Intraoperative 3-T Magnetic Resonance Spectroscopy for Detection of Proliferative Remnants of Glioma. (16th November 2020)

• Record Type: Journal Article
• Authors: Fujita, Yuichi; Kohta, Masaaki; Sasayama, Takashi; Tanaka, Kazuhiro; Hashiguchi, Mitsuru; Nagashima, Hiroaki; Kyotani, Katsusuke; Nakai, Tomoaki; Ito, Tomoo; Kohmura, Eiji
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_913
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Few studies have examined the usefulness of intraoperative magnetic resonance spectroscopy (iMRS) for identifying abnormal signals at the resection margin during glioma surgery. METHODS: Fifteen patients with newly diagnosed glioma underwent single-voxel 3-T iMRS concurrently with intraoperative MRI-assisted surgery. Volumes of interest (VOIs) were placed at T2-hyperintense or contrast-enhancing lesions at the resection margin. In addition to technical verification, the correlation between the MIB-1 labeling index (a pathological feature) and metabolites measured by using iMRS (N-acetyl-L-aspartate [NAA], choline [Cho], and the Cho/NAA ratio) was analyzed. RESULTS: iMRS was performed for 20 VOIs in 15 patients. Fourteen (70%) of these VOIs were confirmed to be MIB-1-positive. There was a significant positive correlation between Cho/NAA ratio and MIB-1 index (r = 0.46, P = .04) Cho level ( P = .003) and Cho/NAA ratio ( P = .002) were significantly higher in VOIs that were MIB-1-positive than in those that were MIB-1-negative. Detection of a Cho level >1.074 mM and a Cho/NAA ratio >0.48 using iMRS resulted in high diagnostic accuracy for MIB-1-positive remnants (Cho level, sensitivity 86%, specificity 100%; Cho/NAA ratio, sensitivity 79%, specificity 100%). CONCLUSION: This study provides evidence that 3-T iMRS can detect proliferative remnants of glioma at the resection margin using Cho level and Cho/NAA ratio, suggesting that intraoperative MRI-assisted surgery with iMRS would be practicable in glioma.