Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis of meningiomas |
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Authors: | Saman Hazany John R Hesselink John F Healy Steven G Imbesi |
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Affiliation: | (1) School of Medicine, University of California, San Diego, CA, USA;(2) Department of Radiology, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8756, USA |
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Abstract: | Introduction Our purpose was to determine the potential of metabolites other than alanine to diagnose intracranial meningiomas on proton
magnetic resonance spectroscopy (MRS).
Methods Using a 1.5-T MR system the lesions were initially identified on FLAIR, and T1- and T2-weighted images. Employing standard
point-resolved spectroscopy (PRESS) for single voxel proton MRS (TR 1500 ms, TE 30 ms, 128 acquisitions, voxel size 2 × 2 × 2 cm,
acquisition time 3.12 min), MR spectra were obtained from 5 patients with meningiomas, from 20 with other intracranial lesions,
and from 4 normal controls. Peak heights of nine resonances, including lipid, lactate, alanine, NAA (N-acetylaspartate), β/γ-Glx (glutamate + glutamine), creatine, choline, myo-inositol, and α-Glx/glutathione, were measured in all spectra. The relative quantity of each metabolite was measured as the
ratio of its peak height to the peak height of creatine.
Results Relative quantities of α-Glx/glutathione, β/γ-Glx, and total Glx/glutathione were significantly elevated in meningiomas compared
to the 20 other intracranial lesions and the normal control brains. Alanine was found in four of five meningiomas, but lactate
partially masked the alanine in three meningiomas. None of the other lesions or control brains showed an alanine peak. The
one meningioma with no alanine and the three others with lactate had elevated Glx.
Conclusion While alanine is a relatively unique marker for meningioma, our results support the hypothesis that the combination of glutamate/creatine
ratios and alanine on proton MRS is more specific and reliable for the diagnosis of meningiomas than alanine alone. |
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Keywords: | Magnetic resonance spectroscopy Brain neoplasm Meningioma |
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