Untreated Glioblastoma Multiforme: Increased Myo-inositol and Glutamine Levels in the Contralateral Cerebral Hemisphere at Proton MR Spectroscopy
Untreated Glioblastoma Multiforme: Increased Myo-inositol and Glutamine Levels in the Contralateral Cerebral Hemisphere at Proton MR Spectroscopy
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DOI：
10.1148/radiol.2533071654
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发表时间：
2009-12-01
期刊：
影响因子：
19.7
通讯作者：
Knauth, Michael
中科院分区：
文献类型：
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作者：
Kallenberg, Kai;Bock, Hans C.;Knauth, Michael
目的：使用本地化的在体内质子磁共振（MR）波谱的对侧半球的多形性胶质母细胞瘤（GBM）的患者，以检测脑代谢物的改变作为潜在的标志物浸润GBM cells.Materials and Methods：本研究是由伦理委员会批准，并获得书面知情同意书。22例新诊断和未经治疗的GBM患者使用3-T MR成像系统进行了体内单体素短回波时间质子MR波谱检查。绝对代谢物浓度在半球对侧的肿瘤进行了比较，从5例低级别胶质瘤（LGGs）和一组14个年龄匹配的对照组的数据，通过方差分析和随后的t检验或相应的非参数tests.Results：在对侧半球，磁共振波谱显示肌醇和谷氨酰胺的浓度增加。GBM患者的平均肌醇水平（3.6 mmol/L +/- 0.8 [标准差]）相对于对照受试者的水平（3.1 mmol/L +/- 0.6; P = 0.03）显著增加，并且相对于LGG患者的水平（2.7 mmol/L +/- 0.8; P = 0.09）更高。GBM患者的平均谷氨酰胺浓度（3.4 mmol/L +/- 0.9）与对照组（2.7 mmol/L +/- 0.7; P <0.01）有显著差异; GBM患者的平均谷氨酰胺浓度与LGG患者的平均谷氨酰胺浓度有显著差异（2.4 mmol/L +/- 0.5; P <0.01）。LGG患者和对照subjects.Conclusion数据之间没有显着差异：肌醇和谷氨酰胺的浓度增加，在对侧正常出现的白色物质的GBM患者是一致的轻度星形胶质细胞增生，并建议检测早期肿瘤浸润，通过使用质子磁共振波谱在体内。(C)RSNA，2009年
Purpose: To use localized in vivo proton magnetic resonance (MR) spectroscopy of the contralateral hemisphere in patients with glioblastoma multiforme (GBM) to detect alterations in cerebral metabolites as potential markers of infiltrating GBM cells.Materials and Methods: The study was approved by the ethics committee, and written informed consent was obtained. Twenty-two patients with newly diagnosed and untreated GBM underwent in vivo single-voxel short echo time proton MR spectroscopy with a 3-T MR imaging system. Absolute metabolite concentrations in the hemisphere contralateral to the tumor were compared with data from five patients with low-grade gliomas (LGGs) and from a group of 14 age-matched control subjects by using analysis of variance and subsequent t tests or corresponding nonparametric tests.Results: In the contralateral hemisphere, MR spectroscopy revealed increased concentrations of myo-inositol and glutamine. Mean myo-inositol levels were significantly increased in patients with GBM (3.6 mmol/L +/- 0.8 [standard deviation]) relative to levels in control subjects (3.1 mmol/L +/- 0.6; P = .03) and tended to be higher relative to levels in patients with LGG (2.7 mmol/L +/- 0.8; P = .09). Mean glutamine concentrations in patients with GBM (3.4 mmol/L +/- 0.9) differed significantly from those in control subjects (2.7 mmol/L +/- 0.7; P < .01); mean concentrations in patients with GBM differed from those in patients with LGG (2.4 mmol/L +/- 0.5; P < .01). There were no significant differences between data in patients with LGG and in control subjects.Conclusion: Increased concentrations of myo-inositol and glutamine in the contralateral normal-appearing white matter of GBM patients are consistent with mild astrocytosis and suggest the detectability of early neoplastic infiltration by using proton MR spectroscopy in vivo. (C) RSNA, 2009