Pediatric Low-grade Gliomas: Prognosis with Proton Magneti Resonance Spectroscopic Imaging

Pediatric Low-grade Gliomas: Prognosis with Proton Magneti Resonance Spectroscopic Imaging AbstractOBJECTIVE:Our aim was to assess the correlation between the low-grade glioma (LGG) metabolic profile and tumor progression. Using in vivo proton magnetic resonance spectroscopic imaging, we specifically asked whether and which metabolic features are associated with tumor regrowth or recurrence.METHODS:Eleven pediatric patients with histologically proven partially resected (<20% resection) midline LGG were treated and followed up for a period of 2 years. All patients underwent proton magnetic resonance spectroscopic imaging studies before any management was determined. Tumor progression was defined as radiological evidence of mass enlargement (>25%) during the follow-up period. Proton magnetic resonance spectroscopic imaging was performed using a PRESS-CSI sequence on a General Electric 1.5-tesla scanner (General Electric Medical System, Waukesha, WI). The signal intensities of N-acetylaspartate, choline (CHO), and creatine from the tumor and the normal brain were used to calculate normalized metabolite intensities and metabolite ratios.RESULTS:Tumors that progressed during a 2-year period displayed higher normalized CHO than those that remained stable (Mann-Whitney test, P < 0.03). The majority (five of six) of the rapidly growing LGG showed values of normalized CHO of at least 1, whereas the nonprogressors had a normalized CHO value of less than 1.CONCLUSION:In association with pediatric LGG, high normalized CHO values seem to herald the potential for rapid tumor growth. These observations may be valuable for defining subsets of patients with LGG who may benefit from early therapeutic interventions. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Pediatric Low-grade Gliomas: Prognosis with Proton Magneti Resonance Spectroscopic Imaging

Pediatric Low-grade Gliomas: Prognosis with Proton Magneti Resonance Spectroscopic Imaging

C L I N I C A L S T U D IE S Pediatric Low-grade Gliomas: Prognosis with Proton Magneti Resonance Spectroscopic Imaging Jorge A. Lazareff, M.D., Kurt H.J. Bockhorst, Ph.D., John Curran, M.D., Charles Olmstead, Ph.D., Jeffrey R. Alger, Ph.D. D ivision of Neurosurgery (JAL, C O ), Departments of Surgery and Radiological Sciences (KH)B, JC, JRA), University of California, Los Angeles, Los Angeles, California OBJECTIVE: Our aim was to assess the correlation between the low-grade glioma (LG G ) metabolic profile and tumor progression. Using in vivo proton magnetic resonance spectroscopic imaging, we specifically asked whether and which metabolic features are associated with tumor regrowth or recurrence. METHODS: Eleven pediatric patients with histologically proven partially resected (< 2 0 % resection) midline LG G were treated and followed up for a period of 2 years. All patients underwent proton magnetic resonance spectroscopic imaging studies before any management was determined. Tumor progression was defined as radiological evidence of mass enlargement (> 2 5 % ) during the follow-up period. Proton magnetic resonance spectroscopic imaging was performed using a PRESS-CSI sequence on a General Electric 1.5-tesla scanner (General Electric Medical System, Waukesha, W I). The signal intensities of N-acetylaspartate, choline (C H O ), and creatine from the tumor and the normal brain were used to calculate normalized metabolite intensities and metabolite ratios. RESULTS: Tumors that progressed during a 2-year period displayed higher normalized C H O than those that remained stable (Mann-Whitney test, P < 0.03). The majority (five of six) of the rapidly growing LGG showed values of normalized C H O of at least 1, whereas the nonprogressors had a normalized C H O value of less than 1. CONCLUSION: In association with pediatric LG G , high normalized C H O values seem to herald the potential for rapid tumor growth. These observations may be valuable for defining...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199810000-00053
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:Our aim was to assess the correlation between the low-grade glioma (LGG) metabolic profile and tumor progression. Using in vivo proton magnetic resonance spectroscopic imaging, we specifically asked whether and which metabolic features are associated with tumor regrowth or recurrence.METHODS:Eleven pediatric patients with histologically proven partially resected (<20% resection) midline LGG were treated and followed up for a period of 2 years. All patients underwent proton magnetic resonance spectroscopic imaging studies before any management was determined. Tumor progression was defined as radiological evidence of mass enlargement (>25%) during the follow-up period. Proton magnetic resonance spectroscopic imaging was performed using a PRESS-CSI sequence on a General Electric 1.5-tesla scanner (General Electric Medical System, Waukesha, WI). The signal intensities of N-acetylaspartate, choline (CHO), and creatine from the tumor and the normal brain were used to calculate normalized metabolite intensities and metabolite ratios.RESULTS:Tumors that progressed during a 2-year period displayed higher normalized CHO than those that remained stable (Mann-Whitney test, P < 0.03). The majority (five of six) of the rapidly growing LGG showed values of normalized CHO of at least 1, whereas the nonprogressors had a normalized CHO value of less than 1.CONCLUSION:In association with pediatric LGG, high normalized CHO values seem to herald the potential for rapid tumor growth. These observations may be valuable for defining subsets of patients with LGG who may benefit from early therapeutic interventions.

Journal

NeurosurgeryOxford University Press

Published: Oct 1, 1998

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