| Neuroimaging in pediatric brain tumors: Gd-DTPA-enhanced, hemodynamic, and diffusion MR imaging compared with MR spectroscopic imaging. | |
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MedLine Citation:
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PMID: 11847064 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Gadolinium-enhanced MR images assist in defining tumor borders; however, the relation between tumor cell extent and contrast-enhanced regions is unclear. Our aim was to improve conventional neuroimaging of pediatric brain tumors with hemodynamic, diffusion, and spectroscopic MR imaging. METHODS: We performed conventional MR and MR spectroscopic imaging in 31 children with neuroglial brain tumors. Hemodynamic MR imaging was performed in 16 patients with a first-pass intravenous bolus of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA); apparent diffusion coefficients (ADCs) were measured in 12 patients. To account for multiple measurements in a patient, we used a nested analysis of variance. RESULTS: At MR spectroscopy, choline (Cho)-containing compounds (indicating tumor) and lipid levels (indicating necrosis) did not correlate with percent Gd-DTPA enhancement on MR images. Percent enhancement was positively correlated with relative cerebral blood volumes (rCBVs) (P =.05) and negatively correlated with ADCs (P <.001). Stepwise multiple linear regression revealed that rCBV (P =.008), ADC (P =.022), and lipid (P <.001) levels were significant independent predictors of percent enhancement. Tumor spectral patterns were detected in tumor regions and outside enhancing tumor beds in patients with clinical progression; these were confirmed at neuropathologic analysis. CONCLUSION: MR spectroscopic imaging improves the assessment of pediatric brain tumors by adding biochemical information regarding tumor involvement and by depicting residual or recurrent tumor outside the Gd-DTPA-enhanced tumor bed. rCBV and ADC mapping complemented MR spectroscopic imaging. We recommend the use of MR spectroscopic imaging in addition to conventional MR imaging in assessing pediatric brain tumors. |
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Authors:
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A Aria Tzika; Maria K Zarifi; Liliana Goumnerova; Loukas G Astrakas; David Zurakowski; Tina Young-Poussaint; Douglas C Anthony; R Michael Scott; Peter McL Black |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 23 ISSN: 0195-6108 ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-02-15 Completed Date: 2002-03-26 Revised Date: 2008-02-14 |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: United States |
Other Details:
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Languages: eng Pagination: 322-33 Citation Subset: IM |
Affiliation:
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Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA 02114, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Blood Volume* Brain Neoplasms / diagnosis*, physiopathology* Cerebrovascular Circulation* Child Child, Preschool Choline / metabolism Contrast Media* Diffusion Disease Progression Gadolinium DTPA / diagnostic use* Humans Infant Lipid Metabolism Magnetic Resonance Imaging / methods* Magnetic Resonance Spectroscopy / diagnostic use* Neoplasm Recurrence, Local / diagnosis Neoplasm, Residual / diagnosis |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 62-49-7/Choline; 80529-93-7/Gadolinium DTPA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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