title: Correlation between choline and MIB-1 index in human gliomas. A quantitative in proton MR spectroscopy study.
abstract: BACKGROUND
  Choline (Cho) containing compounds are usually evaluated using magnetic resonance spectroscopy (MRS) by relative ratios such as Cho/N-acetylaspartate (NAA) and Cho/creatine (Cre) ratios. To clarify the significance of Cho level in gliomas, we evaluated the quantified Cho level using MRS and compared it with the proliferation activity as determined by MIB-1 immunoreactivity in the histological specimen.
  
  
  METHODS
  There were seven benign and seven malignant gliomas. MRS was obtained using a single-voxel proton regional imaging of metabolites (PRIME) sequence with three different TE for T2 compensation. Quantified Cho level was compared with the number of MIB-1 immunopositive positive cells and cell density in surgical specimens.
  
  
  RESULTS
  A positive correlation was observed between Cho and MIB-1 in benign gliomas, whereas there was a trend to an inverse correlation in malignant gliomas. This inverse correlation became a positive correlation when the necrotic area of the tumor (on the T1-weighted gadolinium enhanced images) was excluded from the voxel of interest (VOI) for MRS, but this correlation did not reach statistical significance.
  
  
  CONCLUSIONS
  The quantification data clarified the behavior of Cho in malignant gliomas. The quantification method has the advantage of limiting the influence of other metabolites on Cho determination. In particular, the levels of other commonly measured metabolites, including Cre, may also be altered in glioma, making ratios between metabolites misleading. Heterogeneity in the MRS VOI should be considered when evaluating the proliferative activity of malignant glioma by MRS.
authors.affiliation: Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. matsumur@md.tsukuba.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
authors.forename: Tomonori
authors.initials: T
authors.lastname: Isobe
authors.forename: Izumi
authors.initials: I
authors.lastname: Anno
authors.forename: Shingo
authors.initials: S
authors.lastname: Takano
authors.forename: Hiraku
authors.initials: H
authors.lastname: Kawamura
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology; D002794:Choline / Q000378:metabolism*; D005260:Female; D005910:Glioma / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D013223:Statistics as Topic
chemical_list: D019394:Ki-67 Antigen; D011522:Protons; D002794:Choline