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Characterization of brain tumors by MRS, DWI and Ki-67 labeling index

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Summary

With the advent of fast imaging hardware and specialized software, additional non-invasive magnetic resonance characterization of tumors has become available through proton magnetic resonance spectroscopy (MRS), hemodynamic imaging and diffusion-weighted imaging (DWI). Thus, patterns could be discerned to discriminate different types of tumors and even to infer their possible evolution in time. The purpose of this study was to investigate the correlation between MRS, DWI, histopathology and Ki-67 labeling index in a large number of brain tumors. Localized proton spectra were obtained in 47 patients with brain tumors who subsequently underwent surgery (biopsy or tumor removal). We performed MRS with short echo-time (30 ms) and metabolic values in spectra were measured using an external software with 25 peaks. In all patients who had DWI, we measured apparent diffusion coefficients (ADC) in the same region of interest (ROI) where the voxel in MRS was located. In most tumors the histological diagnosis and Ki-67 labeling index had been determined on our original surgical specimen. Cho/Cr, (Lip+Mm)/Cr, NAA/(Cho+Cr) and Glx/Cr indexes in MRS allowed discriminating between low- and high-grade gliomas and metastases (MTs). Likewise, absolute ADC values differentiated low- from high-grade gliomas expressed by Ki-67 labeling index. A novel finding was that high Glx/Cr in vivo MRS index (similar to other known indexes) was a good predictor of tumor grading.

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References

  1. C Majós J Alonso C Aguilera M Serrallonga JJ Acebes C Arus J. Gili (2002) ArticleTitleAdult primitive neuroectodermal tumor: proton MR spectroscopic findings with possible application for differential diagnosis Radiology 225 IssueID2 556–566 Occurrence Handle12409595

    PubMed  Google Scholar 

  2. X Leclerc TA Huisman AG. Sorensen (2002) ArticleTitleThe potential of proton magnetic resonance spectroscopy ((1)H-MRS) in the diagnosis and management of patients with brain tumors Curr Opin Oncol 14 IssueID3 292–298 Occurrence Handle10.1097/00001622-200205000-00007 Occurrence Handle11981274

    Article  PubMed  Google Scholar 

  3. C Majós J Alonso C Aguilera M Serrallonga J Perez-Martin JJ Acebes C Arus J. Gili (2003) ArticleTitleProton magnetic resonance spectroscopy ((1)H MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization Eur Radiol 13 IssueID3 582–591 Occurrence Handle12594562

    PubMed  Google Scholar 

  4. H Shimizu T Kumabe R Shirane T. Yoshimoto (2000) ArticleTitleCorrelation between choline level measured by proton MR spectroscopy and Ki-67 labeling index in gliomas Am J Neuroradiol 21 IssueID4 659–665 Occurrence Handle1:STN:280:DC%2BD3c3kt1ylug%3D%3D Occurrence Handle10782774

    CAS  PubMed  Google Scholar 

  5. M Castillo L Kwock SK. Mukherji (1996) ArticleTitleClinical applications of proton MR spectroscopy Am J Neuroradiol 17 IssueID1 1–15 Occurrence Handle1:STN:280:BymA28ngs1E%3D Occurrence Handle8770242

    CAS  PubMed  Google Scholar 

  6. H Poptani RK Gupta R Roy R Pandey VK Jain DK. Chhabra (1995) ArticleTitleCharacterization of intracranial mass lesions with in vivo proton MR spectroscopy Am J Neuroradiol 16 IssueID8 1593–1603 Occurrence Handle1:STN:280:BymD1cbit10%3D Occurrence Handle7502961

    CAS  PubMed  Google Scholar 

  7. ME Meyerand JM Pipas A Mamourian TD Tosteson JF. Dunn (1999) ArticleTitleClassification of biopsy-confirmed brain tumors using single-voxel MR spectroscopy Am J Neuroradiol 20 IssueID1 117–123 Occurrence Handle1:STN:280:DyaK1M7jvFKntA%3D%3D Occurrence Handle9974066

    CAS  PubMed  Google Scholar 

  8. 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 2001 IssueID22(4 604–612

    Google Scholar 

  9. FA Howe KS. Opstad (2003) ArticleTitle1H MR spectroscopy of brain tumors and masses NMR Biomed 16 IssueID3 123–131 Occurrence Handle10.1002/nbm.822 Occurrence Handle1:CAS:528:DC%2BD3sXmsl2rur0%3D Occurrence Handle12884355

