Grading of Brain Tumors using MR Spectroscopy: Diagnostic value at Short and Long TE
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Objectives: To evaluate the usefulness of MR spectroscopy (MRS) in grading of brain tumors as well to evaluate which metabolite values/ratios could provide better classification/grading of brain tumors when using, short or long TE. Methods: MRS was performed in 128 patients with brain tumors. Metabolite NAA,Cho,Cr lactates and lipids and metabolite ratios of Choline (Cho)/N-acetylaspartate (NAA), Cho/Creatine (Cr), /NAA/ Cr were calculated at short and long echo time (TEs). Tumors were subdivided into grades on the basis of radiologist results and the standard WHO values. Characteristic analysis of metabolites was performed to find the values in each tumor. The correlations between the metabolite values and grading were calculated. Long TE as (1500/144ms) where the signal from most metabolites in the brain is lost except that of choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), and lactate,and short TEs of (2000/35ms) that allow for identification of many other metabolites Lipids, lactate, ala, myoinositol, glutamate, and glutamine were applied. Results: NAA, Cho, Cr, NAA/ Cr, Lactate and Lipids metabolic values showed no significant relation between the values to be increased or decreased according to grading therefore the dependency of grading should be based upon the Cho/ NAA and Cho/ Cr .From this account and metabolic ratios; the study suggested to diagnose, differentiate and grade gliomas after evaluating the Cho/ NAA and Cho/ Cr. Conclusion :MRS metabolic ratios (Cho/Cr and Cho/NAA) can be used to grade and differentiate gliomas. Ratios less than 1.5 were suggested to be considered as normal values, ratios from 1.5 to 2 were suggested to subsist as low grade glioma and ratios higher than 2 were suggested to be high grade glioma or metastasis. Meningioma can be diagnosed by conventional MRI images. MRS should be added to routine MR imaging studies as it provides greater information concerning tissue characterization than what is possible with MR imaging studies alone.
Authors and Affiliations
Sabri Adulrahman Ibrahim Hamed, Caroline Edward Ayad
Keywords
Related Articles
- EP ID EP244099
- DOI 10.9790/0853-1610078793
- Views 69
- Downloads 0
Evaluation of Serum Sodium And Potassium Levels in Newly Diagnosed Patients of Essential Hypertension At Rims, Ranchi, Jharkhand, India
Introduction: Essential hypertension comprise more than 90% of hypertension. It is a emerging health problem in india.Many studies have shown that a positive correlation between serum sodium and blood pressure and a nega...
Surgical management of Sialolithiasiswith minimal incisionby extraoral push method: A case report.
Salivary gland calculi account for the most common disease of the salivary glands. The majorities of sialoliths occurs in the submandibular gland or its duct and are a common cause of acute and chronic infections. As in...
Operative Management of Distal Femur GCT by Sandwitch Technique for Joint Salvage: A Case Report and Review of Literature
GCT is locally aggressive benign bone tumour located eccentrically in epiphysis. Most common site is distal femur in 20-40 yrs age group with slight female predominance. We report a case of 21 yrs female patient presente...
Role of Intrapleural Instillation of Mesna for Adhesiolysis in Multiloculated Pleural Effusion and Empyema
The management of Multiloculated pleural effusion and empyema with closed pleural aspiration and intercostal tube drainage fails most of the time due to the presence of thick viscous fluid and multiple septations . We ex...
Cost Effective Percutaneous Tracheostomy-An Indian HackHospital Based Study
Tracheostomy is a lifesaving procedure that is done in ICU’s. It reduces both the mortality and morbidity of patients. Slowly percutaneous tracheostomy (PCT) is becoming common in hospitals catering to population of midd...