Erschienen in:
01.08.2014 | Magnetic Resonance Imaging
Recurrent glioblastoma multiforme versus radiation injury: a multiparametric 3-T MR approach
verfasst von:
Alfonso Di Costanzo, Tommaso Scarabino, Francesca Trojsi, Teresa Popolizio, Simona Bonavita, Mario de Cristofaro, Renata Conforti, Adriana Cristofano, Claudio Colonnese, Ugo Salvolini, Gioacchino Tedeschi
Erschienen in:
La radiologia medica
|
Ausgabe 8/2014
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Abstract
Objective
The discrimination between recurrent glioma and radiation injury is often a challenge on conventional magnetic resonance imaging (MRI). We verified whether adding and combining proton MR spectroscopic imaging (1H-MRSI), diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) information at 3 Tesla facilitate such discrimination.
Materials and methods
Twenty-nine patients with histologically verified high-grade gliomas, who had undergone surgical resection and radiotherapy, and had developed new contrast-enhancing lesions close to the treated tumour, underwent MRI, 1H-MRSI, DWI and PWI at regular time intervals. The metabolite ratios choline (Cho)/normal(
n
)Cho
n
, N-acetylaspartate (NAA)/NAA
n
, creatine (Cr)/Cr
n
, lactate/lipids (LL)/LL
n
, Cho/Cr
n
, NAA/Cr
n
, Cho/NAA, NAA/Cr and Cho/Cr were derived from 1H-MRSI; the apparent diffusion coefficient (ADC) from DWI; and the relative cerebral blood volume (rCBV) from PWI.
Results
In serial MRI, recurrent gliomas showed a progressive enlargement, and radiation injuries showed regression or no modification. Discriminant analysis showed that discrimination accuracy was 79.3 % when considering only the metabolite ratios (predictor, Cho/Cr
n
), 86.2 % when considering ratios and ADC (predictors, Cho/Cr
n
and ADC), 89.7 % when considering ratios and rCBV (predictors, Cho/Cr
n
, Cho/Cr and rCBV), and 96.6 % when considering ratios, ADC and rCBV (predictors, Cho/Cho
n
, ADC and rCBV).
Conclusions
The multiparametric 3-T MR assessment based on 1H-MRSI, DWI and PWI in addition to MRI is a useful tool to discriminate tumour recurrence/progression from radiation effects.