    Article  CAS  PubMed  Google Scholar 

  10. W Moller-Hartmann S Herminghaus T Krings G Marquardt H Lanfermann U Pilatus FE. Zanella (2002) ArticleTitleClinical application of proton magnetic resonance spectroscopy in the diagnosis of intracranial mass lesions Neuroradiology 44 IssueID5 371–381 Occurrence Handle10.1007/s00234-001-0760-0 Occurrence Handle1:STN:280:DC%2BD383nt1CgtQ%3D%3D Occurrence Handle12012120

    Article  CAS  PubMed  Google Scholar 

  11. RK Gupta U Sinha TF Cloughesy JR. Alger (1999) ArticleTitleInverse correlation between choline magnetic resonance spectroscopy signal intensity and the apparent diffusion coefficient in human glioma Magn Reson Med 41 IssueID1 2–7 Occurrence Handle10.1002/(SICI)1522-2594(199901)41:1<2::AID-MRM2>3.0.CO;2-Y Occurrence Handle1:CAS:528:DyaK1MXht1ygtb4%3D Occurrence Handle10025604

    Article  CAS  PubMed  Google Scholar 

  12. RK Gupta TF Cloughesy U Sinha J Garakian J Lazareff G Rubino L Rubino DP Becker HV Vinters JR. Alger (2000) ArticleTitleRelationships between choline magnetic resonance spectroscopy, apparent diffusion coefficient and quantitative histopathology in human glioma J Neurooncol 50 IssueID3 215–226 Occurrence Handle10.1023/A:1006431120031 Occurrence Handle1:STN:280:DC%2BD3M7mtlOhtw%3D%3D Occurrence Handle11263501

    Article  CAS  PubMed  Google Scholar 

  13. TW Stadnik C Chaskis A Michotte WM Shabana K Rompaey Particlevan R Luypaert L Budinsky V Jellus M. Osteaux (2001) ArticleTitleDiffusion-weighted MR imaging of intracerebral masses: comparison with conventional MR imaging and histologic findings Am J Neuroradiol 22 IssueID5 969–976 Occurrence Handle1:STN:280:DC%2BD3MzotlGqsQ%3D%3D Occurrence Handle11337344

    CAS  PubMed  Google Scholar 

  14. AA Tzika MK Zarifi L Goumnerova LG Astrakas D Zurakowski T Young-Poussaint DC Anthony RM Scott PM. Black (2002) ArticleTitleNeuroimaging in pediatric brain tumors: Gd-DTPA-enhanced, hemodynamic, and diffusion MR imaging compared with MR spectroscopic imaging Am J Neuroradiol 23 IssueID2 322–333 Occurrence Handle11847064

    PubMed  Google Scholar 

  15. Y Mardor R Pfeffer R Spiegelmann Y Roth SE Maier O Nissim R Berger A Glicksman J Baram A Orenstein JS Cohen T. Tichler (2003) ArticleTitleEarly detection of response to radiation therapy in patients with brain malignancies using conventional and high b-value diffusion-weighted magnetic resonance imaging J Clin Oncol 15 IssueID21(6 1094–1100

    Google Scholar 

  16. S Lu D Ahn G Johnson S. Cha (2003) ArticleTitlePeritumoral diffusion tensor imaging of high-grade gliomas and metastatic brain tumors Am J Neuroradiol 24 IssueID5 937–941 Occurrence Handle12748097

    PubMed  Google Scholar 

  17. AA Tzika LG Astrakas MK Zarifi N Petridou T Young-Poussaint L Goumnerova D Zurakowski DC Anthony PM. Black (2003) ArticleTitleMultiparametric MR assessment of pediatric brain tumors Neuroradiology 45 IssueID1 1–10 Occurrence Handle1:STN:280:DC%2BD3s%2FhvFemsQ%3D%3D Occurrence Handle12525947

    CAS  PubMed  Google Scholar 

  18. C Daumas-Duport ML Tucker H Kolles P Cervera F Beuvon P Varlet N Udo M Koziak JP. Chodkiewicz (1997) ArticleTitleOligodendrogliomas Part II: A new grading system based on morphological and imaging criteria. J Neurooncol 34 IssueID1 61–78 Occurrence Handle1:STN:280:ByiA2MzotFY%3D

