[Brain tumors: interest of magnetic resonance spectroscopy for the diagnosis and the prognosis].
Magnetic resonance spectroscopy (MRS) is a tool for a non-invasive monitoring of brain tumor metabolism. In vivo proton MRS became possible with the development of whole-body high-field magnets. First, it allows to distinguish brain tumors from abscesses. Second, along with other imaging techniques, it permits the differentiation of primary brain tumors, mainly gliomas, from tumors of various origins such as meningiomas or metastasis. However, its ability to give a grading of gliomas stays controversial. Choline, a marker of cell membrane proliferation, could give information on the degree of malignancy but reports on its role are somewhat contradictory. Brain tumor biopsy and histology stay mandatory in the management of brain tumors. In vitro MRS spectra obtained from tumor extracts show that the signal at 3.2ppm, the so-called "cholin peak", corresponds to several compounds among them, glycerophosphocholine, phosphocholine, and choline. Their repartition differs with the grade of the tumor. In vivo proton MRS is the only metabolic technique of non-invasive monitoring of treated brain tumors. It can separate recurrence from radionecrosis. Improved methodology and availability of MR imagers will strengthen its importance in the future.
Sabatier
J
J
Service de Neurochirurgie, CHU Purpan, Toulouse, France. jfs@cict.fr
Ibarrola
D
D
Malet-Martino
M
M
Berry
I
I
D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001706:Biopsy; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000556:secondary; D002794:Choline / Q000378:metabolism; D003937:Diagnosis, Differential; D004734:Energy Metabolism / Q000502:physiology*; D005910:Glioma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D011237:Predictive Value of Tests; D011379:Prognosis
D001224:Aspartic Acid; C000179:N-acetylaspartate; D002794:Choline