Single- and multivoxel proton spectroscopy in pediatric patients with diffuse intrinsic pontine glioma

Emilie A Steffen-Smith; David J Venzon; Robyn S Bent; Sean J Hipp; Katherine E Warren

doi:10.1016/j.ijrobp.2012.01.032

Single- and multivoxel proton spectroscopy in pediatric patients with diffuse intrinsic pontine glioma

Emilie A Steffen-Smith, David J Venzon, Robyn S Bent, Sean J Hipp, Katherine E Warren

Pediatrics

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

PURPOSE: To determine the feasibility of two magnetic resonance spectroscopy (MRS) techniques for treating pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) and to evaluate the relationship of metabolic profiles determined by each technique. Utility of each technique for improving patient management is also discussed.

METHODS AND MATERIALS: Children with DIPG (n = 36) were evaluated using single-voxel spectroscopy (SVS) and magnetic resonance spectroscopic imaging (MRSI) during the same imaging session. Patients were followed longitudinally (n = 150 total studies). Technical feasibility was defined by sufficient water and lipid suppression for detection of metabolites. Correlation of metabolic data obtained by SVS and MRSI was determined using the Spearman rank method. Metabolite ratios, including choline:N-acetyl-aspartate (Cho:NAA) and Cho:creatine (Cho:Cr), were obtained from SVS and MRSI.

RESULTS: SVS and MRSI acquisitions were feasible in >90% of studies. Maximum Cho:NAA and Cho:Cr from MRSI analysis were strongly associated with Cho:NAA and Cho:Cr obtained by SVS (r = 0.67 and 0.76, respectively). MRSI Cho:NAA values were more heterogeneous than Cho:Cr values within the same lesion, and a strong linear relationship between the range and maximum Cho:NAA values was observed.

CONCLUSIONS: SVS and MRSI acquisitions were feasible, with a strong correlation in metabolic data. Both techniques may improve diagnostic evaluation and management of DIPG. SVS is recommended for global assessment of tumor metabolism before and after therapy. MRSI showed heterogeneous patterns of metabolic activity within these tumors and is recommended for planning and monitoring targeted therapies and evaluating nearby tissue for tumor invasion.

Original language	English
Pages (from-to)	774-9
Number of pages	6
Journal	International Journal of Radiation Oncology Biology Physics
Volume	84
Issue number	3
DOIs	https://doi.org/10.1016/j.ijrobp.2012.01.032
State	Published - 1 Nov 2012

Keywords

Adolescent
Aspartic Acid/analogs & derivatives
Brain Stem Neoplasms/diagnosis
Child
Child, Preschool
Choline/metabolism
Creatine/metabolism
Feasibility Studies
Glioma/diagnosis
Humans
Infant
Longitudinal Studies
Magnetic Resonance Spectroscopy/methods
Prospective Studies
Statistics, Nonparametric

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10.1016/j.ijrobp.2012.01.032

Cite this

@article{ac49041c39474e95bace2454e4519a95,

title = "Single- and multivoxel proton spectroscopy in pediatric patients with diffuse intrinsic pontine glioma",

abstract = "PURPOSE: To determine the feasibility of two magnetic resonance spectroscopy (MRS) techniques for treating pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) and to evaluate the relationship of metabolic profiles determined by each technique. Utility of each technique for improving patient management is also discussed.METHODS AND MATERIALS: Children with DIPG (n = 36) were evaluated using single-voxel spectroscopy (SVS) and magnetic resonance spectroscopic imaging (MRSI) during the same imaging session. Patients were followed longitudinally (n = 150 total studies). Technical feasibility was defined by sufficient water and lipid suppression for detection of metabolites. Correlation of metabolic data obtained by SVS and MRSI was determined using the Spearman rank method. Metabolite ratios, including choline:N-acetyl-aspartate (Cho:NAA) and Cho:creatine (Cho:Cr), were obtained from SVS and MRSI.RESULTS: SVS and MRSI acquisitions were feasible in >90% of studies. Maximum Cho:NAA and Cho:Cr from MRSI analysis were strongly associated with Cho:NAA and Cho:Cr obtained by SVS (r = 0.67 and 0.76, respectively). MRSI Cho:NAA values were more heterogeneous than Cho:Cr values within the same lesion, and a strong linear relationship between the range and maximum Cho:NAA values was observed.CONCLUSIONS: SVS and MRSI acquisitions were feasible, with a strong correlation in metabolic data. Both techniques may improve diagnostic evaluation and management of DIPG. SVS is recommended for global assessment of tumor metabolism before and after therapy. MRSI showed heterogeneous patterns of metabolic activity within these tumors and is recommended for planning and monitoring targeted therapies and evaluating nearby tissue for tumor invasion.",

keywords = "Adolescent, Aspartic Acid/analogs & derivatives, Brain Stem Neoplasms/diagnosis, Child, Child, Preschool, Choline/metabolism, Creatine/metabolism, Feasibility Studies, Glioma/diagnosis, Humans, Infant, Longitudinal Studies, Magnetic Resonance Spectroscopy/methods, Prospective Studies, Statistics, Nonparametric",

