Skip to main content

Advertisement

SpringerLink
Log in

Multisection 1H Magnetic Resonance Spectroscopic Imaging Assessment of Glioma Response to Chemotherapy

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Summary

This study evaluated the role of proton magnetic resonance spectroscopic imaging (1H MRSI) in assessing the response of low-grade brain tumors to a chemotherapy-only treatment regimen. Specifically, it was of interest to assess if 1H MRSI could detect early tumor response to therapy prior to magnetic resonance imaging (MRI) changes, and to establish which spectral markers were sensitive to regional changes within and around a heterogeneous tumor mass. A total of 14 patients with lower-grade gliomas were evaluated by multislice 1H MRSI, MRI and clinical examination. Changes associated with chemotherapy were assessed by longitudinal comparisons of regional levels of choline (Cho), N-acetyl-L-aspartate (NAA), and lactate (Lac) relative to total creatine. These changes were, in turn, compared to changes on pre- and post-contrast MR images and to each patient’s clinical status. In enhancing tumor regions, there was a significant association between an increase in Lac/Cr during treatment and decreased progression-free survival time. At baseline, a low NAA/Cr in normal-appearing brain tissue adjacent to non-enhancing tumor was associated with decreased progression-free survival time, as was an increase in Cho/Cr during chemotherapy. An increase in Cho/Cr and Lac/Cr in normal-appearing brain regions next to non-enhancing tumor in one patient was noted 2 months before MRI showed progressive disease. These results suggest that 1H MRSI can be a powerful adjunct to MRI in the assessment of tumor response to chemotherapy, and that Cho/Cr and Lac/Cr appear to be the most reliable markers of tumor progression and may predict response prior to MRI changes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SJ Nelson DB Vigneron WP Dillon (1999) ArticleTitleSerial evaluation of patients with brain tumors using volume MRI, 3D 1H MRSI NMR Biomed. 12 123–138 Occurrence Handle10.1002/(SICI)1099-1492(199905)12:3<123::AID-NBM541>3.0.CO;2-Y Occurrence Handle1:STN:280:DyaK1MzktF2isQ%3D%3D Occurrence Handle10414947

    Article  CAS  PubMed  Google Scholar 

  2. N Leeds A Kumar E Jackson (2002) Diagnostic imaging Levin (Eds) Cancer in the Nervous System Oxford University Press New York 3–60

    Google Scholar 

  3. PE Ricci DH Dungan (2001) ArticleTitleImaging of low- and intermediate-grade gliomas Semin Radiat Oncol 11 103–112 Occurrence Handle1:STN:280:DC%2BD3MzlsFSnuw%3D%3D Occurrence Handle11285548

    CAS  PubMed  Google Scholar 

  4. LL Wald SJ Nelson MR Day SE Noworolski RG Henry SL Huhn S Chang MD Prados PK Sneed DA Larson WM Wara M McDermott WP Dillon PH Gutin DB Vigneron (1997) ArticleTitleSerial proton magnetic resonance spectroscopy imaging of glioblastoma multiforme after brachytherapy J Neurosurg 87 525–534 Occurrence Handle1:STN:280:DyaK2svmt1KitA%3D%3D Occurrence Handle9322843

    CAS  PubMed  Google Scholar 

  5. G Tedeschi N Lundbom R Raman S Bonavita JH Duyn JR Alger G. Chiro ParticleDi (1997) ArticleTitleIncreased choline signal coinciding with malignant degeneration of cerebral gliomas: a serial proton magnetic resonance spectroscopy imaging study J Neurosurg 87 516–524 Occurrence Handle1:STN:280:DyaK2svmt1Kitw%3D%3D Occurrence Handle9322842

    CAS  PubMed  Google Scholar 

  6. JS Taylor JW Langston WE Reddick PB Kingsley RJ Ogg MH Pui LE Kun JJ Jenkins SuffixIII G Chen JJ Ochs RA Sanford RL Heideman (1996) ArticleTitleClinical value of proton magnetic resonance spectroscopy for differentiating recurrent or residual brain tumor from delayed cerebral necrosis Int J Radiat Oncol Biol Phys 36 1251–1261 Occurrence Handle1:STN:280:DyaK2s7jvVShtw%3D%3D Occurrence Handle8985051

    CAS  PubMed  Google Scholar 

  7. JH Duyn J Gillen G Sobering PC Zijl Particlevan CT Moonen (1993) ArticleTitleMultisection proton MR spectroscopic imaging of the brain Radiology 188 277–282 Occurrence Handle1:STN:280:DyaK3s3ovVyqsQ%3D%3D Occurrence Handle8511313

    CAS  PubMed  Google Scholar 

  8. M Castillo L Kwock SK Muherji (1996) ArticleTitleClinical applications of proton MR spectroscopy Am J Neuroradiol 17 1–15 Occurrence Handle1:STN:280:DyaK28zms1Sltw%3D%3D Occurrence Handle8770242

