title: Magnetic resonance spectroscopy suggests key differences in the metastatic behaviour of medulloblastoma.
abstract: BACKGROUND
  Metastatic medulloblastoma has a poorer prognosis than localised disease in part due to inherent properties of the tumour. 1H magnetic resonance spectroscopy (MRS) provides a powerful method for investigating tumour metabolism in vivo.
  
  
  METHODS
  Magnetic resonance imaging and short echo time (Te 30 ms) single voxel MRS were performed on the primary tumour of 16 children with medulloblastoma prior to surgical resection. Tumour volumes were calculated using a segmentation technique and the MRS was analysed using LCModel.
  
  
  RESULTS
  Patients with metastatic disease had primary tumours which were smaller (p=0.01), had higher levels of total choline (p=0.03) and lower levels of mobile lipids (p=0.04).
  
  
  CONCLUSIONS
  Metastatic medulloblastomas have metabolite profiles indicative of increased cell growth and decreased cell death compared with localised tumours reflecting intrinsic differences in underlying biology. Localised tumours with an MRS metabolite profile similar to those with metastatic disease may be at increased risk of metastatic relapse.
authors.affiliation: Academic Department of Paediatrics and Child Health, University of Birmingham, Whittall Street, Birmingham B4 6NH, UK. acpeet@doctors.org.uk
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Peet
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Davies
authors.forename: Lee
authors.initials: L
authors.lastname: Ridley
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Brundler
authors.forename: Dimitris
authors.initials: D
authors.lastname: Kombogiorgas
authors.forename: Shaheen
authors.initials: S
authors.lastname: Lateef
authors.forename: Kal
authors.initials: K
authors.lastname: Natarajan
authors.forename: Spyros
authors.initials: S
authors.lastname: Sgouros
authors.forename: Lesley
authors.initials: L
authors.lastname: MacPherson
authors.forename: Richard G
authors.initials: RG
authors.lastname: Grundy
mesh_terms: D000293:Adolescent; D049109:Cell Proliferation; D002528:Cerebellar Neoplasms / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D006258:Head and Neck Neoplasms / Q000556:secondary*; D006801:Humans; D007223:Infant; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008527:Medulloblastoma / Q000556:secondary*; D013125:Spinal Neoplasms / Q000556:secondary*; D047368:Tumor Burden
chemical_list: D019394:Ki-67 Antigen