU - M. Nelson AU - A. Judkins AU - J. Biegel AU - S. Blüml TI - Pediatric Atypical Teratoid/Rhabdoid Tumors of the Brain: Identification of Metabolic Subgroups Using In Vivo <sup>1</sup>H-MR Spectroscopy AID - 10.3174/ajnr.A6024 DP - 2019 Apr 04 TA - American Journal of Neuroradiology 4099 - http://www.ajnr.org/content/early/2019/04/04/ajnr.A6024.short 4100 - http://www.ajnr.org/content/early/2019/04/04/ajnr.A6024.full AB - BACKGROUND AND PURPOSE: Atypical teratoid/rhabdoid tumors are rare, aggressive central nervous system tumors that are predominantly encountered in very young children. Our aim was to determine whether in vivo metabolic profiles correlate with molecular features of central nervous system pediatric atypical teratoid/rhabdoid tumors.MATERIALS AND METHODS: Twenty confirmed patients with atypical teratoid/rhabdoid tumors who underwent MR spectroscopy were included in this study. In vivo metabolite levels of atypical teratoid/rhabdoid tumors were compared with molecular subtypes assessed by achaete-scute homolog 1 expression. Additionally, brain-specific creatine kinase levels were determined in tissue samples.RESULTS: In vivo creatine concentrations were higher in tumors that demonstrated achaete-scute homolog 1 expression compared with those without achaete-scute homolog 1 expression (3.42 ± 1.1 versus 1.8 ± 0.8 IU, P &lt; .01). Additionally, levels of myo-inositol (mI) (9.0 ± 1.5 versus 4.7 ± 3.6 IU, P &lt; .05) were significantly different, whereas lipids approached significance (44 ± 20 versus 80 ± 30 IU, P = .07) in these 2 cohorts. Higher brain-specific creatine kinase levels were observed in the cohort with achaete-scute homolog 1 expression (P &lt; .05). Pearson correlation analysis showed a significant positive correlation of brain-specific creatine kinase with absolute creatine (P &lt; .05) and myo-inositol (P &lt; .05) concentrations.CONCLUSIONS: In vivo MR spectroscopy may predict key molecular features of atypical teratoid/rhabdoid tumors at initial diagnosis, leading to timely patient risk stratification and accelerating the development of targeted therapies.ASCL1achaete-scute homolog 1AT/RTatypical teratoid/rhabdoid tumorCKBbrain-specific creatine kinaseCrcreatinemImyo-inositolChocholineSMARCB1SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1