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The Significance of Lactate and Lipid Peaks for Predicting Primary Neuroepithelial Tumor Grade with Proton MR Spectroscopy

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Specialty Radiology
Date 2017 Aug 19
PMID 28819084
Citations 7
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Abstract

Purpose: H-MRS is a non-invasive technique used to assess the metabolic activity of brain tumors. The technique is useful for the preoperative prediction of tumor grade, which is important for treatment planning and accurate prognosis. We used H-MRS to study the lactate peak, which appears in various conditions, including hyperglycemia, ischemia, and hypoxia and lipid peak, which is associated with necrotic cells. The purpose of this study was to retrospectively examine the frequency and significance of lactate and lipid peaks in relation to brain tumor grade.

Materials And Methods: Fifty-five patients diagnosed with neuroepithelial tumors of Grades I (3 cases), II (11 cases), III (15 cases), and IV (26 cases) were enrolled. Biopsies were excluded. Single voxel (TE = 144 ms) point resolved H-MRS spectroscopy sequences were retrospectively analyzed. An inverted doublet peak at 1.3 ppm was defined as lactate, a negative and positive peak was defined as combined lactate and lipid, and a clear upward peak was defined as lipid.

Results: Lactate peaks were detected in all grades of brain tumors and were least common in Grade II tumors (9.1%). The frequency of combined lactate-lipid peaks was 0% (Grades I and II), 8.3% (Grade III), and 44% (Grade IV). Grade IV tumors were significantly different to the other grades. There were three cases with a lipid peak. All were glioblastoma.

Conclusions: The presence of a lac peak may be useful to largely rule out the Grade II tumors, and allow the subsequent differentiation of Grade I tumors from Grade III or IV tumors by conventional imaging. The presence of a lipid peak may be associated with Grade IV tumors.

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References
1.
Roy B, Gupta R, Maudsley A, Awasthi R, Sheriff S, Gu M . Utility of multiparametric 3-T MRI for glioma characterization. Neuroradiology. 2013; 55(5):603-13. PMC: 4209475. DOI: 10.1007/s00234-013-1145-x. View

2.
Shimizu H, Kumabe T, Tominaga T, Kayama T, Hara K, Ono Y . Noninvasive evaluation of malignancy of brain tumors with proton MR spectroscopy. AJNR Am J Neuroradiol. 1996; 17(4):737-47. PMC: 8337269. View

3.
Sibtain N, Howe F, Saunders D . The clinical value of proton magnetic resonance spectroscopy in adult brain tumours. Clin Radiol. 2007; 62(2):109-19. DOI: 10.1016/j.crad.2006.09.012. View

4.
Tien R, Lai P, Smith J, Lazeyras F . Single-voxel proton brain spectroscopy exam (PROBE/SV) in patients with primary brain tumors. AJR Am J Roentgenol. 1996; 167(1):201-9. DOI: 10.2214/ajr.167.1.8659372. View

5.
Richmond McKnight T . Proton magnetic resonance spectroscopic evaluation of brain tumor metabolism. Semin Oncol. 2004; 31(5):605-17. DOI: 10.1053/j.seminoncol.2004.07.003. View