Response of non-Hodgkin lymphoma to radiation therapy: early and long-term assessment with H-1 MR spectroscopic imaging.
OBJECTIVE
To determine whether proton magnetic resonance (MR) spectroscopic imaging is a sensitive technique for defining tumor extent and assessing response of cerebral lymphoma to therapy.


METHODS
Four hydrogen-1 MR spectroscopic imaging studies were performed in a patient with non-Hodgkin lymphoma (NHL) before, during, and after radiation therapy and at follow-up at 33 months after diagnosis of the recurrence of disease. The patient had a single, large lesion in the brain and underwent hyperfractionated radiation therapy for 4 weeks. A series of MR images was also obtained.


RESULTS
The pretreatment study showed a lesion with a distinct spectral pattern: marked elevation of choline and lipids and great reduction of creatine and N-acetylaspartate. During and after treatment, H-1 MR spectroscopic images depicted a progressive reduction of the abnormal choline and lipid signals. Thirty-three months after treatment, multiple-section H-1 MR spectroscopic images showed normal spectral patterns in all sections examined.


CONCLUSIONS
H-1 MR spectroscopy may contribute to the neuroradiologic evaluation of NHL and, in particular, may be useful in monitoring therapeutic response.
Bizzi
A
A
Neuroimaging Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892.
Movsas
B
B
Tedeschi
G
G
Phillips
C L
CL
Okunieff
P
P
Alger
J R
JR
Di Chiro
G
G
D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism* / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D012008:Recurrence
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline