ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Magnetic Resonance Spectroscopy in Cerebral Gliomas: Biologic Markers

Bibliography link: Prokudin M. Yu., Odinak М. M., Litvinenko I. V., Martynov B. V., Zheleznyak I. S., Lytkin М. V., Okolzin A. V., Vorontsova D. А. Magnetic Resonance Spectroscopy in Cerebral Gliomas: Biologic Markers. Doctor.Ru. 2018; 1(145): 10–15.
20 January 10:56

Study Objective: To analyse the prognostic importance of metabolic changes in identification of tumour malignancy in patients with cerebral gliomas, duration of a recurrence-free period and expectancy of life following magnetic resonance spectroscopy results.

Study Design: Open diagnostic comparative observational study of “occurrence – monitoring” type.

Materials and Methods. The study enrolled 39 patients with cerebral tumours: 17 — with diffusive astrocytomas, 13 — with anaplastic astrocytomas, 9 — with glioblastomas. The mean age of patients was 44.26 ± 14.66 years old. The control group included 9 healthy volunteers of 25.6 ± 2.07 years old. Relapse-free period and life expectancy were assessed for 26 out of 39 patients: 10 — with diffusive astrocytomas, 9 — with anaplastic astrocytomas, 7 — with glioblastomas. All patients underwent MR imaging and spectroscopy. All spectra showed metabolites: choline (Cho), creatine (Cr), N-acetylaspartate (NAA), lactate.

Study Results. The common characteristic of tumours was significant drop in NAA and Cr levels and increased Cho level. Also statistically significant reduction in NAA/Cho ratio and NAA/Cr ratio was noted in patients with all types of brain tumours vs. controls. Cho/Cr ratio was significantly higher in patients with anaplastic astrocytomas and glioblastomas vs. healthy subjects. Tumour grade was higher with increased Cho/Cr ratio. NAA/Cho ratio was statistically different in patients with low grade (grade II) and high grade (grade III, grade IV) tumours. No significant difference was observed between grade III and grade IV. NAA/Cr ratio was not significantly different in patients with tumours of various grades.

Statistically significant (p < 0.05) difference was observed in life expectancy of patients depending on Cho/Cr ratio (division as per top quartile): median life expectancy with Cho/Cr up to 2.67 was 2,000.6 days, where Cho/Cr exceeded the top quartile, the value made 287.8 days. Also, statistically significant (p < 0.05) difference was observed in relapse-free period depending on Cho/Cr ratio (division as per top quartile): with Cho/Cr up to 2.67 it was 860.5 days (median value), where Cho/Cr exceeded the top quartile, the value made 145 days.

Conclusion. Cho/Cr ratio makes it possible to propose the rate of brain tumour malignancy and may be a non-invasive biological marker of a relapse-free period and life expectancy of patients.