    CAS  PubMed  Google Scholar 

  9. MJ Fulham A Bizzi MJ Dietz HH Shih R Raman GS Sobering JA Frank AJ Dwyer JR Alger G Chiro ParticleDi (1992) ArticleTitleMapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance Radiology 185 675–86 Occurrence Handle1:CAS:528:DyaK3sXhsVClt7o%3D Occurrence Handle1438744

    CAS  PubMed  Google Scholar 

  10. MC Preul MA Zografos J Villemure G Shenoud R LeBlanc A Langleben DL Arnold (2000) ArticleTitleUsing proton magnetic resonance spectroscopic imaging to predict in vivo the response of recurrent malignant gliomas to tamoxifen chemotherapy Neurosurgery 46 306–312 Occurrence Handle1:STN:280:DC%2BD3c7lt1Gkug%3D%3D Occurrence Handle10690719

    CAS  PubMed  Google Scholar 

  11. PE Ricci DH Dungan (2001) ArticleTitleImaging of low- and intermediate-grade gliomas Semin Radiat Oncol 11 103–112 Occurrence Handle1:STN:280:DC%2BD3MzlsFSnuw%3D%3D Occurrence Handle11285548

    CAS  PubMed  Google Scholar 

  12. H Kugel W Heindel RI Ernestus J Bunke R Mesnil Particledu G Friedmann (1992) ArticleTitleHuman brain tumors: Spectral patterns detected with localized H-1 MR spectroscopy Radiology 183 701–709 Occurrence Handle1:STN:280:DyaK383mt1Krug%3D%3D Occurrence Handle1584924

    CAS  PubMed  Google Scholar 

  13. PR Luyten AJH Marien W Heindel PHJ Gerwen Particlevan K Herholz JA Hollander Particleden G Friedmann WD Heiss (1990) ArticleTitleMetabolic imaging of patients with intracranial tumors: H-1 MR spectroscopic imaging and PET Radiology 176 791–799 Occurrence Handle1:STN:280:DyaK3czls1OrtA%3D%3D Occurrence Handle2389038

    CAS  PubMed  Google Scholar 

  14. PE Sijens CJ Vecht PC Levendag P Dijk ParticleVan M Oudkerk (1995) ArticleTitleHydrogen magnetic resonance spectroscopy follow-up after radiation therapy of human brain cancer Invest Radiol 30 738–744 Occurrence Handle1:STN:280:DyaK28zlt12msQ%3D%3D Occurrence Handle8748188

    CAS  PubMed  Google Scholar 

  15. K Houkin K Kamada Y Sawamura Y Iwasaki H Abe T Kashiwaba (1995) ArticleTitleProton magnetic resonance spectroscopy (1H-MRS) for the evaluation of treatment of bran tumors Neuroradiology 37 99–103 Occurrence Handle1:STN:280:DyaK2M3otFWgsA%3D%3D Occurrence Handle7761009

    CAS  PubMed  Google Scholar 

  16. L Chang DQ McBride BL Miller M Cornford F Chiang RA Booth (1995) ArticleTitleLocalized in vivo 1H magnetic resonance spectroscopy and in vitro analyses of heterogenous brain tumors J Neuroimaging 5 157–163 Occurrence Handle1:STN:280:DyaK2Mzlt1yqsg%3D%3D Occurrence Handle7626823

    CAS  PubMed  Google Scholar 

  17. DQ McBride BL Miller DL Nikas S Buchthal L Chang F Chiang RA Booth (1995) ArticleTitleAnalysis of brain tumors using 1H magnetic resonance spectroscopy Surg Neurol 44 137–144 Occurrence Handle1:STN:280:DyaK287gt1ehsg%3D%3D Occurrence Handle7502203

    CAS  PubMed  Google Scholar 

  18. H Bruhn J Frahm ML Gyngell KD Merboldt W Haenicke R Sauter C Hamburger (1989) ArticleTitleNoninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: Initial experience in patients with cerebral tumors Radiology 172 541–548 Occurrence Handle1:STN:280:DyaL1Mzhs1egtg%3D%3D Occurrence Handle2748837

    CAS  PubMed  Google Scholar 

  19. M Utriainen M Komu V Vuorinen P Lehikoinen P Sonninen T Kurki T Utriainen A Roivainen H Kalimo H Minn (2003) ArticleTitleEvaluation of brain tumor metabolism with [11C] choline PET and 1H-MRS J Neuro-Oncol 62 329–338 Occurrence Handle10.1023/A:1023342516925 Occurrence Handle1:STN:280:DC%2BD3s3ltlahsg%3D%3D

