title: Possible role of single-voxel (1)H-MRS in differential diagnosis of suprasellar tumors.
abstract: The objective of the present study was investigation of the possible role of proton magnetic resonance spectroscopy ((1)H-MRS) for differential diagnosis of suprasellar tumors. Forty patients (23 men and 17 women; median age, 45 years) with suprasellar, hypothalamic, and third ventricle neoplasms underwent long-echo (TR: 2000 ms, TE: 136 ms, 128-256 acquisitions) single-voxel (1)H-MRS before surgical treatment. The volume of the voxel was either 3.4 cc or 8 cc. Spectroscopic data were analyzed by calculation of the various metabolite ratios as well as by determination of the type of the pathological (1)H-MR spectra. There were 19 pituitary adenomas, 7 gliomas, 5 craniopharyngiomas, 3 chordomas, meningioma, hemangiopericytoma, malignant lymphoma, germinoma, Rathke cleft cyst, and hypothalamic hamartoma (one of each). Six tumors were recurrent after initial surgical resection with or without irradiation. Comparison of the individual metabolite ratios revealed only few subtle differences among neoplasms. In the same time, pattern analysis with determination of the type of the pathological (1)H-MR spectra disclosed certain specific characteristics, which seemingly can be used for tumor typing. Meanwhile, metabolic imaging was less effective for characterization of recurrent neoplasms. In conclusion, in cases of initially diagnosed suprasellar tumors with involvement of the hypothalamus and extension into the third ventricle pattern analysis of the single-voxel (1)H-MRS can provide valuable information, which, in addition to structural MRI, can be effectively used for diagnostic purposes.
authors.affiliation: International Research and Educational Institute for Integrated Medical Sciences , Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan. m_chernov@yahoo.com
authors.forename: Mikhail F
authors.initials: MF
authors.lastname: Chernov
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.forename: Kosaku
authors.initials: K
authors.lastname: Amano
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ono
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Nakamura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muragaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iseki
authors.forename: Osami
authors.initials: O
authors.lastname: Kubo
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Hori
authors.forename: Kintomo
authors.initials: K
authors.lastname: Takakura
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001254:Astrocytoma / Q000175:diagnosis; D016009:Chi-Square Distribution; D002794:Choline / Q000378:metabolism; D003397:Craniopharyngioma / Q000175:diagnosis; D003401:Creatine / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis; D011522:Protons; D015173:Supratentorial Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism*
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline