Differentiation of high-grade and low-grade gliomas using pattern analysis of long-echo single-voxel proton magnetic resonance spectroscopy ( 1H-MRS)

M. F. Chernov, Y. Ono, Y. Muragaki, O. Kubo, R. Nakamura, H. Iseki, T. Hori, K. Takakura

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9 Citations (Scopus)

Abstract

The usefulness of proton magnetic resonance spectroscopy ( 1H-MRS) for glioma grading is not clear, particularly due to the absence of standard criteria for data analysis. Previously we had developed an original classification of the pathological 1H-MR spectra based on the identification of the predominant metabolite peak, N-acetylaspartate (NAA)for Type I, choline-containing compounds (Cho) for Type II, and mobile lipids (Lip) for Type III, and presence or absence of other metabolite peaks: lactate (Lac), Lip, or Cho. The present study evaluated the effectiveness of this classification in grading of previously non-treated gliomas. A total of 38 low-grade and 33 high-grade neoplasms were investigated. Four tumors had 1H-MR spectra Type I, and all of those were low-grade. Three tumors had 1H-MR spectra Type III, and all those were glioblastomas. Fifteen tumors with 1H-MR spectra Type II had a Lip/NAA ratio more than 1 (Type II C with moderate elevation of lipids), and 12 of those neoplasms were high-grade. The differences in distribution of high-grade and low-grade gliomas among another 49 gliomas with 1H-MR spectra Type II did not depend on the presence of Lac and/or Lip peaks, and in this subgroup NAA/Cho ratio was also evaluated. Inclusion of both characteristics (type of the 1H-MR spectrum and NAA/Cho ratio with defined cut-off level of 0.6) into the diagnostic algorithm yielded 72% diagnostic accuracy (95% confidence interval: 62%-82%) in discriminating high-grade and low-grade neoplasms. In conclusion, pattern analysis of the pathological 1H-MR spectra using the proposed classification along with evaluation of NAA/Cho ratio might be helpful for non-invasive glioma grading.

Original languageEnglish
Pages (from-to)338-349
Number of pages12
JournalNeuroradiology Journal
Volume21
Issue number3
DOIs
Publication statusPublished - 2008 Jun
Externally publishedYes

Keywords

  • Differential diagnosis
  • Glioma
  • Proton magnetic resonance spectroscopy
  • Tumor grading

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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