Metabolic changes in cerebral gliomas within hours of treatment with intra-arterial BCNU demonstrated by phosphorus magnetic resonance spectroscopy.
A 40-year-old female with a recurrent mixed astrocytoma/oligodendroglioma was treated with intra-arterial BCNU at six week intervals. Phosphorus magnetic resonance spectroscopy was performed before, and on two occasions after her third treatment. Before treatment, phosphodiesters were 25% less than normal and intracellular pH was 7.14 (normal 6.97 +/- 0.02). Eight hours following treatment phosphocreatine and phosphodiesters were reduced by approximately 40% and pHi increased to 7.24. Thirty-two hours after treatment, phosphocreatine and phosphodiesters had reversed their decline, but pHi had increased further to 7.35. MRI and x-ray CT scans did not show any change during this period. This study demonstrates that chemical changes can be observed in a glioma by magnetic resonance spectroscopy shortly after chemotherapy in a clinical setting and before changes are observable by imaging modalities. This approach evidently offers a possible means of monitoring the acute metabolic response of tumours to chemotherapy or other forms of treatment by a non-invasive repeatable quantitative method.
Montreal Neurological Institute and Hospital, Quebec, Canada.
D L
DL
Arnold
E A
EA
Shoubridge
W
W
Feindel
J G
JG
Villemure
D000328:Adult; D001254:Astrocytoma / Q000188:drug therapy* / Q000378:metabolism; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D002330:Carmustine / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D009682:Magnetic Resonance Spectroscopy; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000378:metabolism; D009837:Oligodendroglioma / Q000188:drug therapy* / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism
D010710:Phosphates; D002330:Carmustine