In vivo 3-T MR spectroscopy in the distinction of recurrent glioma versus radiation effects: Initial experience

James D. Rabinov, Patricia Lani Lee, Frederick G. Barker, David N. Louis, Griffith R. Harsh IV, G. Rees Cosgrove, E. Antonio Chiocca, Allan F. Thornton, Jay S. Loeffler, John W. Henson, R. Gilberto Gonzalez

Research output: Contribution to journalArticlepeer-review

128 Scopus citations

Abstract

PURPOSE: To determine if 3-T magnetic resonance (MR) spectroscopy allows accurate distinction of recurrent tumor from radiation effects in patients with gliomas of grade II or higher. MATERIALS AND METHODS: This blinded prospective study included 14 patients who underwent in vivo 3-T MR spectroscopy prior to stereotactic biopsy. All patients received a previous diagnosis of glioma (grade II or higher) and high-dose radiation therapy (>54 Gy). Prior to MR spectroscopy, conventional MR imaging was performed at 1.5 T to identify a gadolinium-enhanced region within the irradiated volume. Diagnosis was assigned by means of histopathologic analysis of the biopsy samples. RESULTS: Sixteen of 17 biopsy locations could be classified as predominantly tumor or predominantly radiation effect on the basis of the ratio of choline at the biopsy site to normal creatine level by using a value greater than 1.3 as the criterion for tumor. The remaining case, classified as recurrent tumor on the basis of MR spectroscopy results, was diagnosed as predominantly radiation effect on the basis of histopathologic findings. Disease in this patient progressed to biopsy-proven recurrence within 3 months. Overall, the ratio of choline at the biopsy site to normal creatine level was significantly elevated (unpaired two-tailed Student t test, P < .002) in those biopsy samples composed predominantly of tumor (n = 9) compared with those containing predominantly radiation effects (n = 8). The ratio was not significantly different between the two histopathologic groups. CONCLUSION: In vivo 3-T MR spectroscopy has sufficient spatial resolution and chemical specificity to allow distinction of recurrent tumor from radiation effects in patients with treated gliomas.

Original languageEnglish (US)
Pages (from-to)871-879
Number of pages9
JournalRADIOLOGY
Volume225
Issue number3
DOIs
StatePublished - Dec 2002
Externally publishedYes

Keywords

  • Brain neoplasms, diagnosis
  • Brain neoplasms, MR
  • Brain neoplasms, MR spectroscopy
  • Brain, biopsy
  • Brain, effects of irradiation on
  • Radiations, injurious effects

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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