Biomedical subjects

Sarah J Nelson

Publications and source records attributed to Sarah J Nelson.

At least 19 recordsLinked to original sources

PubMed2006

Considerations in applying 3D PRESS H-1 brain MRSI with an eight-channel phased-array coil at 3 T.

The purpose of this study was to assess the benefits of a 3 T scanner and an eight-channel phased-array head coil for acquiring three-dimensional PRESS (Point REsolved Spectral Selection) proton (H-1) magnetic resonance spectroscopic imaging (MRSI) data from the brains of volunteers and patients with brain tumors relative to previous studies that used a 1.5 T scanner and a quadrature head coil. Issues that were of concern included differences in chemical shift artifacts, line broadening due to increased susceptibility at higher field strengths, changes in relaxation times and the increased complexity of the postprocessing software due to the need for combining signals from the multichannel data. Simulated and phantom spectra showed that very selective suppression pulses with a thickness of 40 mm and an overpress factor of at least 1.2 are needed to reduce chemical shift artifact and lipid contamination at higher field strengths. Spectral data from a phantom and those from six volunteers demonstrated that the signal-to-noise ratio (SNR) in the eight-channel coil was more than 50% higher than that in the quadrature head coil. For healthy volunteers and eight patients with brain tumors, the SNR at 3 T with the eight-channel coil was on average 1.5 times higher relative to the eight-channel coil at 1.5 T in voxels from normal-appearing brains. In combination with the effect of a higher field strength, the use of the eight-channel coil was able to provide an increase in the SNR of more than 2.33 times the corresponding acquisition at 1.5 T with a quadrature head coil. This is expected to be critical for clinical applications of MRSI in patients with brain tumors because it can be used to either decrease acquisition time or improve spatial resolution.

Adult↗

PubMed2006

Partial-volume model for determining white matter and gray matter cerebral blood volume for analysis of gliomas.

PURPOSE: To model the partial voluming of gray matter (GM) and white matter (WM) in perfusion imaging, and to use this model to estimate the cerebral blood volume (CBV) of pure WM and GM, which could then be used to normalize data across patients in preparation for analyzing tumor perfusion. MATERIALS AND METHODS: Dynamic susceptibility contrast (DSC) perfusion imaging was performed on 20 glioma patients. The perfusion data were registered to the T1 image using rigid-body and non-rigid algorithms. The rCBV for each voxel was computed by gamma-variate fitting and then fit as a linear function of the estimated fractional WM content. The estimated CBV of pure WM was used to normalize across patients, and the resulting tumor CBV values were compared with expectations. RESULTS: Rigid registration improved the correlation between the fractional WM content and CBV for all patients, with non-rigid registration yielding further improvements for all but two patients. The mean GM-to-WM CBV ratio was estimated at 2.15 +/- 0.33 (mean +/- SD). Voxels that exhibited both T1-Gd contrast enhancement and an abnormal proton spectrum were found to have a CBV 2.53 +/- 0.89 times higher than that in the WM. CONCLUSION: A partial-volume model is demonstrated for estimating pure WM and GM CBV. It is also shown that the relationship between the tumor CBV as estimated with this model is generally consistent with expectations based on spectroscopy and imaging.

Adult↗

PubMed2006

Feasibility of dynamic susceptibility contrast perfusion MR imaging at 3T using a standard quadrature head coil and eight-channel phased-array coil with and without SENSE reconstruction.

