Proton magnetic resonance spectroscopic imaging of pediatric low-grade astrocytomas

Despite their uniform histologic appearance, pediatric low-grade astrocytomas (LGA) often exhibit a rather unpredictable clinical course. It is presently unclear whether certain specific genetic, immunologic and/or metabolic features underlie these observed variations. In order to address this quest...

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Bibliographic Details
Published in:Child's nervous system 1996-03, Vol.12 (3), p.130-135
Main Authors: Lazareff, J A, Olmstead, C, Bockhorst, K H, Alger, J R
Format: Article
Language:English
Subjects:
Astrocytoma - diagnostic imaging
Astrocytoma - pathology
Astrocytoma - surgery
Automatic Data Processing
Brain - diagnostic imaging
Brain - pathology
Brain - surgery
Brain Neoplasms - diagnostic imaging
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Child
Child, Preschool
Humans
Radionuclide Imaging
Spectrometry, X-Ray Emission
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Summary:Despite their uniform histologic appearance, pediatric low-grade astrocytomas (LGA) often exhibit a rather unpredictable clinical course. It is presently unclear whether certain specific genetic, immunologic and/or metabolic features underlie these observed variations. In order to address this question we examined the tumor distribution of choline compounds (Cho), creatine (Cr) and N-acetyl aspartate (NAA) in seven children with midline LGA by means of proton magnetic resonance spectroscopy imaging (H-MRSI). Studies were performed with a 1.5 T GE Signa Scanner equipped with the standard head coil; nominal voxel size was 7.5 x 7.5 x 15 mm. This spatial resolution allowed us to select and independently evaluate multiple regions of interest (ROI) in the tumor as well as in areas of normal brain from the same individual. Normalized values of the observed signal intensities demonstrated a lower NAA and Cr content in the tumors than in the surrounding normal brain. Intratumoral Cho signals were also below normal values in all but one patient. The average Cho:NAA ratio was consistently higher in the tumor than in the normal brain. However, there was a wide variation (up to fourfold) in the Cho:NAA ratios of different ROIs, even within the same tumor. Our results clearly indicate that pediatric LGAs are metabolically heterogeneous, a feature that may be relevant to the understanding of their variable biologic behavior. Inasmuch as unique metabolic patterns were observed in some LGAs, we believe that systematic HMRSI studies of these patients may help define subsets within the group with specific therapeutic requirements.
ISSN:0256-7040
1433-0350
DOI:10.1007/BF00266813