title: Quantitative assessment of gliomas by proton magnetic resonance spectroscopy.
abstract: BACKGROUND
  Advanced magnetic resonance (MR) techniques provide physiological and metabolic information that complements the anatomical information available from conventional MR imaging. The purpose of this study was to evaluate the clinical usefulness of proton MR spectroscopy (1H-MRS) in preoperative quantitative assessment of intracranial gliomas.
  
  
  METHODS
  Eight patients with histologically verified gliomas, comprising 2 cases with glioblastoma multiforme (GBM, grade 4), 5 cases with anaplastic oligodendroglioma (AO, grade 3; high-grade glioma), and 1 case with fibrillary astrocytoma (FA, grade 2; low-grade glioma) were evaluated using the 1H-MRS protocol following conventional MR imaging, diffusion-weighted imaging (DWI), and perfusion-weighted imaging (PWI) preoperatively.
  
  
  RESULTS
  High-grade gliomas tended to demonstrate signal hyperintensity by DWI and higher relative cerebral blood volume (rCBV) by PWI. Increased ratios of choline (Cho) to N-acetylaspartate (NAA) (Cho/NAA) and Cho to creatine (Cr) (Cho/Cr) correlated highly with tumor malignancy. The presence of lactate and lipid was predominately detected in patients with high-grade glioma.
  
  
  CONCLUSIONS
  The combination of multiple MR parameters, based on DWI, PWI and 1H-MRS, appears valuable for preoperatively predicting the degree of malignancy in glioma.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. s-oshiro@fukuoka-u.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Oshiro
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsugu
authors.forename: Fuminari
authors.initials: F
authors.lastname: Komatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Onishi
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Ohmura
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Iwaasa
authors.forename: Seisaburo
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukushima
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011522:Protons
chemical_list: D011522:Protons