PURPOSE: To investigate changes in image and dynamic signal-to-noise ratios (SNRs) of the DeltaR2* curve, as well as magnetic susceptibility-induced artifacts between a standard quadrature head coil and an eight-channel phased-array coil with and without sensitivity-encoding (SENSE) at 3T, compared to the current clinical standard head coil acquisition at 1.5T. MATERIALS AND METHODS: Dynamic susceptibility contrast (DSC) perfusion MRI was performed on 80 brain tumor patients using a gradient-echo, echo-planar imaging (EPI) sequence. Image and dynamic SNR were compared between 1.5T and 3T field strengths, a quadrature and eight-channel phased-array coil, and a conventional vs. partially parallel EPI acquisition with SENSE reconstruction. The amount of geometric distortion and signal dropout was quantified and compared between conventional and SENSE EPI acquisitions within the same exam at 3T. RESULTS: An initial 2.6-fold elevation in dynamic SNR was observed in normal-appearing white matter when doubling the field strength (P < 0.001), with an additional 1.7-fold increase found when employing an eight-channel phased-array coil (P < 0.002). Compared to the standard 3T eight-channel coil acquisition, the implementation of SENSE reduced the number of voxels experiencing large anterior shifts in the phase-encode direction, lowered the volume of signal dropout by 2.0-11.5%, and allowed a 1.4-fold increase in slice coverage, while only decreasing the dynamic SNR by 22%. CONCLUSION: SENSE EPI at 3T yielded a significant improvement in dynamic SNR over the 1.5T acquisitions. A significant reduction in magnetic susceptibility-induced artifacts was achieved with SENSE EPI compared to the standard EPI eight-channel coil acquisition at 3T.

Adult↗

PubMed2006

Unaliasing lipid contamination for MR spectroscopic imaging of gliomas at 3T using sensitivity encoding (SENSE).

3D magnetic resonance spectroscopic imaging (MRSI) has been successfully employed to extract information about brain tumor metabolism, such as cell membrane breakdown, cellular energetics, and neuronal integrity, through its ability to differentiate signals coming from choline (Cho), creatine (Cr), and N-acetyl aspartate (NAA) molecules. The additional presence of lipids within subregions of the tumor may indicate cellular membrane breakdown due to cell death. Another potential source of lipids is subcutaneous fat, which may be excited with point-resolved spectroscopy (PRESS) volume selection and aliased into the spectral field of view (FOV) due to the chemical shift artifact and the low bandwidth of the selection pulses. The purpose of our study was to employ a postprocessing method for unaliasing lipid resonances originating from in-slice subcutaneous lipids from the 3D MRSI of gliomas at 3T, using an eight-channel phased-array coil and sensitivity encoding (SENSE).

Algorithms↗

PubMed2006

Quantification of prostate MRSI data by model-based time domain fitting and frequency domain analysis.

This paper compares two spectral processing methods for obtaining quantitative measures from in vivo prostate spectra, evaluates their effectiveness, and discusses the necessary modifications for accurate results. A frequency domain analysis (FDA) method based on peak integration was compared with a time domain fitting (TDF) method, a model-based nonlinear least squares fitting algorithm. The accuracy of both methods at estimating the choline + creatine + polyamines to citrate ratio (CCP:C) was tested using Monte Carlo simulations, empirical phantom MRSI data and in vivo MRSI data. The paper discusses the different approaches employed to achieve the quantification of the overlapping choline, creatine and polyamine resonances. Monte Carlo simulations showed induced biases on the estimated CCP:C ratios. Both methods were successful in identifying tumor tissue, provided that the CCP:C ratio was greater than a given (normal) threshold. Both methods predicted the same voxel condition in 94% of the in vivo voxels (68 out of 72). Both TDF and FDA methods had the ability to identify malignant voxels in an artifact-free case study using the estimated CCP:C ratio. Comparing the ratios estimated by the TDF and the FDA, the methods predicted the same spectrum type in 17 out of 18 voxels of the in vivo case study (94.4%).

Algorithms↗

PubMed2006

Perfusion, diffusion and spectroscopy values in newly diagnosed cerebral gliomas.