M. Yu. Prokudin — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

М. M. Odinak — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

I. V. Litvinenko — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

B. V. Martynov — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

I. S. Zheleznyak — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

М. V. Lytkin — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

A. V. Okolzin — A. M. Nikiforov All-Russia Centre of Emergency and Radiation Medicine, St. Petersburg

D. А. Vorontsova — S. M. Kirov Military Medical Academy, St. Petersburg. E-mail: odinak@rambler.ru

Доктор.ру
20 January 10:56
LITERATURE
  1. Семенова Н. А., Ахадов Т. А., Ублинский М. В., Варфоломеев С. Д. Использование магнитно-резонансной спектроскопии для диагностики и мониторинга лечения неврологических и психических заболеваний. В кн.: Угрюмов М. В., ред. Нейродегенеративные заболевания: от генома до целостного организма. Т. 2. М.: Научный мир; 2014: 662–679. [Semenova N. A., Akhadov T. A., Ublinskii M. V., Varfolomeev S. D. Ispol'zovanie magnitno-rezonansnoi spektroskopii dlya diagnostiki i monitoring lecheniya nevrologicheskikh i psikhicheskikh zabolevanii. V kn.: Ugryumov M. V., red. Neirodegenerativnye zabolevaniya: ot genoma do tselostnogo organizma. T. 2. M.: Nauchnyi mir; 2014: 662–679. (in Russian)]
  2. Rémy C., Grand S., Laï E. S., Belle V., Hoffmann D., Berger F. et al. 1HMRS of human brain abscesses in vivo and in vitro. Magn. Rson. Med. 1995; 34 (4): 508–14.
  3. Anbarloui M. R., Ghodsi S. M., Khoshnevisan A., Khadivi M., Abdollahzadeh S., Aoude A. et al. Accuracy of magnetic resonance spectroscopy in distinction between radiation necrosis and recurrence of brain tumor. Iran J. Neurol. 2015; 14 (1): 29–34.
  4. Chernov M. F., Ono Y., Abe K., Usukura M., Hayashi M., Izawa M. et al. Differentiation of tumor progression and radiation-induced effects after intracranial radiosurgery. Acta Neurochir. Suppl. 2013; 116: 193–210.
  5. Окользин А. В. Возможности магнитно-резонансной спектроскопии по водороду в характеристике опухолей головного мозга: Автореф. дис. .... канд. мед. наук. СПб.; 2007. 25 с. [Okol'zin A. V. Vozmozhnosti magnitno-rezonansnoi spektroskopii po vodorodu v kharakteristike opukholei golovnogo mozga: Avtoref. dis. ... kand. med. nauk. SPb.; 2007. 25 s. (in Russian)]
  6. Окользин А. В. Магнитно-резонансная спектроскопия по водороду в характеристике опухолей головного мозга. Онкология. 2007; 8: 132–51. [Okol'zin A. V. Magnitno-rezonansnaya spektroskopiya po vodorodu v kharakteristike opukholei golovnogo mozga. Onkologiya. 2007; 8: 132–51. (in Russian)]
  7. Труфанов Г. Е., Тютина Л. А. Магнитно-резонансная спектроскопия: руководство для врачей. СПб.: ЭЛБИ-СПб; 2008. 239 с. [Trufanov G. E., Tyutina L. A. Magnitno-rezonansnaya spektroskopiya: rukovodstvo dlya vrachei. SPb.: ELBI-SPb; 2008. 239 s. (in Russian)]
  8. Bradac O., Vrana J., Jiru F., Kramar F., Netuka D., Hrabal P. et al. Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy. Br. J. Neurosurg. 2014; 28 (5): 631–6.
  9. Rao P. J., Jyoti R., Mews P. J., Desmond P., Khurana V. G. Preoperative magnetic resonance spectroscopy improves diagnostic accuracy in a series of neurosurgical dilemmas. Br. J. Neurosurg. 2013; 27 (5): 646–53.
  10. Peng J., Ouyang Y., Fang W. D., Luo T. Y., Li Y. M., Lv F. J. et al. Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur. J. Radiol. 2012; 81 (12): 4057–63.
  11. De Simone M., Brogna B., Sessa G., Oliva G., Guida B., Magliulo M. Valuable contribution of magnetic resonance spectroscopy in differentiation of brain abscess from glioma. Infect. Dis. (Lond). 2017; 49 (11–12): 871–3.
  12. Lai P. H., Weng H. H., Chen C. Y., Hsu S. S. Ding S., Ko C. W. et al. In vivo differentiation of aerobic brain abscesses and necrotic glioblastomas multiforme using proton MR spectroscopic imaging. AJNR Am. J. Neuroradiol. 2008; 29 (8): 1511–18.
  13. Nagashima H., Sasayama T., Tanaka K., Kyotani K., Sato N., Maeyama M. et al. Myo-inositol concentration in MR spectroscopy for differentiating high grade glioma from primary central nervous system lymphoma. J. Neurooncol. 2018; 136 (2): 317–26.
  14. Imani F., Boada F. E., Lieberman F. S., Davis D. K., Mountz J. M. Molecular and metabolic pattern classification for detection of brain glioma progression. Eur. J. Radiol. 2014; 83 (2): e100–5.
  15. Zhang H., Ma L., Wang Q., Zheng X., Wu C., Xu B. N. Role of magnetic resonance spectroscopy for the differentiation of recurrent glioma from radiation necrosis: a systematic review and meta-analysis. Eur. J. Radiol. 2014; 83(12): 2181–9.
  16. Bulik M., Jancalek R., Vanicek J., Skoch A., Mechl M. Potential of MR spectroscopy for assessment of glioma grading. Clin. Neurol. Neurosurg. 2013; 115(2): 146–53.
  17. Porto L., Kieslich M., Franz K., Lehrnbecher T., Zanella F., Pilatus U. et al. MR spectroscopy differentiation between high and low grade astrocytomas: a comparison between paediatric and adult tumours. Eur. J. Paediatr. Neurol. 2011; 15(3): 214–21.
  18. Анохина Ю. Е., Гайдар Б. В., Мартынов Б. В., Свистов Д. В., Папаян Г. В., Григорьевский Д. И. Прогностическая значимость объема хирургического вмешательства в условиях применения интраоперационной флуоресцентной диагностики у пациентов со злокачественными глиомами головного мозга. Вестн. Российской военно-медицинской академии. 2014; 1(45): 19–24. [Anokhina Yu. E., Gaidar B. V., Martynov B. V., Svistov D. V., Papayan G. V., Grigor'evskii D. I. Prognosticheskaya znachimost' ob"ema khirurgicheskogo vmeshatel'stva v usloviyakh primeneniya intraoperatsionnoi fluorestsentnoi diagnostiki u patsientov so zlokachestvennymi gliomami golovnogo mozga. Vestn. Rossiiskoi voenno-meditsinskoi akademii. 2014; 1(45): 19–24. (in Russian)]
  19. Мартынов Б. В., Парфенов В. Е., Труфанов Г. Е., Фокин В. А., Цибиров А. А., Холявин А. И. и др. Прогностические факторы у больных с глиомами: симптомно-синдромальный анализ. Вестн. Российской военно-медицинской академии. 2010; 1(29): 7–14. [Martynov B. V., Parfenov V. E., Trufanov G. E., Fokin V. A., Tsibirov A. A., Kholyavin A. I. i dr. Prognosticheskie faktory u bol'nykh s gliomami: simptomno-sindromal'nyi analiz. Vestn. Rossiiskoi voenno-meditsinskoi akademii. 2010; 1(29): 7–14. (in Russian)]
  20. Roldan-Valadez E., Rios C., Motola-Kuba D., Matus-Santos J., Villa A. R., Moreno-Jimenez S. Choline-to-N-acetylaspartateandlipids-lactate-to-creatine ratios together with age assemble a significant Cox´s proportional-hazards regression model for prediction of survival in high-grade gliomas. Br. J. Radiol. 2016; 89(1067): 1–9.
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