author = "Steffen-Smith, {Emilie A} and Venzon, {David J} and Bent, {Robyn S} and Hipp, {Sean J} and Warren, {Katherine E}",

note = "Published by Elsevier Inc.",

year = "2012",

month = nov,

day = "1",

doi = "10.1016/j.ijrobp.2012.01.032",

language = "English",

volume = "84",

pages = "774--9",

journal = "International Journal of Radiation Oncology Biology Physics",

issn = "0360-3016",

publisher = "Elsevier Inc.",

number = "3",

}

TY - JOUR

T1 - Single- and multivoxel proton spectroscopy in pediatric patients with diffuse intrinsic pontine glioma

AU - Steffen-Smith, Emilie A

AU - Venzon, David J

AU - Bent, Robyn S

AU - Hipp, Sean J

AU - Warren, Katherine E

N1 - Published by Elsevier Inc.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - PURPOSE: To determine the feasibility of two magnetic resonance spectroscopy (MRS) techniques for treating pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) and to evaluate the relationship of metabolic profiles determined by each technique. Utility of each technique for improving patient management is also discussed.METHODS AND MATERIALS: Children with DIPG (n = 36) were evaluated using single-voxel spectroscopy (SVS) and magnetic resonance spectroscopic imaging (MRSI) during the same imaging session. Patients were followed longitudinally (n = 150 total studies). Technical feasibility was defined by sufficient water and lipid suppression for detection of metabolites. Correlation of metabolic data obtained by SVS and MRSI was determined using the Spearman rank method. Metabolite ratios, including choline:N-acetyl-aspartate (Cho:NAA) and Cho:creatine (Cho:Cr), were obtained from SVS and MRSI.RESULTS: SVS and MRSI acquisitions were feasible in >90% of studies. Maximum Cho:NAA and Cho:Cr from MRSI analysis were strongly associated with Cho:NAA and Cho:Cr obtained by SVS (r = 0.67 and 0.76, respectively). MRSI Cho:NAA values were more heterogeneous than Cho:Cr values within the same lesion, and a strong linear relationship between the range and maximum Cho:NAA values was observed.CONCLUSIONS: SVS and MRSI acquisitions were feasible, with a strong correlation in metabolic data. Both techniques may improve diagnostic evaluation and management of DIPG. SVS is recommended for global assessment of tumor metabolism before and after therapy. MRSI showed heterogeneous patterns of metabolic activity within these tumors and is recommended for planning and monitoring targeted therapies and evaluating nearby tissue for tumor invasion.

AB - PURPOSE: To determine the feasibility of two magnetic resonance spectroscopy (MRS) techniques for treating pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) and to evaluate the relationship of metabolic profiles determined by each technique. Utility of each technique for improving patient management is also discussed.METHODS AND MATERIALS: Children with DIPG (n = 36) were evaluated using single-voxel spectroscopy (SVS) and magnetic resonance spectroscopic imaging (MRSI) during the same imaging session. Patients were followed longitudinally (n = 150 total studies). Technical feasibility was defined by sufficient water and lipid suppression for detection of metabolites. Correlation of metabolic data obtained by SVS and MRSI was determined using the Spearman rank method. Metabolite ratios, including choline:N-acetyl-aspartate (Cho:NAA) and Cho:creatine (Cho:Cr), were obtained from SVS and MRSI.RESULTS: SVS and MRSI acquisitions were feasible in >90% of studies. Maximum Cho:NAA and Cho:Cr from MRSI analysis were strongly associated with Cho:NAA and Cho:Cr obtained by SVS (r = 0.67 and 0.76, respectively). MRSI Cho:NAA values were more heterogeneous than Cho:Cr values within the same lesion, and a strong linear relationship between the range and maximum Cho:NAA values was observed.CONCLUSIONS: SVS and MRSI acquisitions were feasible, with a strong correlation in metabolic data. Both techniques may improve diagnostic evaluation and management of DIPG. SVS is recommended for global assessment of tumor metabolism before and after therapy. MRSI showed heterogeneous patterns of metabolic activity within these tumors and is recommended for planning and monitoring targeted therapies and evaluating nearby tissue for tumor invasion.

KW - Adolescent

KW - Aspartic Acid/analogs & derivatives

KW - Brain Stem Neoplasms/diagnosis

KW - Child

KW - Child, Preschool

KW - Choline/metabolism

KW - Creatine/metabolism

KW - Feasibility Studies

KW - Glioma/diagnosis

KW - Humans

KW - Infant

KW - Longitudinal Studies

KW - Magnetic Resonance Spectroscopy/methods

KW - Prospective Studies

KW - Statistics, Nonparametric

U2 - 10.1016/j.ijrobp.2012.01.032

DO - 10.1016/j.ijrobp.2012.01.032

M3 - Article

C2 - 22445531

SN - 0360-3016

VL - 84

SP - 774

EP - 779

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

IS - 3

ER -