Monitoring individual response to brain-tumour chemotherapy: proton MR spectroscopy in a patient with recurrent glioma after stereotactic radiotherapy.
Since antineoplastic activity varies, sensitive methods for individual assessment of efficacy are needed. We demonstrate the clinical value of MR spectroscopy in monitoring chemotherapy in a patient with recurrent glioma after stereotactic radiotherapy. Diagnostic imaging before and after chemotherapy included contrast-enhanced MRI, single-voxel proton MR spectroscopy ((1)H MRS), (1)H MR spectroscopic imaging ((1)H SI), and fluorodeoxyglucose (FDG) positron-emission tomography (PET). A significant decrease in choline signal intensity was observed 2 months after chemotherapy indicating tumour chemosensitivity, in line with tumour shrinkage on MRI and decreased uptake of FDG. Assessment of early response by MRS may help to improve treatment protocols in other patients.
Lichy
M P
MP
Department of Radiology, German Cancer Research Centre, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. m.lichy@dkfz-heidelberg.de
Bachert
P
P
Henze
M
M
Lichy
C M
CM
Debus
J
J
Schlemmer
H P
HP
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001254:Astrocytoma / Q000188:drug therapy* / Q000601:surgery; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004734:Energy Metabolism / Q000187:drug effects*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008130:Lomustine / Q000008:administration & dosage; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009460:Neurologic Examination / Q000187:drug effects; D011344:Procarbazine / Q000008:administration & dosage; D016634:Radiosurgery; D013702:Temporal Lobe / Q000187:drug effects* / Q000473:pathology; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D001224:Aspartic Acid; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline