[The usefulness of fused MRI and SPECT images for the voxel positioning in proton magnetic resonance spectroscopy and planning the biopsy of brain tumors: presentation of the method].
OBJECTIVE
Progress in neurooncology suggests a need to combine information from anatomical-morphological and functional imaging in diagnosis and management. It is not always possible to establish a correct diagnosis using MRI imaging techniques alone, especially in the case of recurrent brain tumors. It is suggested that the results of different imaging techniques should be combined especially in these circumstances. The aim of this study was to evaluate the usefulness of fused post gadolinium MRI and single photon emission tomography (SPECT) images for planning 1H MRS.


METHODS
19 patients with a histopathological diagnosis of glial brain neoplasms were examined. SPECT was performed after i.v. administration of iodine-alpha-methyltyrozine (IMT). Fused SPECT and post Gd MR images were obtained on a peripheral console (Linux, PC), using a self developed technique. 1H MRS was performed on a 1.5 T scanner with the single voxel (SVS) technique using STEAM (TE 20 ms, TR 2000 ms) and (PRESS TE 136 TR 2000 ms) sequences.


RESULTS
1H MRS with a volume of interest positioned in the most metabolically active areas on fused images, gave a more accurate diagnosis of tumor type and grade that was clinically relevant in 3 patients.


CONCLUSIONS
The authors conclude that planning 1H MRS with the use of fused MRI and SPECT images improves the diagnosis.
Gajewicz
Witold
W
Zakład Radiologii Diagnostyki Obrazowej, Uniwersytet Medyczny, USK nr 1, ul. Kopcińskiego 22, 90-155 Łódź. gajewicz@onet.poczta.pl
Grzelak
Piotr
P
Górska-Chrzastek
Magdalena
M
Zawirski
Marek
M
Kuśmierek
Jacek
J
Stefańczyk
Ludomir
L
D000328:Adult; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007457:Iodine Radioisotopes; D008279:Magnetic Resonance Imaging; D008297:Male; D008781:Methyltyrosines; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D008781:Methyltyrosines; D019275:Radiopharmaceuticals; C030855:3-iodo-alpha-methyltyrosine