Variation of post-treatment H-MRSI choline intensity in pediatric gliomas.
Pediatric brain gliomas are not always amenable for complete surgical excision, therefore adjuvant treatment for a large tumor mass is often required. As tumor volume shrinkage may not be a reliable method for assessing response to treatment, information about the tumor growth potential is desirable for an adequate follow-up of the patients. Choline (Cho) signal intensity, determined by proton magnetic resonance spectroscopy imaging (H-MRSI), has proved to be a reliable indicator of the metabolic activity and of tumor progression in various intracranial tumors. In this study we have sought to determine if H-MRSI can be of use in monitoring the response of pediatric gliomas to different forms of therapy. We performed pretreatment and post-treatment H-MRSI in 10 children with biopsed or partially excised brain gliomas. The follow-up period ranged between 6 and 40 months. A total of 38 H-MRSI were performed. All the patients had chemotherapy or radiotherapy. As an indicator of tumor activity we utilized the ratio between tumor/brain Cho signal intensity. Treatment response was evaluated as a function of tumor volume and clinical outcome. In 6 patients whose tumor volume decreased or remained stable we observed that the Cho ratio decreased (p < 0.01) after treatment and remained low during longitudinal follow-up. In the 4 patients whose tumors progressed the Cho ratio increased after treatment. These observations suggest that serial H-MRSI can provide valuable information regarding the response to therapy in pediatric gliomas and therefore be of use in the follow-up of these neoplasms of childhood.
Lazareff
J A
JA
Department of Surgery, University of California Los Angeles School of Medicine, 90095-7039, USA.
Gupta
R K
RK
Alger
J
J
D001254:Astrocytoma / Q000175:diagnosis*; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000032:analysis*; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D016896:Treatment Outcome
D002794:Choline