ABE Kayoko
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Proton magnetic resonance spectroscopy differentiates tumefactive demyelinating lesions from gliomas.
Journal Formal name：Multiple sclerosis and related disorders
Abbreviation：Mult Scler Relat Disord
ISSN code：22110356/22110348
Domestic / ForeginForegin
Volume, Issue, Page 26,pp.77-84
Author and coauthor Ikeguchi Ryotaro†, Shimizu Yuko*, Abe Kayoko, Shimizu Satoru, Maruyama Takashi, Nitta Masayuki, Abe Koichiro, Kawamata Takakazu, Kitagawa Kazuo
Publication date 2018/11
Summary BACKGROUND:It is often difficult to accurately differentiate tumefactive demyelinating lesions (TDLs) from gliomas using MRI.OBJECTIVE:To investigate the utility of proton magnetic resonance spectroscopy (MRS) in differentiating TDLs from gliomas.METHODS:Cohort 1 included 6 patients with TDLs and 5 with gliomas (3 high-grade), as assessed using a 1.5T MR unit. Cohort 2 included 6 patients with TDLs and 17 patients with gliomas (8 high-grade), as assessed using a 3.0T MR unit. Single-voxel proton MRS was performed to compare the following metabolite area ratios: choline (Cho)/creatine (Cr), N-acetylaspartate (NAA)/Cr, and Cho/NAA in both cohorts. Correlations between the target-to-normal-tissue ratio (TNR) obtained using methionine-positron emission tomography (MET-PET) and each MRS metabolite ratio were examined in a subset of cohort 2 (4 patients with TDLs and 11 with gliomas).RESULTS:Mean Cho/NAA ratio was significantly higher in gliomas than in TDLs or MS in cohort 1 (p < 0.05). Mean Cho/NAA ratio was significantly higher in high-grade gliomas than in TDLs in both cohorts (ps < 0.05). In the receiver operating characteristic analysis, high-grade glioma rather than TDL was indicated when the Cho/NAA ratio was >1.72 (the area under the curve was 0.958, and the maximum sensitivity and specificity were 100% and 87%, respectively). A significant positive correlation was observed between Cho/NAA ratio and the MET-PET TNR (r2 = 0.35, p < 0.05).CONCLUSION:MRS effectively differentiates TDLs from high-grade gliomas. Therefore, the clinical use of MRS is likely to enhance patient outcomes.
DOI 10.1016/j.msard.2018.08.025
PMID 30237108