title: 1H-MR spectroscopy guided gamma knife radiosurgery for treatment of glioma.
abstract: OBJECTIVE
  To observe the outcomes of 1H- MR-spectroscopy (MRS) guided gamma knife surgery for treatment of glioma.
  
  
  METHODS
  Twenty patients with glioma diagnosed pathologically were randomly divided into MRI group and MRI plus MRS group. The target volume was defined as the tumor enhanced area plus the surrounding area with a short T1 and a long T2 in the MRI group, while the tumor enhanced area plus the surrounding area with a short T1 and a long T2 and choline: N-acetyl aspartate index (CNI) ≥ 1.6 in the MRI plus MRS group.12 months after surgery were set as the endpoint.
  
  
  RESULTS
  Thirteen (65%) patients were successfully treated, of whom 6 were in the MRI group and 7 in the MRI plus MRS group. Ten patients suffered from cerebral edema during treatment, including 8 in the MRI group and 2 in the other group. The cases of cerebral edema were significantly fewer in the MRI plus MRS group than the MRI group. The average maximum diameter of the target volume was smaller in the MRI plus MRS group.
  
  
  CONCLUSIONS
  The MRS-guided gamma knife radiosurgery helps to identify and remove the lesion of glioma and reduce complications due to extended surgical scope.
authors.affiliation: Research Institute of Surgery & Daping Hospital, Third Military Medical University, Department of Neurosurgery, Chongqing, Chongqing, China.
authors.forename: Guangjian
authors.initials: G
authors.lastname: Shen
authors.forename: Lunshan
authors.initials: L
authors.lastname: Xu
authors.forename: Minhui
authors.initials: M
authors.lastname: Xu
authors.forename: Minying
authors.initials: M
authors.lastname: Geng
authors.forename: Yong
authors.initials: Y
authors.lastname: Tan
authors.forename: Feipeng
authors.initials: F
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D016634:Radiosurgery / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult