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MR spectroscopy in gliomatosis cerebri
M Bendszus1, M Warmuth-Metz, R Klein
1Department of Neuroradiology, University of Würzburg, Germany.
AJNR. American Journal of Neuroradiology
|March 1, 2000
Summary
Magnetic resonance spectroscopy aids in diagnosing and grading gliomatosis cerebri, offering insights into disease progression and guiding biopsy. This advanced imaging technique improves diagnostic accuracy for this challenging brain tumor.
Area of Science:
- Neuroimaging
- Neuro-oncology
- Biomarkers
Background:
- Gliomatosis cerebri diagnosis is challenging with conventional MR imaging.
- MR spectroscopy (MRS) offers potential for improved diagnostic accuracy.
- This study evaluates MRS in eight patients with histopathologically confirmed gliomatosis cerebri.
Observation:
- Patients underwent MR imaging and MRS (PRESS and CSI) prior to biopsy.
- Biopsy samples were targeted from regions with elevated choline/N-acetylaspartate (Cho/NAA) ratios.
- MRS revealed elevated Cho/Cr and Cho/NAA, with decreased NAA/Cr ratios, varying by lesion grade.
Findings:
- Low-grade lesions showed a maximum Cho/NAA ratio of 1.3; anaplastic tumors had ratios of at least 2.5.
- Lactate peaks were observed in grade III lesions, and lactate/lipid signals in grade IV.
- Biopsies from high Cho/NAA regions confirmed dense tumor cell infiltration.
Implications:
- MRS can help classify gliomatosis cerebri as stable or progressive.
- This classification has potential therapeutic relevance.
- MRS may improve biopsy planning and diagnostic yield for gliomatosis cerebri.