Proton magnetic resonance spectroscopic imaging of cerebral gliomas: Correlation of metabolite ratios with histopathologic grading

Yuan Yu Hsu*, Chen Nen Chang, Kuo Jen Wie, Kun Eng Lim, Wen Chin Hsu, Shih Ming Jung

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

16 Scopus citations

Abstract

Background: Magnetic resonance spectroscopic imaging (MRSI) can provide spatially encoded metabolite information and improve tissue specificity in human brains. The major goal of this study was to evaluate the correlation of metabolite ratios measured by MRSI with histopathological grading of cerebral gliomas. Methods: Twenty-seven patients with cerebral gliomas were referred consecutively for pre-surgical evaluation. The lesions included 10 grade II, 5 grade III, and 12 grade IV gliomas. MRSI data were acquired during the same session of conventional magnetic resonance imaging and analyzed in terms of N-acetylaspartate (NAA), creatine-phosphocreatine (Cr), choline-containing compounds (Cho), and lactate. Results: There were significantly lower NAA/Cr and higher Cho/Cr, Cho/NAA and (Cho+Cr)/NAA ratios (ps<0.001) in gliomas than in normal tissues. There were significantly lower NAA/Cr and higher Cho/NAA and (Cho+Cr)/NAA ratios (ps<0.05) in World Health Organization (WHO) grade III or IV gliomas than in grade II gliomas. A significant correlation was identified between the (Cho+Cr)/NAA ratio and WHO grade (p<0.05). There was no significant metabolite difference between grade III and grade IV tumors (ps>0.1), or significant difference in lactate occurrence rates among different grades (p=0.26). Conclusions: Proton MRSI can provide in vivo information about the metabolic status of cerebral gliomas, and the (Cho+Cr)/NAA ratio can discriminate different grades better than other metabolite ratios. However, substantial overlap of metabolite ratios among different severities of malignancy makes it impossible to confirm the WHO grade of a specific cerebral glioma by using clinical MRSI.

Original languageEnglish
Pages (from-to)399-407
Number of pages9
JournalChang Gung Medical Journal
Volume27
Issue number6
StatePublished - 06 2004
Externally publishedYes

Keywords

  • Brain
  • Glioma
  • Proton MR spectroscopy

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