TITLE:
The value of magnetic resonance spectroscopy and diffusion tensor imaging in characterization of gliomas growth patterns and treatment efficiency
AUTHORS:
Anvita Bieza, Gaida Krumina
KEYWORDS:
Glioma; Perifocal Zone; Treatment; Fractional Anisotropy; Magnetic Resonance Spectroscopy
JOURNAL NAME:
Journal of Biomedical Science and Engineering,
Vol.6 No.5,
May
22,
2013
ABSTRACT: The
objective of the study was to assess the usefulness of magnetic resonance
spectroscopy (MRS) and diffusion tensor imaging (DTI) in detection of vital tumor cell infiltration presence in peritumoral brain areas and determination of biochemical changes in the
brain parenchyma after received treatment. 73 patients with present,
morphologically conformed brain gliomas and 77 gliomas patients in remission
stage after combined therapy underwent magnetic resonance imaging (MRI)
including MRS and DTI. Fractional anisotropy (FA) and metabolite ratios—choline/creatine
(Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine
(LL/Cr), N-acetyl aspartate/creatine (NAA/Cr)—were measured in the
tumor, perifocal edema zone, distant and contra-lateral normal appearing
white matter. We observed gradual reduction of Cho/Cr, MI/Cr, LL/Cr mean
ratios and step-by-step increase of NAA/Cr, FA mean values in the direction
from the tumor to the distant and contra-lateral normal-appearing white
matter. LL/Cr ratios within distal normal appearing white matter decreased in
patients after radiotherapy/chemotherapy. Our study suggests that MRS and DTI in combination with structural
MRI sequences enhance vital glial tumor cells areas and possible infiltration
border. MRS and DTI quantitative
measurements in the glioma peritumoral area
reveal pathological changes, despite the normal signal intensity in
structural MRI. We suggest that increased LL/Cr ratios and decreased FA
values may have the superior implications in the detecting of glial tumors
extent along the white matter tracts. NAA/Cr reduction and Cho/Cr increase
may provide additional diagnostic value. LL/Cr ratio in distal normal signal
intensity area could be used
as radiation/chemotherapy effectiveness criteria, as this will reduce after the
received treatment and in remission period.