This article was published online on 14 October 2011. Subsequently, it was determined that the fourth author's name was incorrect, and the article was corrected on 5 November 2011.
Comparison of 3 Tesla proton MR spectroscopy, MR perfusion and MR diffusion for distinguishing glioma recurrence from posttreatment effects†
Article first published online: 14 OCT 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Magnetic Resonance Imaging
Volume 35, Issue 1, pages 56–63, January 2012
How to Cite
Fink, J. R., Carr, R. B., Matsusue, E., Iyer, R. S., Rockhill, J. K., Haynor, D. R. and Maravilla, K. R. (2012), Comparison of 3 Tesla proton MR spectroscopy, MR perfusion and MR diffusion for distinguishing glioma recurrence from posttreatment effects. J. Magn. Reson. Imaging, 35: 56–63. doi: 10.1002/jmri.22801
- Issue published online: 15 DEC 2011
- Article first published online: 14 OCT 2011
- Manuscript Accepted: 11 AUG 2011
- Manuscript Received: 8 APR 2011
- AUR GE Radiology Research Academic Fellowship (GERRAF) Award for 2009–2011
- 3 Tesla MRI;
- proton MR spectroscopy;
- perfusion MRI;
- diffusion MRI;
- malignant glioma;
- postradiation injury
To compare 3 Tesla (3T) multi-voxel and single-voxel proton MR spectroscopy (MRS), dynamic susceptibility contrast perfusion MRI (DSC), and diffusion-weighted MRI (DWI) for distinguishing recurrent glioma from postradiation injury.
Materials and Methods:
We reviewed all 3T MRS, DSC and DWI studies performed for suspicion of malignant glioma recurrence between October 2006 and December 2008. Maximum Cho/NAA and Cho/Cr peak-area and peak-height ratios were recorded for both multi-voxel and single-voxel MRS. Maximum cerebral blood volume (CBV) and minimum apparent diffusion coefficient (ADC) were normalized to white matter. Histopathology and clinical-radiologic follow-up served as reference standards. Receiver operating characteristic curves for each parameter were compared.
Forty lesions were classified as glioma recurrence (n = 30) or posttreatment effect (n = 10). Diagnostic performance was similar for CBV ratio (AUC = 0.917, P < 0.001), multi-voxel Cho/Cr peak-area (AUC = 0.913, P = 0.002), and multi-voxel Cho/NAA peak-height (AUC = 0.913, P = 0.002), while ADC ratio (AUC = 0.726, P = 0.035) did not appear to perform as well. Single-voxel MRS parameters did not reliably distinguish tumor recurrence from posttreatment effects.
A 3T DSC and multi-voxel MRS Cho/Cr peak-area and Cho/NAA peak-height appear to outperform DWI for distinguishing glioma recurrence from posttreatment effects. Single-voxel MRS parameters do not appear to distinguish glioma recurrence from posttreatment effects reliably, and therefore should not be used in place of multi-voxel MRS. J. Magn. Reson. Imaging 2012;35:56-63. © 2011 Wiley Periodicals, Inc.