Proton magnetic resonance spectroscopy predicts proliferative activity in diffuse low-grade gliomas.
The aim of the study was to investigate the ability of (1)HMRS to reflect proliferative activity of diffuse low-grade gliomas (WHO grade II). Between November 2002 and March 2007, a prospective study was performed on consecutive patients with suspected supratentorial hemispheric diffuse low-grade tumors. All the patients underwent MR examination using uniform procedures, and then surgical resection or biopsy within 2 weeks of the MR examination. Proliferative activity of the tumors was assessed by Ki-67 immunochemistry (Mb-1) on paraffin embedded tumor sections. Spectroscopic data was compared with Ki-67 labeling index and other histologic data such as histological subtype, cellular atypia, cellular density using univariate and multivariate analysis. 82 of 97 consecutive patients had histologically confirmed WHO grade 2 gliomas. Ki-67 proliferation index (PI) was correlated with specific spectral patterns: (1) low PI (<4%) was associated with increased Cho/Cr and absence of both free lipids or lactates; (2) intermediate PI (4-8%) was associated with resonance of lactates; and (3) high PI (>8%) was characterized by a resonance of free lipids. On multivariate analysis, resonance of lactates and resonance of free lipids appeared as independent predictors of intermediate PI (P < 0.001) and high PI (P < 0.001), respectively; moreover, free lipids resonance was correlated with cellular atypia (P < 0.05). This study suggests that (1)HMRS is a reliable tool to evaluate the proliferation activity of WHO grade 2 glioma and to identify potentially more aggressive clinical behavior.
Guillevin
Remy
R
Department of Neuroradiology, Pitié Salpêtrière Hospital, Paris, France. remy.guillevin@psl.aphp.fr
Menuel
Carole
C
Duffau
Hugues
H
Kujas
Michel
M
Capelle
Laurent
L
Aubert
Agnès
A
Taillibert
Sophie
S
Idbaih
Ahmed
A
Pallud
Joan
J
Demarco
Giovanni
G
Costalat
Robert
R
Hoang-Xuan
Khê
K
Chiras
Jacques
J
Vallée
Jean-Noel
JN
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D049109:Cell Proliferation; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011522:Protons
D019394:Ki-67 Antigen; D011522:Protons