The Value of Magnetic Resonance in Differentiation between Brain Glioma and Treatment Induced Injury

Abstract

SummaryIntroduction.The further therapeutic management decisions in glioma patients after the radiation/chemotherapy may be difficult because the treatment induced brain injury can mimic tumor recurrence clinically and on neuroimaging.Aim of the Studywas to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in differentiation between glial tumor recurrence and radiation/chemotherapy-induced changes in the brain.Material and methods.73 patients with primary brain gliomas and 77 gliomas patients after combined therapy with possibly treatment induced changes underwent MRS and DTI. Fractional anisotropy (FA) and metabolite ratios were measured in the tumor and pathological signal intensity area adjacent to post-surgical cavity.Results.Mean choline/creatine (Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine (LL/Cr) ratios of brain gliomas was statistically significant higher and FA values lower than those in the pathological signal intensity area adjacent to post-surgical cavity. No differences were found in mean N-acetyl aspartate/creatine (NAA/Cr) ratios among two groups.Conclusions.Our study suggests that Cho/Cr, MI/Cr, LL/Cr and FA measures should be recommended as additional highly informative tool to conventional structural magnetic resonance imaging (MRI) when monitoring gliomas patients after combined therapy.