PURPOSE: To evaluate perfusion, diffusion, and spectroscopy values in enhancing and non-enhancing lesions for patients with newly diagnosed gliomas of different grades. MATERIALS AND METHODS: Sixty-seven patients with newly diagnosed glioma were entered into the study 20 grade II, 26 grade III and 21 grade IV. MR data were acquired at 1.5T and included diffusion weighted images (59/67 patients), dynamic perfusion weighted images (30/67 patients) and 3D H-1 MR spectroscopy (64/67 patients). Enhancing and non-enhancing lesions were delineated by a neuroradiologist and applied to maps of relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC), relative anisotropy (RA) and metabolite intensities. RESULTS: The median rCBV within enhancing regions of grade IV gliomas was significantly elevated relative to enhancing regions in grade III gliomas and normal brain. ADC was elevated relative to normal brain, but was not significantly different between grades or between enhancing and non-enhancing regions. The RA was higher in the non-enhancing region of grade IV gliomas relative to grade II and grade III. Levels of lactate plus lipid were significantly elevated in grade IV relative to grade II and grade III gliomas. Both enhancing and non-enhancing regions in grade IV gliomas showed significant correlations between CBV, ADC and choline levels. CONCLUSION: The data were consistent with grade IV gliomas having higher membrane turnover, increased cell density and increased vascularity within enhancing lesions. Analysis of the correlations among parameters within grade IV gliomas suggested that high vascularity (high rCBV) was correlated with increased cellularity (low ADC) and increased membrane turnover (high choline) in these lesions. The non-enhancing region of grades II and III gliomas had MR parameters consistent with increased cellularity and/or membrane turnover.

Adult↗

PubMed2005

Measurement of in vivo multi-component T2 relaxation times for brain tissue using multi-slice T2 prep at 1.5 and 3 T.

The objective of this study was to implement a clinically relevant multi-slice multi-echo imaging sequence in order to quantify multi-component T2 relaxation times for normal volunteers at both 1.5 and 3 T. Multi-echo data were fitted using a nonnegative least square algorithm. Twelve echo data with nonlinear echo sampling were acquired using a receive-only eight-channel phased array coil and volume head coil for phantoms and normal volunteers, and compared to 32-echo data with linear echo sampling. It was observed that the performance of the 180 degrees refocusing trains was more spatially uniform for the receive-only eight-channel phased array coil than for the head coil, particularly at 3 T. The phantom study showed that the estimated T2 relaxation times were accurate and reproducible for both single- and multi-slice acquisition from a commercial phantom with known T2 relaxation times. Short T2 components (T2 <50 ms) were mainly observed within the white matter for normal volunteers, and the fraction of short T2 water components (i.e., myelin water) was 7-12% of total water. It was observed that the calculated myelin water fraction map from the nonlinearly sampled 12-echo data was comparable with that from the linearly sampled 32-echo data. Quantification of T2 relaxation times from multi-slice images was accomplished with a clinically acceptable scan times (16 min) for normal volunteers by using a nonselective T2 prep imaging sequence. The use of the eight-channel head coil involved more accurate quantification of T2 relaxation times particularly when the number of echoes was limited.

Adult↗

PubMed2005

Spectroscopic imaging of the brain with phased-array coils at 3.0 T.

The goal of this study was to develop and evaluate high-resolution magnetic resonance spectroscopic imaging (MRSI) utilizing the gains in signal-to-noise ratio (SNR) provided by combining higher magnetic field with high-sensitivity phased-array (PA) coils. We investigated the maximum improvement in spatial resolution as small as 0.09 cm(3) for brain MRSI while maintaining adequate SNR and acquisition time. The use of low peak power, dual-band spectral-spatial pulses was also investigated for application to 3 T MRSI of the brain using the body coil for radiofrequency excitation and PA coils for signal reception.

Adult↗

PubMed2005

Dynamic susceptibility contrast perfusion imaging of radiation effects in normal-appearing brain tissue: changes in the first-pass and recirculation phases.

PURPOSE: To identify radiation-induced changes in the cerebral vasculature of healthy tissue in the first four months following radiotherapy through the analysis of dynamic-susceptibility contrast perfusion imaging. MATERIALS AND METHODS: Dynamic gradient-echo imaging was performed on 22 patients during injection of a bolus of Gd-DTPA contrast. The relative cerebral blood volume (rCBV), maximum DeltaR2* of the first passage of the bolus, and a recirculation parameter were derived from gamma-variate fits of the dynamic data. The white matter (WM) rCBV and peak heights were estimated through correlation with segmented T1-weighted images. A percent recovery to baseline was also computed to further describe the recirculation phase. RESULTS: A significant elevation of the recirculation phase was observed at doses>15 Gy at two months following radiotherapy. This was reflected in an increased recirculation parameter in the fitted curves in the 15-30, 30-45, and >45 Gy dose groups to 2.8%, 3.8%, and 2.4% above the <15 Gy voxels, as well as in a decline in percent recovery to baseline. A trend toward lower rCBV and peak heights was observed at that same time point. CONCLUSION: The observed results suggest a dose-dependent decline in vessel density and increase in vascular permeability and/or tortuosity in irradiated normal-appearing brain tissue at two months following radiotherapy.

