title: Increased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study.
abstract: The authors tested the hypothesis that proton magnetic resonance spectroscopy (1H-MRS) imaging can be used as a supportive diagnostic tool to differentiate clinically stable brain tumors from those progressing as a result of low- to high-grade malignant transformation or posttherapeutic recurrence. Twenty-seven patients with cerebral gliomas verified on histological examination were studied repeatedly with 1H-MRS imaging over a period of 3.5 years. At the time of each 1H-MRS imaging study, clinical examination, MR imaging, positron emission tomography with 18F-fluorodeoxyglucose, and biopsy findings (when available) were used to categorize each patient as having either stable or progressive disease. Measures of the percentage changes in the choline (Cho) 1H-MRS imaging signal intensity between studies, which were obtained without knowledge of the clinical categorization, allowed the investigators to segregate the groups with a high degree of statistical significance. All progressive cases showed a Cho signal increase between studies of more than 45%, whereas all stable cases showed an elevation of less than 35%, no change, or even a decreased signal. The authors conclude that increased Cho levels coincide with malignant degeneration of cerebral gliomas and therefore may possibly be used as a supportive indicator of progression of these neoplasms.
authors.affiliation: Neuroimaging Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.forename: N
authors.initials: N
authors.lastname: Lundbom
authors.forename: R
authors.initials: R
authors.lastname: Raman
authors.forename: S
authors.initials: S
authors.lastname: Bonavita
authors.forename: J H
authors.initials: JH
authors.lastname: Duyn
authors.forename: J R
authors.initials: JR
authors.lastname: Alger
authors.forename: G
authors.initials: G
authors.lastname: Di Chiro
mesh_terms: D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D002471:Cell Transformation, Neoplastic / Q000378:metabolism / Q000473:pathology; D002794:Choline / Q000032:analysis*; D003401:Creatine / Q000032:analysis; D003847:Deoxyglucose / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005910:Glioma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D006801:Humans; D006859:Hydrogen; D019344:Lactic Acid / Q000032:analysis; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D010725:Phosphocreatine / Q000032:analysis; D011379:Prognosis; D011522:Protons; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed
chemical_list: D014408:Biomarkers, Tumor; D005462:Fluorine Radioisotopes; D011522:Protons; D019275:Radiopharmaceuticals; D010725:Phosphocreatine; D019788:Fluorodeoxyglucose F18; D001224:Aspartic Acid; D019344:Lactic Acid; D006859:Hydrogen; C000179:N-acetylaspartate; D003847:Deoxyglucose; D003401:Creatine; D002794:Choline