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, Hiroshi Iseki, T. Hori, K. Takakura

Research output: Contribution to journalArticle

8 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
Publication statusPublished - 2008 Jun
Externally publishedYes

Fingerprint

Glioma
Lipids
Neoplasms
Lactic Acid
Glioblastoma
Choline
Proton Magnetic Resonance Spectroscopy
N-acetylaspartate
Confidence Intervals

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Chernov, M. F., Ono, Y., Muragaki, Y., Kubo, O., Nakamura, R., Iseki, H., ... Takakura, K. (2008). Differentiation of high-grade and low-grade gliomas using pattern analysis of long-echo single-voxel proton magnetic resonance spectroscopy ( 1H-MRS). Neuroradiology Journal, 21(3), 338-349.

Differentiation of high-grade and low-grade gliomas using pattern analysis of long-echo single-voxel proton magnetic resonance spectroscopy ( 1H-MRS). / Chernov, M. F.; Ono, Y.; Muragaki, Y.; Kubo, O.; Nakamura, R.; Iseki, Hiroshi; Hori, T.; Takakura, K.

In: Neuroradiology Journal, Vol. 21, No. 3, 06.2008, p. 338-349.

Research output: Contribution to journalArticle

Chernov, MF, Ono, Y, Muragaki, Y, Kubo, O, Nakamura, R, Iseki, H, Hori, T & Takakura, K 2008, 'Differentiation of high-grade and low-grade gliomas using pattern analysis of long-echo single-voxel proton magnetic resonance spectroscopy ( 1H-MRS)', Neuroradiology Journal, vol. 21, no. 3, pp. 338-349.
Chernov, M. F. ; Ono, Y. ; Muragaki, Y. ; Kubo, O. ; Nakamura, R. ; Iseki, Hiroshi ; Hori, T. ; Takakura, K. / Differentiation of high-grade and low-grade gliomas using pattern analysis of long-echo single-voxel proton magnetic resonance spectroscopy ( 1H-MRS). In: Neuroradiology Journal. 2008 ; Vol. 21, No. 3. pp. 338-349.
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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.",
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