title: Proton MR spectroscopy of cerebral gliomas at 3 T: spatial heterogeneity, and tumour grade and extent.
abstract: This study aimed to evaluate the usefulness of proton MR spectroscopic imaging ((1)H-MRSI) at 3 T in differentiating high- from low-grade gliomas, and tumour from necrosis, oedema or normal tissue. Forty-four patients with brain gliomas and four with meningiomas were retrospectively reviewed. The normalised metabolites choline (nCho), N-acetylaspartate (nNAA), creatine (nCr) and lactate/lipids (nLL), and the metabolite ratios Cho/NAA, NAA/Cr and Cho/Cr were calculated. Necrotic-appearing areas showed two spectroscopic patterns: "necrosis" with variable nCho and high nLL, and "cystic necrosis" with variable nLL or nonevident peaks. Peri-enhancing oedematous-appearing areas showed three spectroscopic patterns ("tumour" with abnormal Cho/NAA, "oedema" with normal Cho/NAA and "tumour/oedema" with normal nCho and abnormal Cho/NAA) in gliomas, and one ("oedema") in meningiomas. Peri-enhancing or peri-tumour normal-appearing areas showed two patterns ("infiltrated" with abnormal nCho and/or Cho/NAA and "normal" with normal spectra) in gliomas and one ("normal") in meningiomas. Discriminant analysis showed that classification accuracy between high- and low-grade glioma masses was better with normalised metabolites or all parameters together than metabolite ratios and that among peri-enhancing areas was much better with normalised metabolites. The analysis of spatial distribution of normalised metabolites by 3-T (1)H-MRSI helps to discriminate among different tissues, offering information not available with conventional MRI.
authors.affiliation: Department of Health Sciences, University of Molise, Via Giovanni Paolo II, 86100, Campobasso, Italy. alfonso.dicostanzo@unimol.it
authors.forename: Alfonso
authors.initials: A
authors.lastname: Di Costanzo
authors.forename: Tommaso
authors.initials: T
authors.lastname: Scarabino
authors.forename: Francesca
authors.initials: F
authors.lastname: Trojsi
authors.forename: Teresa
authors.initials: T
authors.lastname: Popolizio
authors.forename: Domenico
authors.initials: D
authors.lastname: Catapano
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Giannatempo
authors.forename: Simona
authors.initials: S
authors.lastname: Bonavita
authors.forename: Maurizio
authors.initials: M
authors.lastname: Portaluri
authors.forename: Michela
authors.initials: M
authors.lastname: Tosetti
authors.forename: Vincenzo A
authors.initials: VA
authors.lastname: d'Angelo
authors.forename: Ugo
authors.initials: U
authors.lastname: Salvolini
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Tedeschi
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons
chemical_list: D014408:Biomarkers, Tumor; D011522:Protons