Adult↗

PubMed2005

Quantitative apparent diffusion coefficients and T2 relaxation times in characterizing contrast enhancing brain tumors and regions of peritumoral edema.

PURPOSE: To investigate the potential value and relationship of in vivo quantification of apparent diffusion coefficients (ADCs) and T2 relaxation times for characterizing brain tumor cellularity and tumor-related edema. MATERIALS AND METHODS: A total of 26 patients with newly diagnosed gliomas, meningiomas, or metastases underwent diffusion-weighted and six-echo multisection T2-preparation imaging. Regions of interest (ROIs) were drawn on conventional MR images to include tumor (as defined by contrast agent enhancement) and immediate and peripheral edema. Areas of necrosis were excluded. Median values of ADCs and T2 in the ROIs were calculated. RESULTS: ADCs for gliomas were similar to those for meningiomas or metastases in all regions. Tumor T2 values for gliomas (159.5+/-30.6 msec) were significantly higher than those for meningiomas or metastases (125.0+/-31.1 msec; P=0.005). Immediate-edema T2 values for meningiomas or metastases (226.0+/-44.1 msec) were significantly higher than those for gliomas (203.5+/-32.8 msec; P=0.033). Peripheral-edema T2 values for gliomas (219.5+/-41.9 msec) were similar to those for meningiomas or metastases (202.5+/-26.5 msec; P=0.377). Both immediate- and peritumoral-edema ADCs and T2 values were significantly higher than those in tumor for both tumor types. ADCs and T2 values from all regions correlated significantly for gliomas (r=0.95; P<0.0001) and for meningiomas or metastases (r=0.81; P<0.0001). CONCLUSION: The higher immediate-edema T2 values for nonglial tumors than for gliomas suggest tumor-related edema (vasogenic vs. infiltrated) can be further characterized by using T2 values. There were significant correlations between ADC and T2 values.

Adult↗

PubMed2005

Improved signal to noise in high-resolution magic angle spinning total correlation spectroscopy studies of prostate tissues using rotor-synchronized adiabatic pulses.

A rotor-synchronized WURST-8 adiabatic pulse scheme was compared to the conventional MLEV-17 hard pulse scheme for isotropic mixing in total correlation spectroscopy (TOCSY) studies of intact human prostate tissues under high-resolution magic angle spinning (HR-MAS) conditions. Both mixing schemes were extremely sensitive to the rotational resonance condition and dramatic reductions in signal to noise were observed when pulse durations deviated from 1/(spin rate). A significant increase in cross-peak intensities was observed using rotor-synchronized WURST-8 adiabatic pulses versus those observed using the rotor-synchronized MLEV-17 hard pulse scheme in both solution and tissue. In tissue, absolute signal intensities ranged from 1.5x to 10.5x greater (average: 4.75x) when WURST-8 was used in place of MLEV-17. Moreover, the difference was so dramatic that several metabolite cross peaks observed using WURST-8 pulses were not observed using MLEV-17 pulses, including cross peaks corresponding to many of the choline- and ethanolamine-containing metabolites. Due to the complex modulation of TOCSY cross peaks for multiply coupled spins and the shorter T(2) relaxation times of tissue metabolites, maximum cross-peak intensities occurred at shorter mixing times than predicted by theory. In summary, a WURST-8 adiabatic mixing scheme produced significantly greater absolute cross-peak signal intensities than MLEV-17 hard pulse mixing, and maximum cross-peak intensity versus mixing time must be established for specific spin systems and T(2) relaxation times.

Humans↗

PubMed2005

Design of flyback echo-planar readout gradients for magnetic resonance spectroscopic imaging.

