title: Spectroscopic Characterization of Gliosarcomas-Do They Differ From Glioblastomas and Metastases?
abstract: OBJECTIVE
  To evaluate the spectroscopic pattern of gliosarcomas for differentiation from glioblastomas or metastases.
  
  
  METHODS
  H-nuclear magnetic resonance (NMR) spectroscopic intermediate echo time data of 5 patients with histologically proven gliosarcomas were compared with data of 17 metastases and 54 glioblastomas. Specialized H-NMR spectroscopy analysis software was used offline. Lipid and macromolecular resonances between 0.9 ppm and 1.4 ppm were compared besides the main metabolites using the Mann-Whitney U test.
  
  
  RESULTS
  Gliosarcomas showed higher lipid and macromolecule resonances and a higher lipid-choline ratio compared with glioblastomas (P < 0.024 and P < 0.036). Glioblastomas showed higher creatine concentrations compared with metastases (P < 0.007) but not compared with gliosarcomas. We found no significant differences between metastases and gliosarcomas.
  
  
  CONCLUSIONS
  Gliosarcomas may mimic metastases on H NMR spectroscopy showing high signal intensities from lipid and macromolecule resonances. This tumor type should be suspected if conventional imaging suggests an intra-axial brain neoplasm in combination with high lipids in solid tumor parts.
authors: From the *Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover; †Institute of Neuroradiology, Johann-Wolfgang-Goethe University, Frankfurt/Main; ‡Department of Neuroradiology, Clinic of Radiology, University Bonn, Bonn; §Department of Neurosurgery, Johann-Wolfgang-Goethe University, Frankfurt/Main; and ∥Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
authors: Peter
authors: P
authors: Raab
authors: Ulrich
authors: U
authors: Pilatus
authors: Elke
authors: E
authors: Hattingen
authors: Kea
authors: K
authors: Franz
authors: Elvis
authors: E
authors: Hermann
authors: Friedhelm E
authors: FE
authors: Zanella
authors: Heinrich
authors: H
authors: Lanfermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001932:Brain Neoplasms / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000556:secondary*; D002794:Choline / Q000032:analysis; D003937:Diagnosis, Differential; D005909:Glioblastoma / Q000737:chemistry* / Q000000981:diagnostic imaging; D018316:Gliosarcoma / Q000737:chemistry* / Q000000981:diagnostic imaging; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D008055:Lipids; D002794:Choline