title: Absolute choline concentration measured by quantitative proton MR spectroscopy correlates with cell density in meningioma.
abstract: BACKGROUND
  This study was aimed to investigate the relationship between quantitative proton magnetic resonance spectroscopy (1H-MRS) and pathological changes in meningioma.
  
  
  METHODS
  Twenty-two meningioma cases underwent single voxel 1H-MRS (point-resolved spectroscopy sequence, repetition time/echo time = 2,000 ms/68, 136, 272 ms). Absolute choline (Cho) concentration was calculated using tissue water as the internal reference and corrected according to intra-voxel cystic/necrotic parts. Pathological specimens were stained with MIB-1 antibody to measure cell density and proliferation index. Correlation analysis was performed between absolute Cho concentration and cell density and MIB-1 labeled proliferation index.
  
  
  RESULTS
  Average Cho concentration of all meningiomas before correction was 2.95 +/- 0.86 mmol/kg wet weight. It was increased to 3.23 +/- 1.15 mmol/kg wet weight after correction. Average cell density of all meningiomas was 333 +/- 119 cells/HPF, and average proliferation index was 2.93 +/- 5.72%. A linear, positive correlation between cell density and Cho concentration was observed (r = 0.650, P = 0.001). After correction of Cho concentration, the correlation became more significant (r = 0.737, P < 0.001). However, no significant correlation between Cho concentration and proliferation index was found. There seemed to be a positive correlation trend after correction of Cho concentration but did not reach significant level.
  
  
  CONCLUSIONS
  Absolute Cho concentration, especially Cho concentration corrected according to intra-voxel cystic/necrotic parts, reflects cell density of meningioma.
authors.affiliation: Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba Science City, Ibaraki, 305-8575, Japan.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yue
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shibata
authors.forename: Tomonori
authors.initials: T
authors.lastname: Isobe
authors.forename: Izumi
authors.initials: I
authors.lastname: Anno
authors.forename: Hiraku
authors.initials: H
authors.lastname: Kawamura
authors.forename: Qi-Yong
authors.initials: QY
authors.lastname: Gong
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumura
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry; D001932:Brain Neoplasms / Q000737:chemistry* / Q000473:pathology*; D002452:Cell Count; D002794:Choline / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016014:Linear Models; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008579:Meningioma / Q000737:chemistry* / Q000473:pathology*; D008875:Middle Aged; D011522:Protons; D055815:Young Adult
chemical_list: D011522:Protons; D002794:Choline