The spatial resolution of conventional magnetic resonance spectroscopic imaging-(MRSI) is typically coarse, mainly due to SNR limitations. The increased signal available with higher field scanners and new array coils now permits higher spatial resolution, but conventional chemical shift imaging (phase encoding) limits the spatial coverage possible in a patient-acceptable acquisition time. The "flyback" echo-planar trajectory is particularly insensitive to errors and provides data that are simple to process. In this study, high-efficiency gradient waveforms for flyback echo-planar MRSI were designed and implemented. Normal volunteer studies at 3 T showed the feasibility of acquiring high spatial resolution with large coverage in a short scan time (2048 voxels in 2.3 min and 4096 voxels in 8.5 min). The trajectories were insensitive to errors in timing and require only a modest (10 to 30%) penalty in SNR relative to conventional phase encoding using the same acquisition time.

Algorithms↗

PubMed2005

Differentiation of low-grade oligodendrogliomas from low-grade astrocytomas by using quantitative blood-volume measurements derived from dynamic susceptibility contrast-enhanced MR imaging.

BACKGROUND AND PURPOSE: Histopathologic evaluation remains the reference standard for diagnosis of glioma and classification of histologic subtypes, but is challenged by subjective criteria, tissue sampling error, and lack of specific tumor markers. Anatomic imaging is essential for surgical planning of gliomas but is limited by its nonspecificity and its inability to depict beyond morphologic aberrations. The purpose of our study was to investigate dynamic susceptibility contrast-enhanced (DSC) MR imaging characteristics of the two most common subtypes of low-grade infiltrating glioma: astrocytoma and oligodendroglioma. We hypothesized that tumor blood-volume measurements, derived from DSC MR imaging, would help differentiate the two on the basis of differences in tumor vascularity. METHODS: We studied 25 consecutive patients with treatment-naive, histopathologically confirmed World Health Organization grade II astrocytoma (n = 11) or oligodendroglioma (n = 14). All patients underwent anatomic and DSC MR imaging immediately before surgical resection. Histologic confirmation was obtained in all patients. Anatomic MR images were analyzed for morphologic features, and DSC MR data were processed to yield quantitative cerebral blood volume (CBV) measurements. RESULTS: The maximum relative CBV (rCBV(max)) in tumor ranged from 0.48 to 1.34 (0.92 +/- 0.27, median +/- SD) in astrocytomas and from 1.29 to 9.24 (3.68 +/- 2.39) in oligodendrogliomas. The difference in median rCBV(max) between the two tumor types was significant (P < .0001). CONCLUSION: The tumor rCBV(max) measurements derived from DSC MR imaging were significantly higher in low-grade oligodendrogliomas than in astrocytomas. Our findings suggest that tumor rCBV(max) derived from DSC MR imaging can be used to distinguish between the two low-grade gliomas.

Adult↗

PubMed2005

Relationship of MR-derived lactate, mobile lipids, and relative blood volume for gliomas in vivo.

BACKGROUND AND PURPOSE: Gliomas are heterogeneous tumors with increased microvasculature, hypoxia, and necrosis. The purpose of this study was to examine the distribution and relationship of the MR-derived relative cerebral blood volume (rCBV), lactate (Lac), and mobile lipids (Lip), which have been proposed as markers for these phenomena of gliomas in vivo. METHODS: Twenty-three patients with newly diagnosed gliomas were examined before surgical biopsy and/or resection (seven grade II, five grade III, and 11 grade IV), and 27 patients were studied after surgery but before radiation treatment and/or chemotherapy (11 grade II, two grade III, and 14 grade IV gliomas). Lac and Lip were estimated from Lac-edited three-dimensional MR spectroscopic images. Dynamic susceptibility-contrast MR imaging was applied to obtain perfusion-weighted images and rCBV maps. RESULTS: Before surgical biopsy/resection, one low-grade and 12 of 16 high-grade gliomas had significantly elevated Lac. No low-grade and 10 of 16 high-grade gliomas had significantly elevated Lip. In presurgical high-grade gliomas, volumes of elevated Lip and macronecrosis were significantly correlated. rCBV was significantly increased in regions with elevated Lac. After we excluded macronecrosis, the rCBV for regions with elevated Lip but no Lac was significantly higher than rCBV in regions with elevated Lac but no Lip. After surgical biopsy/resection, more low-grade patients showed significantly elevated Lac and Lip than before. CONCLUSION: The in vivo distribution of rCBV, Lac, and Lip, as evaluated with three-dimensional MR spectroscopic imaging, may help in the diagnosis and selection of the most appropriate therapy for patients with gliomas.

