[Can proton magnetic resonance spectroscopy be of any value as a prognostic factor in medulloblastoma?].
Proton MR spectroscopy (MRS) is a noninvasive chemical analysis of metabolites in brain tissue. Metabolite ratios are useful because age dependant normal values are known and differ significantly from the values obtained in various diseases of brain tissues.


OBJECTIVE
The aim of our study was to evaluate whether MRS correlates with magnetic resonance imaging (MRI), course of disease, pathology of resected tumours after preoperative chemotherapy and can be of prognostic value in patients with medulloblastoma (MB).


METHODS
Eight patients with histologically proven MB were studied. All patients underwent MRS and MRI at diagnosis and after neoadjuvant chemotherapy consisting of VCR,VP,CTX,CBCA. Preoperative chemotherapy was followed by surgery, radiotherapy and maintenance chemotherapy. Assessment whether MRI correlates with MRS after preoperative chemotherapy was performed. Additionally MRS was correlated with the course of disease and pathology results.


RESULTS
Out of 8 patients 5 had partial remission of their tumours on MRI. Two of them had favorable reaction on MRS defined as elevation of NAA and Cr decrease in Cho,Lac/Lip. Both are alive and disease free. In 2 patients no changes, compared with MRS at diagnosis were found. Both died of the disease. One had an indistinct positive change and died. Stabilization on MRI was observed in 1 patient, who also had a good reaction on MRS. He is alive, disease free. Two patients had disease progression on MRI. Both had poor reaction on MRS, one died, one is alive with disease. It was noticed that good response on MRS correlated with chemotherapy induced tumour changes observed in pathology specimens from resected tumours. Small number of patients does not allow to draw conclusions but our results signal that MRS might be of prognostic value in brain tumours.
Dembowska-Bagińska
Bozenna
B
Klinika Onkologii, Instytut Pomnik Centrum Zdrowia Dziecka, al. Dzieci Polskich 20, 04-730 Warszawa, Poland.
Perek
Danuta
D
Perek-Polnik
Marta
M
Drogosiewicz
Monika
M
Jurkiewicz
Elzbieta
E
Pakuła-Kościesza
Iwona
I
Grajkowska
Wiesława
W
Roszkowski
Marcin
M
D014408:Biomarkers, Tumor; D002528:Cerebellar Neoplasms / Q000378:metabolism* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008527:Medulloblastoma / Q000378:metabolism* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011522:Protons; D012307:Risk Factors; D013997:Time Factors
D014408:Biomarkers, Tumor; D011522:Protons