    Article  CAS  Google Scholar 

  20. C Dowling AW Bollen SM Noworolski MW McDermott NM Barbaro MR Day RG Henry SM Chang WP Dillon SJ Nelson DB Vigneron (2001) ArticleTitlePreoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens Am J Neuroradiol 22 604–612 Occurrence Handle1:STN:280:DC%2BD3Mzot1GrtQ%3D%3D Occurrence Handle11290466

    CAS  PubMed  Google Scholar 

  21. EE Graves SJ Nelson DB Vigneron L Verhey M McDermott D Larson S Chang MD Prados WP Dillon (2001) ArticleTitleSerial proton MR spectroscopic imaging of recurrent malignant gliomas after gamma knife radiosurgery Am J Neuroradiol 22 613–614 Occurrence Handle1:STN:280:DC%2BD3Mzot1Grug%3D%3D Occurrence Handle11290467

    CAS  PubMed  Google Scholar 

  22. SJ Nelson S Huhn DB Vigneron MR Day LL Wald M Prados S Chang P Gutin PK Sneed R Hawkins W Dillon (1997) ArticleTitleVolume MRI and MRSI techniques for the quantitation of treatment response in brain tumors: Presentation of a detailed case study J Mag Res Imaging 7 1146–1152 Occurrence Handle1:STN:280:DyaK1c%2Fmt1SgsQ%3D%3D Occurrence Handle10.1002/jmri.1880070630

    Article  CAS  Google Scholar 

  23. TR McKnight SM Noworolski DB Vigneron SJ Nelson (2001) ArticleTitleAn automated technique for the quantitative assessment of 3D-MRSI data from patients with glioma J Mag Res Imaging 13 167–177 Occurrence Handle1:STN:280:DC%2BD3MzmslejtA%3D%3D Occurrence Handle10.1002/1522-2586(200102)13:2<167::AID-JMRI1026>3.0.CO;2-K

    Article  CAS  Google Scholar 

  24. F Traber W Block S Flacke R Lamerichs H Schuller H Urbach E Keller HH Schild (2002) ArticleTitle1H-MR spectroscopy of brain tumors in the course of radiation therapy: Use of fast spectroscopic imaging and single-voxel spectroscopy for diagnosing recurrence [German] ROFO-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden 174 33–42 Occurrence Handle1:STN:280:DC%2BD38%2FmvVKlsw%3D%3D

    CAS  Google Scholar 

  25. J Lazareff R Gupta J Alger (1999) ArticleTitleVariation of post-treatment H-MRSI choline signal intensity in pediatric gliomas J Neuro-Oncol 41 291–298 Occurrence Handle10.1023/A:1006120623949 Occurrence Handle1:STN:280:DyaK1M3osFKntw%3D%3D

    Article  CAS  Google Scholar 

  26. AA Tzika D Zurakowski TY Poussaint L Goumnerova LG Astrakas PD Barnes DC Anthony AL Billett NJ Tarbell RM Scott PM Black (2001) ArticleTitleProton magnetic spectroscopic imaging of the child’s brain: The response of tumors to treatment Neuroradiology 43 169–177 Occurrence Handle10.1007/s002340000454 Occurrence Handle1:STN:280:DC%2BD3MzlsVansw%3D%3D Occurrence Handle11326567

    Article  CAS  PubMed  Google Scholar 

  27. R Tarnawski M Sokol P Pieniazek B Maciejewski J Walecki L Miszczyk T Krupska (2002) ArticleTitle1H-MRS predicts the early treatment outcome of postoperative radiotherapy for malignant gliomas Int J Radiat Oncol Biol Phys 52 IssueID5 1271–1276 Occurrence Handle10.1016/S0360-3016(01)02769-9 Occurrence Handle11955739

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Neurology, College of Physicians and Surgeons, Columbia University, USA

    Casilda Balmaceda & Dana Critchell

  2. Departments of Radiology, Weill Medical College of Cornell University, USA

    Xiangling Mao & Dikoma C. Shungu

  3. Departments of Biostatistics, College of Physicians and Surgeons, Columbia University, USA

    Kenneth Cheung

  4. Departments of Neurological Surgery, Weill Medical College of Cornell University, USA

    Susan Pannullo

  5. Departments of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Robert L. DeLaPaz

Authors
  1. Casilda Balmaceda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dana Critchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiangling Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kenneth Cheung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susan Pannullo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert L. DeLaPaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dikoma C. Shungu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dikoma C. Shungu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Balmaceda, C., Critchell, D., Mao, X. et al. Multisection 1H Magnetic Resonance Spectroscopic Imaging Assessment of Glioma Response to Chemotherapy. J Neurooncol 76, 185–191 (2006). https://doi.org/10.1007/s11060-005-5261-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-005-5261-2

Keywords

Search

Navigation