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Role of Proton Magnetic Resonance Spectroscopy in Differentiating Oligodendrogliomas from Astrocytomas
Author(s) -
Chawla Sanjeev,
Oleaga Laura,
Wang Sumei,
Krejza Jaroslaw,
Wolf Ronald L.,
Woo John H.,
O'Rourke Donald M.,
Judy Kevin D.,
Grady Michael S.,
Melhem Elias R.,
Poptani Harish
Publication year - 2010
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2008.00307.x
Subject(s) - medicine , metabolite , proton magnetic resonance , magnetic resonance imaging , oligodendroglioma , creatine , astrocytoma , nuclear medicine , receiver operating characteristic , nuclear magnetic resonance , voxel , pathology , glioma , radiology , cancer research , physics
BACKGROUND AND PURPOSE Preoperative differentiation of astrocytomas from oligodendrogliomas is clinically important, as oligodendrogliomas are more sensitive to chemotherapy. The purpose of this study was to assess the role of proton magnetic resonance spectroscopy in distinguishing astrocytomas from oligodendrogliomas.METHODS Forty‐six patients [astrocytomas ( n = 17) and oligodendrogliomas ( n = 29)] underwent magnetic resonance imaging and multi voxel proton magnetic resonance spectroscopic imaging before treatment. Peak areas for N‐acetylaspartate (NAA), creatine (Cr), choline (Cho), myo‐inositol (mI), glutamate/glutamine (Glx), and lipids + lactate (Lip+Lac) were analyzed from voxels that exhibited hyperintensity on fluid‐attenuated inversion recovery images and were normalized to Cr from each voxel. The average metabolite/Cr ratios from these voxels were then compared between astrocytomas and oligodendrogliomas. Receiver‐operating curve analyses were used as measures of differentiation accuracy of metabolite ratios. A threshold value for a metabolite ratio was estimated by maximizing the sum of sensitivity and specificity.RESULTS A significant difference in mI/Cr was observed between astrocytomas and oligodendrogliomas (.50 ± .18 vs. 0.66 ± 0.20, P < .05). Using a threshold value of .56 for mI/Cr ratio, it was possible to differentiate oligodendrogliomas from astrocytomas with a sensitivity of 72.4% and specificity of 76.4%.CONCLUSION These results suggest that mI/Cr might aid in distinguishing oligodendrogliomas from astrocytomas. J Neuroimaging 2010;20:3‐8.