    CAS  Google Scholar 

  19. T Hoshino LA Rodriguez KG Cho KS Lee CB Wilson MS Edwards VA Levin RL. Davis (1998) ArticleTitlePrognostic implications of the proliferative potential of low-grade astrocytomas J Neurosurg 69 IssueID6 839–842

    Google Scholar 

  20. CB Ostertag B Volk T Shibata P Burger P. Kleihues (1987) ArticleTitleThe monoclonal antibody Ki-67 as a marker for proliferating cells in stereotactic biopsies of brain tumors Acta Neurochir (Wien) 89 IssueID3–4 117–121 Occurrence Handle1:STN:280:BieC3s%2FgtFA%3D

    CAS  Google Scholar 

  21. T Shibata CB Ostertag B. Volk (1989) ArticleTitle[KI-67 PAP stain for histologic grading of brain tumors by squash preparations No To Shinkei 41 IssueID1 55–60 Occurrence Handle1:STN:280:BiaB2cjhvFU%3D Occurrence Handle2470401

    CAS  PubMed  Google Scholar 

  22. A Naressi C Couturier JM Devos M Janssen C Mangeat R Beer Particlede D. Graveron-Demilly (2001) ArticleTitleJava-based graphical user interface for the MRUI quantitation package MAGMA 12 IssueID2–3 141–152 Occurrence Handle1:STN:280:DC%2BD3MzitVelsA%3D%3D Occurrence Handle11390270

    CAS  PubMed  Google Scholar 

  23. WWF Pijnappel A Boogaart Particlevan den R Beer Particlede D. Ormondt Particlevan (1992) ArticleTitleSVD-based quantification of magnetic resonance signals J Magn Reson 97 122–134

    Google Scholar 

  24. L Vanhamme A Boogaart Particlevan den S. Van Huffel (1997) ArticleTitleImproved method for accurate and efficient quantification of MRS data with use of prior knowledge J Magn Reson 129 35–43 Occurrence Handle1:CAS:528:DyaK2sXnvFWnu7o%3D Occurrence Handle9405214

    CAS  PubMed  Google Scholar 

  25. KH Chang IC Song SH Kim MH Han HD Kim SO Seong HW Jung MC. Han (1998) ArticleTitleIn vivo single-voxel proton MR spectroscopy in intracranial cystic masses Am J Neuroradiol 19 IssueID3 401–405 Occurrence Handle1:STN:280:DyaK1c3gtVemuw%3D%3D Occurrence Handle9541289

    CAS  PubMed  Google Scholar 

  26. C Majós G Cucurella C Aguilera S Coll LC. Pons (1999) ArticleTitleIntraventricular meningiomas: MR imaging and MR spectroscopic findings in two cases Am J Neuroradiol 20 IssueID5 882–885 Occurrence Handle10369360

    PubMed  Google Scholar 

  27. H Ishimaru M Morikawa S Iwanaga M Kaminogo M Ochi K. Hayashi (2001) ArticleTitleDifferentiation between high-grade glioma and metastatic brain tumor using single-voxel proton MR spectroscopy Eur Radiol 11 IssueID9 1784–1791 Occurrence Handle10.1007/s003300000814 Occurrence Handle1:STN:280:DC%2BD3Mvms1CqsQ%3D%3D Occurrence Handle11511902

    Article  CAS  PubMed  Google Scholar 

  28. G. Hagberg (1998) ArticleTitleFrom magnetic resonance spectroscopy to classification of tumors A review of pattern recognition methods. NMR Biomed 11 IssueID4–5 148–156 Occurrence Handle1:STN:280:DyaK1czosVSktg%3D%3D

    CAS  Google Scholar 

  29. YE Kuznetsov Z Caramanos SB Antel MC Preul R Leblanc J-G Villemure R Pokrupa A Olivier A Sadikot DL. Arnold (2003) ArticleTitleProton magnetic resonance spectroscopy imaging can predict length of survival in patients with supratentorial gliomas Neurosurgery 53 IssueID3 565–574 Occurrence Handle12943573

    PubMed  Google Scholar 

  30. AR Tate C Majós A Moreno FA Howe JR Griffiths C. Arus (2003) ArticleTitleAutomated classification of short echo time in in vivo 1H brain tumor spectra: a multicenter study Magn Reson Med 49 IssueID1 29–36 Occurrence Handle1:CAS:528:DC%2BD3sXmvVSitQ%3D%3D Occurrence Handle12509817

