| MR Spectroscopy Using Normalized and Non-normalized Metabolite Ratios for Differentiating Recurrent Brain Tumor from Radiation Injury. | |
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MedLine Citation:
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PMID: 21820634 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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RATIONALE AND OBJECTIVES: To compare the ability of normalized versus non-normalized metabolite ratios to differentiate recurrent brain tumor from radiation injury using magnetic resonance spectroscopy (MRS) in previously treated patients. MATERIALS AND METHODS: Twenty-five patients with previous diagnosis of primary intracranial neoplasm confirmed with biopsy/resection, previously treated with radiation therapy (range, 54-70 Gy) with or without chemotherapy and new contrast enhancing lesion on a 1.5 T magnetic resonance imaging at the site of the primary neoplasm participated in this retrospective study. After MRS, clinical, radiological, and histopathology data were used to classify new contrast-enhancing lesions as either recurrent neoplasm or radiation injury. Volume of interest included both the lesion and normal-appearing brain on the contralateral side. Non-normalized metabolic ratios were calculated from choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) spectroscopic values obtained within the contrast-enhancing lesion: Cho/Cr, NAA/Cr, and Cho/NAA. Normalized ratios were calculated using the metabolic values from the contralateral normal side: Cho/normal creatinine (nCr), Cho/normal N-acetylaspartate (nNAA), Cho/normal choline, NAA/nNAA, NAA/nCr, and Cr/nCr. Results were correlated with the final diagnosis by Wilcoxon rank-sum analysis. RESULTS: Two of three non-normalized ratios, Cho/NAA (sensitivity 86%, specificity 90%) and NAA/Cr (sensitivity 93%, specificity 70%) significantly associated with tumor recurrence even after correcting for multiple comparisons. Of the six normalized ratios, only Cho/nNAA significantly correlated with tumor recurrence (sensitivity 73%, specificity 40%), but did not remain significant after correcting for multiple comparisons. CONCLUSION: Cho/NAA and NAA/Cr were the two ratios with the best discriminating ability and both had better discriminating ability than their corresponding normalized ratios (Area under the curve = 0.92 versus 0.77, AUC= 0.85 vs. 0.66), respectively. |
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Authors:
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Augusto E Elias; Ruth C Carlos; Ethan A Smith; Dan Frechtling; Bekris George; Pavel Maly; Pia C Sundgren |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Academic radiology Volume: 18 ISSN: 1878-4046 ISO Abbreviation: Acad Radiol Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-08-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9440159 Medline TA: Acad Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 1101-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Radiology, University of Michigan Health Systems, 1500 E. Medical Center Drive, Ann Arbor, MI 48109. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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