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Citrate in pediatric CNS tumors?
Z A Seymour1, A Panigrahy, J L Finlay
1Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
AJNR. American Journal of Neuroradiology
|February 15, 2008
Summary
Citrate was identified as an unassigned peak in pediatric brain tumor MR spectra. This metabolite was detected in various pediatric brain tumors and the developing infant brain.
Area of Science:
- Biochemistry
- Neuro-oncology
- Medical imaging
Background:
- An unassigned peak was observed in in vivo MR spectra of pediatric brain tumors.
- The origin and prevalence of this chemical signal were unknown.
Purpose of the Study:
- To identify the molecule responsible for the unassigned peak in pediatric brain tumor MR spectra.
- To determine the prevalence and concentration of this molecule in various pediatric brain tumors.
Main Methods:
- Analysis of single-voxel point-resolved spectroscopy (PRESS) spectra from 85 pediatric brain tumor patients and 469 controls.
- Citrate was proposed as the candidate molecule, and its spectra were incorporated into the LCModel basis set for automated processing.
- Absolute apparent concentrations and Cramer-Rao lower bounds (CRLB) were determined for citrate detection reliability.
Main Results:
- Citrate was detected in 26 of 85 pediatric brain tumors (CRLB < 25%).
- Diffuse intrinsic brain stem glioma (DIBSG) showed the highest mean citrate concentration (4.0 ± 1.1 mmol/kg), with 8 of 12 patients having CRLB < 25%.
- Citrate levels decreased significantly (P < .01) in DIBSGs after radiation therapy. Citrate was also detected in medulloblastomas, ependymomas, astrocytomas, and pilocytic astrocytomas. In controls, citrate (CRLB < 25%) was only observed in 39 of 194 infants younger than 6 months.
Conclusions:
- MR signals consistent with citrate were identified in pediatric brain tumors.
- Citrate was also detected in the developing brain of infants under 6 months old.
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