    CAS  PubMed  Google Scholar 

  31. S Herminghaus T Dierks U Pilatus W Moller-Hartmann J Wittsack G Marquardt G Labisch H Lanfermann W Schlote F. Zanella (2003) ArticleTitleDetermination of histopathological tumor grade in neuroepithelial brain tumors by using spectral pattern analysis of in vivo spectroscopic data J Neurosurg 98 74–81 Occurrence Handle12546355

    PubMed  Google Scholar 

  32. M Rijpkema J Schuuring Y Meulen Particlevan der M Graaf Particlevan der H Bernsen R Boerman A Kogel Particlevan der A. Heerschap (2003) ArticleTitleCharacterization of oligodendrogliomas using short echo time 1H MR spectroscopic imaging NMR Biomed 16 IssueID1 12–18 Occurrence Handle1:CAS:528:DC%2BD3sXit1Ghtbo%3D Occurrence Handle12577293

    CAS  PubMed  Google Scholar 

  33. Pascual JMª, Carceller F, Cerdán S, Roda JM. (1999). Diagnóstico diferencial de tumores cerebrales “in vitro” por espectroscopía de resonancia magnética de protón. Método de los cocientes espectrales. Revista Neurología Volume 9 N°1 http://empresas.mundivia.es/neurocirugia/artic5/artic5.htm

  34. S Mazurek E. Eigenbrodt (2003) ArticleTitleThe tumor metabolome Anticancer Res 23 IssueID2A 1149–1154 Occurrence Handle1:CAS:528:DC%2BD3sXltlGnur0%3D Occurrence Handle12820363

    CAS  PubMed  Google Scholar 

  35. EA Newsholme B Crabtree MS. Ardawi (1985) ArticleTitleThe role of high rates of glycolysis and glutamine utilization in rapidly dividing cells Biosci Rep 5 IssueID5 393–400 Occurrence Handle1:CAS:528:DyaL2MXltVans7c%3D Occurrence Handle3896338

    CAS  PubMed  Google Scholar 

  36. T Takano JH Lin G Arcuino Q Gao J Yang M. Nedergaard (2001) ArticleTitleGlutamate release promotes growth of malignant gliomas Nat Med 7 IssueID9 1010–1015 Occurrence Handle1:CAS:528:DC%2BD3MXmvFOlsrw%3D Occurrence Handle11533703

    CAS  PubMed  Google Scholar 

  37. JH Hwang GD Graham KL Behar JR Alger JW Prichard DL. Rothman (1996) ArticleTitleShort echo time proton magnetic resonance spectroscopic imaging of macromolecule and metabolite signal intensities in the human brain Magn Reson Med 35 IssueID5 633–639 Occurrence Handle1:CAS:528:DyaK28Xjtleiu7Y%3D Occurrence Handle8722812

    CAS  PubMed  Google Scholar 

  38. AC Kuesel GR Sutherland W Halliday IC. Smith (1994) ArticleTitle1H MRS of high grade astrocytomas: mobile (Lip+Mm) accumulation in necrotic tissue NMR Biomed 7 IssueID3 149–155 Occurrence Handle1:STN:280:ByuA287ptFw%3D Occurrence Handle8080717

    CAS  PubMed  Google Scholar 

  39. AM Herneth S Guccione M. Bednarski (2003) ArticleTitleApparent diffusion coefficient: a quantitative parameter for in vivo tumor characterization Eur J Radiol 45 IssueID3 208–213 Occurrence Handle12595105

    PubMed  Google Scholar 

  40. N Bulakbasi M Kocaoglu F Ors C Tayfun T. Ucoz (2003) ArticleTitleCombination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors AJNR Am J Neuroradiol 24 IssueID2 225–233 Occurrence Handle12591638

    PubMed  Google Scholar 

  41. I Tkac P Andersen G Adriany H Merkle K Ugurbil R. Gruetter (2001) ArticleTitleIn vivo 1H NMR spectroscopy of the human brain at 7 T Magn Reson Med 46 IssueID3 451–456 Occurrence Handle1:CAS:528:DC%2BD3MXnt1Ortb0%3D Occurrence Handle11550235

    CAS  PubMed  Google Scholar 

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Calvar, J.A., Meli, F.J., Romero, C. et al. Characterization of brain tumors by MRS, DWI and Ki-67 labeling index. J Neurooncol 72, 273–280 (2005). https://doi.org/10.1007/s11060-004-3342-2

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