Glutamic Acid and Total Creatine as Predictive Markers for Epilepsy in Glioblastoma by Using Magnetic Resonance Spectroscopy Before Surgery
Glutamic Acid and Total Creatine as Predictive Markers for Epilepsy in Glioblastoma by Using Magnetic Resonance Spectroscopy Before Surgery
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术前使用磁共振波谱检查谷氨酸和总肌酸作为胶质母细胞瘤癫痫的预测标志物
DOI：
10.1016/j.wneu.2022.01.056
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发表时间：
2022
影响因子：
2
通讯作者：
Sasayama Takashi
中科院分区：
文献类型：
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作者：
Hashiguchi Mitsuru;Tanaka Kazuhiro;Nagashima Hiroaki;Fujita Yuichi;Tanaka Hirotomo;Kohta Masaaki;Nakai Tomoaki;Uozumi Yoichi;Maeyama Masahiro;Somiya Yuichiro;Kohmura Eiji;Sasayama Takashi
胶质母细胞瘤患者的癫痫显著降低了他们的生活质量;然而，关于预测癫痫与肿瘤代谢物之间的关联知之甚少。在这项研究中，我们使用3.0-T磁共振成像和1H-磁共振波谱（MRS），以量化代谢物浓度在不同的癫痫history. MethodsFifty 1例胶质母细胞瘤患者进行了预处理3.0-T MRI/1H-MRS扫描。采用双回波点分辨光谱序列和化学位移选择性水抑制，在增强病变中采集单体素（1.5 cm 3）MRS。MRS数据用线性组合模型（LC-Model）软件定量。结果肿瘤组织中谷氨酸（Glu）和谷氨酸+谷氨酰胺（Glx）与总肌酸（Glu/tCr）的比值（Glu/tCr）和Glx/tCr与癫痫病史有关。受试者工作特征曲线分析表明，Glu/tCr值为1.81时预测EP的敏感性为70%，特异性为90%（曲线下面积：0.82）。在分析中，排除术前癫痫患者，Glu/tCr值为1.81是75%的敏感性和88%的预测特异性（曲线下面积：0.87）。我们的研究表明，肿瘤中Glu/tCr比值在预测EP方面具有足够的可靠性。治疗前MRS是一种微创和简单的程序，可以提供胶质母细胞瘤患者的有用信息。
ObjectiveEpilepsy in glioblastoma patients significantly reduces their quality of life; however, little is known about the association between predicting epilepsy and metabolites in tumors. In this study, we used 3.0-T magnetic resonance imaging and1H-magnetic resonance spectroscopy (MRS) to quantify metabolite concentrations in patients with varying epilepsy histories.MethodsFifty-one patients with glioblastoma underwent pretreatment 3.0-T MRI/1H-MRS scanning. Single-voxel (1.5 cm3) MRS, in an enhanced lesion, was acquired using a double-echo point-resolved spectroscopic sequence with chemical-shift selective water suppression. MRS data were quantified with linear combination model (LC-Model) software. We compared the MRS data between groups with and without epilepsy during the postoperative course (EP).ResultsThe ratios of glutamate (Glu) and glutamate + glutamine (Glx) to total creatine (Glu/tCr and Glx/tCr) in the tumor were associated with epilepsy history. The receiver operating characteristic curve analysis showed that a Glu/tCr value of 1.81 was 70% sensitive and 90% specific for the prediction of EP (area under curve: 0.82). In the analysis excluding patients with preoperative epilepsy, a Glu/tCr value of 1.81 was 75% sensitive and 88% specific for the prediction (area under curve: 0.87).ConclusionsIntratumoral metabolite concentrations measured using pretreatment 3.0-T MRI/1H-MRS changed characteristically in the group with EP. Our study suggests that the Glu/tCr ratio in tumors has adequate reliability in predicting EP. Pretreatment MRS is a minimally invasive and simple procedure that can provide useful information on glioblastoma patients.