Blood Volume↗

PubMed2004

3D MRSI for resected high-grade gliomas before RT: tumor extent according to metabolic activity in relation to MRI.

PURPOSE: To evaluate the presence of residual disease after surgery but before radiotherapy (RT) in patients with high-grade glioma by MRI and magnetic resonance spectroscopy imaging (MRSI) and to estimate the impact of MRSI on the definition of postoperative target volumes for RT treatment planning. METHODS AND MATERIALS: Thirty patients (27 glioblastoma multiforme, 3 Grade III astrocytoma) underwent MRI and MRSI within 4 weeks after surgery but before the initiation of RT. The MRI data were manually contoured; the regions of interest included T(2)-weighted hyperintensity (T(2)), T(1)-weighted contrast enhancement (T(1)), and the resection cavity (RC). Levels of choline and N-acetyl-aspartate (NAA) in the three-dimensional MRSI data were analyzed on the basis of a choline-to-N-acetyl-aspartate index (CNI). The CNI and other metabolic indexes were superimposed on the MRI data as three-dimensional contours. Composite, conjoint, and disjoint volumes were defined for T(1) and T(2), with/without RC, and within the CNI contour, corresponding to a value of 2. In addition, follow-up MRI studies were examined for new onset contrast enhancement and compared with the initial spectroscopic findings obtained before RT. RESULTS: Substantial variation was found in the spatial relationship between the MRI and MRSI volumes. Ten patients had no contrast enhancement after surgery, and MRSI revealed abnormal metabolic activity in 8 of 10, averaging 20 cm(3) and extending 11-36 mm beyond the RC. In 20 patients with contrast-enhancing lesions, substantial variation was found between T(1) and CNI2; metabolic activity fell outside the contrast enhancement in 19 patients, averaging 21 cm(3) and extending 8-33 mm beyond the contrast enhancement. For all patients, the T(2) encompassed most of the metabolic volume. However, the CNI2 extended beyond the T(2) in 6 of 10 patients without contrast enhancement (mean, 8 cm(3); maximum, 15-23 mm) and in 13 of 20 patients with contrast enhancement (mean, 7 cm(3); maximum, 8-22 mm), representing an increase in the T(2) volume by as much as 180% (median 13%) and 86% (median 14%) for non-contrast-enhancing and contrast-enhancing patients, respectively. Preliminary evaluation of the MRI follow-up examinations revealed correspondence of areas of new contrast enhancement with initial MRSI abnormalities in 8 of 10 non-contrast-enhancing patients. In addition, CNI volumes correlated inversely with the time to onset of new contrast enhancement. CONCLUSION: MRSI is a valuable diagnostic tool for the assessment of residual disease after surgical resection in high-grade glioma. The incorporation of areas of metabolic abnormality into treatment planning for postoperative patients would produce different sizes and shapes of target volumes for both primary and boost volumes. It also may encourage the use of nonuniform margins to define the extent of tumor cell infiltration, rather than the current use of uniform margins.

Astrocytoma↗

PubMed2004

Corpus callosum axonal injury in multiple sclerosis measured by proton magnetic resonance spectroscopic imaging.

