Document Detail


Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy.
MedLine Citation:
PMID:  24377726     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. The recognition of anaplastic foci within low-grade gliomas is of extreme importance in patients under follow-up for Grade II gliomas. We present the algorithm of MR spectroscopy (MRS)-guided brain biopsy and its correlation with tumour histology. Methods. Twenty-seven patients harbouring suspected Grade II/III glioma were examined on our 3T MR. 2D PRESS-CSI metabolite images of Choline/Creatine, Creatine/N-acetylaspartate and Choline/N-acetylaspartate were calculated and exported to the DICOM format. According to these maps, a stereobiopsy was performed at the point of maximum Choline/Creatine ratio prior to tumour resection. In the case of enhancing tumour, a subsequent biopsy was performed from the point of enhancement. Comparisons were made between the histology of the biopsied specimens and the resected tumours. Results. Eleven tumours were diagnosed as high-grade and sixteen as low-grade lesions. The correlation between main spectroscopic ratios (Cho/Cr and Cho/NAA) was strongly positive at the points of maximum Cho/Cr. Similar results were obtained at the points of contrast enhancement. Comparison of histological parameters of biopsy samples at the points of maximum Cho/Cr and histological examination of the completely resected tumours gives a strong correlation of tumour grade, number of mitoses and Ki-67 expression. The diagnostic accuracy of MRS-guided biopsy was 84%. The absolute value of Cho/NAA was higher in high-grade compared to that of low-grade lesions. The value of Cho/NAA ratio of 0.9 using MRS produced a sensitivity and specificity of 78% in the differentiation between low-grade and high-grade lesions. Combining MRS with structural MR, the sensitivity increased to 86% and the specificity to 80%. Conclusions. Strong correlation was demonstrated between Cho/Cr and Ch/NAA ratios. Strong correlation was demonstrated between histological parameters of biopsy samples taken using Cho/Cr ratio and those from total tumour examination. Diagnostic accuracy of MRS-guided biopsy was 84%. Sensitivity and specificity of MRS combined with structural MR reaches 86% and 80%.
Authors:
Ondrej Bradac; Jiri Vrana; Filip Jiru; Filip Kramar; David Netuka; Petr Hrabal; Daniel Horinek; Patricia de Lacy; Vladimir Benes
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-30
Journal Detail:
Title:  British journal of neurosurgery     Volume:  -     ISSN:  1360-046X     ISO Abbreviation:  Br J Neurosurg     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8800054     Medline TA:  Br J Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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