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Cerebral gliomas: prospective comparison of multivoxel 2D chemical-shift imaging proton MR spectroscopy, echoplanar
1Department of Radiology, Kumamoto University School of Medicine, Kumamoto, Japan.
Abstract:
Developments in MRI have made it possible to use diffusion-weighted MRI, perfusion MRI and proton MR spectroscopy (MRS) to study lesions in the brain. We evaluated whether these techniques provide useful, complementary information for grading gliomas, in comparison with conventional MRI. We studied 17 patients with histologically verified gliomas, adding multivoxel proton MRS, echoplanar diffusion and perfusion MRI the a routine MRI examination. The maximum relative cerebral blood volume (CBV), minimum apparent diffusion coefficient (ADC) and metabolic peak area ratios in proton MRS were calculated in solid parts of tumours on the same slice from each imaging data set. The mean minimum ADC of the 13 high-grade gliomas (0.92+/-0.27 x 10(-3) mm(2)/s) was lower than that of the four low-grade gliomas (1.28+/-0.15 x 10(-3) mm(2)/s) ( P<0.05). Means of maximum choline (Cho)/N-acetylaspartate (NAA), Cho/creatine (Cr), Cho/Cr in normal brain (Cr-n) and minimum NAA/Cr ratios were 5.90+/-2.62, 4.73+/-2.22, 2.66+/-0.68 and 0.40+/-0.06, respectively, in the high-grade gliomas, and 1.65+/-1.37, 1.84+/-1.20, 1.61+/-1.29 and 1.65+/-1.61, respectively, in the low-grade gliomas. Significant differences were found on spectroscopy between the high- and low-grade gliomas ( P<0.05). Mean maximum relative CBV in the high-grade gliomas (6.10+/-3.98) was higher than in the low-grade gliomas (1.74+/-0.57) ( P<0.05). Echoplanar diffusion, perfusion MRI and multivoxel proton MRS can offer diagnostic information, not available with conventional MRI, in the assessment of glioma grade.
Insights
Advanced MRI techniques like diffusion, perfusion, and proton MR spectroscopy (MRS) offer valuable insights for grading brain gliomas. These methods provide complementary diagnostic information beyond conventional MRI assessments.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Conventional MRI has limitations in accurately grading gliomas.
- Diffusion-weighted MRI, perfusion MRI, and proton MR spectroscopy (MRS) are advanced techniques for brain lesion study.
Purpose of the Study:
- To evaluate the utility of diffusion-weighted MRI, perfusion MRI, and multivoxel proton MRS in grading gliomas.
- To compare the diagnostic information provided by these advanced MRI techniques against conventional MRI.
Main Methods:
- Seventeen patients with histologically verified gliomas were studied.
- Advanced MRI techniques (multivoxel proton MRS, echoplanar diffusion and perfusion MRI) were added to routine MRI examinations.
- Key metrics including minimum apparent diffusion coefficient (ADC), maximum relative cerebral blood volume (CBV), and metabolic peak area ratios (e.g., Choline/N-acetylaspartate) were calculated.
Main Results:
- High-grade gliomas showed significantly lower minimum ADC values (0.92×10⁻³ mm²/s) compared to low-grade gliomas (1.28×10⁻³ mm²/s).
- Proton MRS revealed significant differences in metabolic ratios (e.g., Cho/NAA, Cho/Cr) between high- and low-grade gliomas.
- High-grade gliomas exhibited significantly higher maximum relative CBV (6.10) than low-grade gliomas (1.74).
Conclusions:
- Echoplanar diffusion, perfusion MRI, and multivoxel proton MRS provide crucial diagnostic information for glioma grading.
- These advanced MRI techniques offer complementary data not obtainable with conventional MRI.
- The integration of these advanced MRI methods can improve the accuracy of glioma grading.
