Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens

C. Dowling, A. W. Bollen, S. M. Noworolski, M. W. McDermott, N. M. Barbaro, M. R. Day, R. G. Henry, S. M. Chang, W. P. Dillon, S. J. Nelson, D. B. Vigneron

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Abstract

BACKGROUND AND PURPOSE: Tumor progression is often difficult to distinguish from nonneoplastic treatment response on the basis of MR images alone. This study correlates metabolite levels measured by preoperative MR spectroscopic (MRS) imaging with histologic findings of biopsies, obtained during image-guided resections of brain mass lesions, to clarify the potential role of MRS in making this distinction. METHODS: Twenty-nine patients with brain tumors underwent high-resolution (0.2-1 cc) 3D proton MRS imaging and MR imaging before undergoing surgery; 11 had a newly diagnosed neoplasm, and 18 had recurrent disease. Surgical biopsies were obtained from locations referenced on MR images by guidance with a surgical navigation system. MR spectral voxels were retrospectively centered on each of 79 biopsy locations, and metabolite levels were correlated with histologic examination of each specimen. RESULTS: All mass lesions studied, whether attributable to tumor or noncancerous effects of previous therapy, showed abnormal MR spectra compared with normal parenchyma. When the pattern of MRS metabolites consisted of abnormally increased choline and decreased N-acetyl aspartate (NAA) resonances, histologic findings of the biopsy specimen invariably was positive for tumor. When choline and NAA resonances were below the normal range, histologic findings were variable, ranging from radiation necrosis, astrogliosis, and macrophage infiltration to mixed tissues that contained some low-, intermediate-, and high-grade tumor. CONCLUSION: This study demonstrated that 3D MRS imaging can identify regions of viable cancer, which may be valuable for guiding surgical biopsies and focal therapy. Regions manifesting abnormal MR spectra had a mixture of histologic findings, including astrogliosis, necrosis, and neoplasm.

Original languageEnglish (US)
Pages (from-to)604-612
Number of pages9
JournalAmerican Journal of Neuroradiology
Volume22
Issue number4
StatePublished - Apr 28 2001

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Brain Neoplasms
Protons
Biopsy
Neoplasms
Choline
Necrosis
Reference Values
Therapeutics
Macrophages
Radiation
Brain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Dowling, C., Bollen, A. W., Noworolski, S. M., McDermott, M. W., Barbaro, N. M., Day, M. R., ... Vigneron, D. B. (2001). Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. American Journal of Neuroradiology, 22(4), 604-612.

Preoperative proton MR spectroscopic imaging of brain tumors : Correlation with histopathologic analysis of resection specimens. / Dowling, C.; Bollen, A. W.; Noworolski, S. M.; McDermott, M. W.; Barbaro, N. M.; Day, M. R.; Henry, R. G.; Chang, S. M.; Dillon, W. P.; Nelson, S. J.; Vigneron, D. B.

In: American Journal of Neuroradiology, Vol. 22, No. 4, 28.04.2001, p. 604-612.

Research output: Contribution to journalArticle

Dowling, C, Bollen, AW, Noworolski, SM, McDermott, MW, Barbaro, NM, Day, MR, Henry, RG, Chang, SM, Dillon, WP, Nelson, SJ & Vigneron, DB 2001, 'Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens', American Journal of Neuroradiology, vol. 22, no. 4, pp. 604-612.
Dowling C, Bollen AW, Noworolski SM, McDermott MW, Barbaro NM, Day MR et al. Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. American Journal of Neuroradiology. 2001 Apr 28;22(4):604-612.
Dowling, C. ; Bollen, A. W. ; Noworolski, S. M. ; McDermott, M. W. ; Barbaro, N. M. ; Day, M. R. ; Henry, R. G. ; Chang, S. M. ; Dillon, W. P. ; Nelson, S. J. ; Vigneron, D. B. / Preoperative proton MR spectroscopic imaging of brain tumors : Correlation with histopathologic analysis of resection specimens. In: American Journal of Neuroradiology. 2001 ; Vol. 22, No. 4. pp. 604-612.
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AU - Bollen, A. W.

AU - Noworolski, S. M.

AU - McDermott, M. W.

AU - Barbaro, N. M.

AU - Day, M. R.

AU - Henry, R. G.

AU - Chang, S. M.

AU - Dillon, W. P.

AU - Nelson, S. J.

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