Proton magnetic resonance spectroscopic imaging to differentiate between nonneoplastic lesions and brain tumors in children

Roula Hourani, Alena Horská, Sait Albayram, Larry J. Brant, Elias Melhem, Kenneth J. Cohen, Peter C. Burger, John D. Weingart, Benjamin Carson, Moody D. Wharam, Peter B. Barker

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate whether in vivo proton magnetic resonance spectroscopic imaging (MRSI) can differentiate between 1) tumors and nonneoplastic brain lesions, and 2) high- and low-grade tumors in children. Materials and Methods: Thirty-two children (20 males and 12 females, mean age = 10 ± 5 years) with primary brain lesions were evaluated retrospectively. Nineteen patients had a neuropathologically confirmed brain tumor, and 13 patients had a benign lesion. Multislice proton MRSI was performed at TE = 280 msec. Ratios of N-acetyl aspartate/choline (NAA/Cho), NAA/creatine (Cr), and Cho/Cr were evaluated in the lesion and the contralateral hemisphere. Normalized lesion peak areas (Chonorm, Crnorm, and NAA norm) expressed relative to the contralateral hemisphere were also calculated. Discriminant function analysis was used for statistical evaluation. Results: Considering all possible combinations of metabolite ratios, the best discriminant function to differentiate between nonneoplastic lesions and brain tumors was found to include only the ratio of Cho/Cr (Wilks' lambda, P = 0.012; 78.1% of original grouped cases correctly classified). The best discriminant function to differentiate between high- and low-grade tumors included the ratios of NAA/Cr and Chonorm (Wilks' lambda, P = 0.001; 89.5% of original grouped cases correctly classified). Cr levels in low-grade tumors were slightly lower than or comparable to control regions and ranged from 53% to 165% of the control values in high-grade tumors. Conclusion: Proton MRSI may have a promising role in differentiating pediatric brain lesions, and an important diagnostic value, particularly for inoperable or inaccessible lesions.

Original languageEnglish (US)
Pages (from-to)99-107
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume23
Issue number2
DOIs
StatePublished - Feb 2006

Keywords

  • Brain
  • Choline
  • Creatine
  • N-acetyl aspartate
  • Pediatric tumors
  • Proton MRSI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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