title: Prognostic value of proton MR spectroscopy of cerebral hemisphere tumors in children.
abstract: We studied 14 young people with newly diagnosed hemisphere tumors, aged from 3 to 20 years (average 10 years). All underwent surgery following MR imaging (MRI) and spectroscopy (MRS). The tumors studied were three glioblastomas, one each of ganglio-glioblastoma, primitive neuroectodermal tumor (PNET), rhabdoid teratoid tumor, pilocytic astrocytoma, ependymoma, anaplastic ependymoma, and gliomatosis cerebri, and four gangliogliomas. Four patients died; ten patients are alive (five with stable residual tumor, five with no evident tumor). Images and spectra were acquired on a 1.5-T imager. Proton MRS was performed before gadolinium injection in all but one case. Single-voxel techniques were utilized in all cases, using a spin-echo or STEAM sequence with a long echo time (135 or 270 ms). Peak areas of N-acetyl aspartate (NAA), choline (Cho), and creatine and phosphocreatine (Cr) were assessed. The NAA/Cho peak-area ratio was very low in the patients who died (mean +/- s.d. 0.20 +/- 0.14), and higher in the patients who are alive (0.74 +/- 0.47; P = 0.007 by two-tailed t-test). The Cr/Cho peak-area ratio also followed a similar trend for the two groups (mean +/- s.d. 0.17 +/- 0.07 and 0.49 +/- 0.30, respectively; P = 0.01 by two-tailed t-test).
authors.affiliation: Department of Neuroradiology & Vascular Radiology, Hôpital de la Timone, Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Girard
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Wang
authors.forename: A
authors.initials: A
authors.lastname: Erbetta
authors.forename: L N
authors.initials: LN
authors.lastname: Sutton
authors.forename: P C
authors.initials: PC
authors.lastname: Phillips
authors.forename: L B
authors.initials: LB
authors.lastname: Rorke
authors.forename: R A
authors.initials: RA
authors.lastname: Zimmerman
mesh_terms: D001921:Brain / Q000378:metabolism / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis