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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. Bothmore » 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.« less

Authors:
 [1];  [2];  [1];  [1];  [3];  [3];  [1]
  1. Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland (United States)
  2. Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)
  3. (United States)
Publication Date:
OSTI Identifier:
22149593
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHILDREN; CHOLINE; CREATINE; EVALUATION; GLIOMAS; MAGNETIC RESONANCE; METABOLISM; METABOLITES; MONITORING; NEUTRON ACTIVATION ANALYSIS; NMR IMAGING; PATIENTS; PEDIATRICS; PROTONS; RADIOTHERAPY

Citation Formats

Steffen-Smith, Emilie A., Venzon, David J., Bent, Robyn S., Hipp, Sean J., Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and Warren, Katherine E., E-mail: warrenk@mail.nih.gov. Single- and Multivoxel Proton Spectroscopy in Pediatric Patients With Diffuse Intrinsic Pontine Glioma. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.01.032.
Steffen-Smith, Emilie A., Venzon, David J., Bent, Robyn S., Hipp, Sean J., Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, & Warren, Katherine E., E-mail: warrenk@mail.nih.gov. Single- and Multivoxel Proton Spectroscopy in Pediatric Patients With Diffuse Intrinsic Pontine Glioma. United States. doi:10.1016/J.IJROBP.2012.01.032.
Steffen-Smith, Emilie A., Venzon, David J., Bent, Robyn S., Hipp, Sean J., Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and Warren, Katherine E., E-mail: warrenk@mail.nih.gov. Thu . "Single- and Multivoxel Proton Spectroscopy in Pediatric Patients With Diffuse Intrinsic Pontine Glioma". United States. doi:10.1016/J.IJROBP.2012.01.032.
@article{osti_22149593,
title = {Single- and Multivoxel Proton Spectroscopy in Pediatric Patients With Diffuse Intrinsic Pontine Glioma},
author = {Steffen-Smith, Emilie A. and Venzon, David J. and Bent, Robyn S. and Hipp, Sean J. and Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland and Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland and Warren, Katherine E., E-mail: warrenk@mail.nih.gov},
abstractNote = {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.},
doi = {10.1016/J.IJROBP.2012.01.032},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}