BACKGROUND: Axonal damage has been observed in normal-appearing white matter (NAWM) for patients with multiple sclerosis (MS). OBJECTIVES: To investigate changes in brain metabolite ratios in a region of normal-appearing corpus callosum (CC) for patients with MS and to test its relationship to changes in other regions of NAWM. DESIGN AND METHODS: Data were collected from 24 patients with MS and 15 control subjects. Two-dimensional proton magnetic resonance spectroscopic imaging was performed centered at the CC. Regions of interest from normal-appearing CC were manually segmented using anatomical images. The NAWM outside the CC region was segmented based on the signal intensity in T1- and T2-weighted images. RESULTS: The N-acetylaspartate-creatine-phosphocreatine ratio was lower in both regions for patients with secondary progressive MS compared with the controls; the N-acetylaspartate-creatine-phosphocreatine was lower only in the normal-appearing CC region for patients with relapsing-remitting MS (P<.001) compared with the controls. The ratio of choline-containing compound compared with the creatine-phosphocreatine ratio was also lower in the region of normal-appearing CC for patients with relapsing-remitting MS (P =.003) compared with the controls. There was a correlation between the N-acetylaspartate-creatine-phosphocreatine ratio in the normal-appearing CC and T1 lesions (r = -0.53, P =.01) for all patients. CONCLUSIONS: The CC was a more sensitive location for depicting axonal injury than other regions of NAWM. A correlation between the reduction of the N-acetylaspartate-creatine-phosphocreatine ratio in the normal-appearing CC and the T1 lesions may suggest that transection of axons in lesions may cause distant axonal damage and/or dysfunction that are expressed and more sensitively detectable in the CC.

Adult↗

PubMed2004

1H-MRSI of radiation effects in normal-appearing white matter: dose-dependence and impact on automated spectral classification.

PURPOSE: To identify radiation-induced changes in healthy white-matter spectra in the first six months following radiotherapy, and assess the impact of these changes on an automated algorithm for detecting spectral abnormalities. MATERIALS AND METHODS: 1H-MRSI was performed on 10 patients with grade IV gliomas who were to undergo radiation therapy. Choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) ratios were studied as a function of dose and time. The impact of these spectral changes on a spectral analysis algorithm was evaluated. RESULTS: The Cho/NAA ratios rose to values of 0.66 +/- 0.15, 0.75 +/- 0.21, and 0.73 +/- 0.15 two months after therapy, compared to immediate post-therapy values of 0.56 +/- 0.15, 0.60 +/- 0.16, and 0.61 +/- 0.15 for the < 25, 25-50, and > 50 Gy dose groups, respectively. These maxima were followed by a dose-dependent recovery. A similar trend was found in the Cho/Cr ratio. The automated spectral analysis system incorporated the changing Cho/NAA ratio into a global redefinition of healthy tissue, but did not account for dose-dependent spatial variations in Cho/NAA ratios. CONCLUSION: Radiation significantly alters the spectra of healthy tissues in the first six months after radiotherapy. This suggests that the radiation dose distribution should be considered during analysis of post-therapy spectra.

Aspartic Acid↗

PubMed2004

Survival analysis in patients with glioblastoma multiforme: predictive value of choline-to-N-acetylaspartate index, apparent diffusion coefficient, and relative cerebral blood volume.

PURPOSE: To investigate the potential value of pre-external-beam radiation therapy (XRT) choline-to-NAA (N-acetylaspartate) index (CNI), apparent diffusion coefficient (ADC), and relative cerebral blood volume (rCBV) for predicting survival in newly diagnosed patients with glioblastoma multiforme (GBM). MATERIALS AND METHODS: Twenty-eight patients with GBM were studied using in vivo proton magnetic resonance spectroscopic imaging (1H MRSI) and diffusion- and perfusion-weighted imaging after surgery but prior to XRT. Patients were categorized on the basis of their volumes of morphologic and metabolic abnormalities (volume of CNI > or = 2 and CNI values), normalized ADC (nADC), or rCBV values within the T1 contrast-enhancing and T2 regions. The median survival time was compared. RESULTS: A significantly shorter median survival time was observed for patients with a large volume of metabolic abnormality than for those with a small abnormality (12.0 and 17.1 months, respectively, P = 0.002). A similar pattern was observed for patients with a low mean nADC value compared to those with high mean nADC value within the T2 region (11.2 and 21.7 months, respectively, P = 0.004). A shorter median survival time was also observed for patients with contrast-enhancing residual disease than for those without the presence of contrast enhancement with marginal significance. CONCLUSION: The pre-XRT volume of the metabolic abnormality and the nADC value within the T2 region may be valuable in predicting outcome for patients with GBM.

Adolescent↗