Abstract
Abstract Objective: In diffusely infiltrating gliomas (DIG), positron emission tomography (PET) imaging is a clinically powerful method for detection of anaplastic foci. Recently, 1H-magnetic resonance spectroscopy chemical shift imaging (CSI) using choline/creatine (Cho/Cr) or choline/N-acetylaspartate (Cho/NAA) ratios has emerged as new non-invasive and widely available alternative. We therefore correlated CSI with 11C-methionine (MET)-PET data in a series of DIG with non-significant contrast-enhancement (CE). Methods: Thirty-two patients with DIG were examined with CSI on 3T MRI scanner and MET-PET. Maximum pathologic intratumoral ratios of CSI (=CSImax) and maximum tumor-to-normal-brain PET ratios (=PETmax; T/N ratio) were determined. Co-registration of MRI with CSI and PET was performed and the topographic overlap of CSImax and PETmax was analyzed. Cell proliferation rate in tumor samples inside and outside of CSImax was assessed by MIB-1 labeling index (LI). Results: CSI showed a pathologic ratio in all patients, whereas PET demonstrated a pathologic T/N ratio in 21/32 patients. Topographical correlation of CSImax and PETmax revealed a ≥50% overlap in 18/21 and <50% overlap in 3/21 patients, respectively. Cho/Crmax and Cho/NAAmax showed a ≥50% overlap in 24/32, a <50% overlap in 8/32 patients. MIB-1 LI was significantly higher inside than outside the CSImax (13.6% versus 6.9%, p<0.001). Conclusion: Our results indicate that CSI is a promising method for detection of anaplastic foci within DIG with non-significant CE. Intraoperative use of CSI by multimodal neuronavigation may increase the reliability of detection of malignant areas in glioma surgery and therefore optimize allocation of patients to adjuvant treatments. Citation Information: Clin Cancer Res 2010;16(7 Suppl):B44
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.