title: Proton magnetic spectroscopic imaging of the child's brain: the response of tumors to treatment.
abstract: Our aim was to determine and/or predict response to treatment of brain tumors in children using proton magnetic resonance spectro-scopic imaging (MRSI). We studied 24 patients aged 10 months to 24 years, using MRI and point-resolved spectroscopy (PRESS; TR 2000 TE 65 ms) with volume preselection and phase-encoding in two dimensions on a 1.5 T imager. Multiple logistic regression was used to establish independent predictors of active tumor growth. Biologically vital cell metabolites, such as N-acetyl aspartate and choline-containing compounds (Cho), were significantly different between tumor and control tissues (P < 0.001). The eight brain tumors which responded to radiation or chemotherapy, exhibited lower Cho (P = 0.05), higher total creatine (tCr) (P = 0.02) and lower lactate and lipid (L) (P = 0.04) than 16 tumors which were not treated (except by surgery) or did not respond to treatment. The only significant independent predictor of active tumor growth was tCr (P < 0.01). We suggest that tCr is useful in assessing response of brain tumors to treatment.
authors.affiliation: Department of Radiology, Children's Hospital and Harvard Medical School, Boston, MA, USA. tzika@a1.tch.harvard.edu
authors.forename: A A
authors.initials: AA
authors.lastname: Tzika
authors.forename: D
authors.initials: D
authors.lastname: Zurakowski
authors.forename: T Y
authors.initials: TY
authors.lastname: Poussaint
authors.forename: L
authors.initials: L
authors.lastname: Goumnerova
authors.forename: L G
authors.initials: LG
authors.lastname: Astrakas
authors.forename: P D
authors.initials: PD
authors.lastname: Barnes
authors.forename: D C
authors.initials: DC
authors.lastname: Anthony
authors.forename: A L
authors.initials: AL
authors.lastname: Billett
authors.forename: N J
authors.initials: NJ
authors.lastname: Tarbell
authors.forename: R M
authors.initials: RM
authors.lastname: Scott
authors.forename: P M
authors.initials: PM
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001923:Brain Chemistry; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male