A J Martin1, H Liu, W A Hall, C L Truwit. 1. Department of Radiology, University of Minnesota School of Medicine, 420 Delaware St. SE, Minneapolis, MN, USA.
Abstract
BACKGROUND AND PURPOSE: Brain biopsy remains an integral and necessary component in the diagnosis of brain lesions. We assessed the ability of turbo spectroscopic imaging (TSI) to provide a physiologically based target for tissue sampling. METHODS: TSI was performed in 26 anesthetized patients immediately before MR-guided brain biopsy. In 10 patients, single-voxel spectroscopy was performed on the TSI-indicated target and correlated with the TSI findings. Biopsy samples were taken from the imaging and spectroscopically defined target(s) under MR guidance, and pathologic findings were compared with preoperative spectra. RESULTS: TSI alone provided a definitive target based on a region of elevated choline in 17 of 21 patients in whom a neoplasm was confirmed. The remaining four neoplasms exhibited relatively low metabolic levels and were difficult to distinguish from the five cases of radiation necrosis seen in this study. TSI findings were in qualitative agreement with those obtained at single-voxel spectroscopy, although TSI spectra exhibited more contamination. Quantitative spectral analysis of TSI data is limited by low spectral resolution. CONCLUSION: TSI is helpful for determining an appropriate biopsy target in heterogeneous lesions. Coupling TSI targeting with conventional imaging and intraoperative confirmation of needle positioning resulted in a 100% diagnostic success rate and increased the clinician's confidence in the histologic findings.
BACKGROUND AND PURPOSE: Brain biopsy remains an integral and necessary component in the diagnosis of brain lesions. We assessed the ability of turbo spectroscopic imaging (TSI) to provide a physiologically based target for tissue sampling. METHODS: TSI was performed in 26 anesthetized patients immediately before MR-guided brain biopsy. In 10 patients, single-voxel spectroscopy was performed on the TSI-indicated target and correlated with the TSI findings. Biopsy samples were taken from the imaging and spectroscopically defined target(s) under MR guidance, and pathologic findings were compared with preoperative spectra. RESULTS: TSI alone provided a definitive target based on a region of elevated choline in 17 of 21 patients in whom a neoplasm was confirmed. The remaining four neoplasms exhibited relatively low metabolic levels and were difficult to distinguish from the five cases of radiation necrosis seen in this study. TSI findings were in qualitative agreement with those obtained at single-voxel spectroscopy, although TSI spectra exhibited more contamination. Quantitative spectral analysis of TSI data is limited by low spectral resolution. CONCLUSION: TSI is helpful for determining an appropriate biopsy target in heterogeneous lesions. Coupling TSI targeting with conventional imaging and intraoperative confirmation of needle positioning resulted in a 100% diagnostic success rate and increased the clinician's confidence in the histologic findings.
Authors: S G Silverman; B D Collick; M R Figueira; R Khorasani; D F Adams; R W Newman; G P Topulos; F A Jolesz Journal: Radiology Date: 1995-10 Impact factor: 11.105
Authors: P R Luyten; A J Marien; W Heindel; P H van Gerwen; K Herholz; J A den Hollander; G Friedmann; W D Heiss Journal: Radiology Date: 1990-09 Impact factor: 11.105
Authors: C R Maurer; D L Hill; A J Martin; H Liu; M McCue; D Rueckert; D Lloret; W A Hall; R E Maxwell; D J Hawkes; C L Truwit Journal: IEEE Trans Med Imaging Date: 1998-10 Impact factor: 10.048
Authors: M C Preul; Z Caramanos; D L Collins; J G Villemure; R Leblanc; A Olivier; R Pokrupa; D L Arnold Journal: Nat Med Date: 1996-03 Impact factor: 53.440
Authors: M de Fatima Vasco Aragao; M Law; D Batista de Almeida; G Fatterpekar; B Delman; A S Bader; M Pelaez; M Fowkes; R Vieira de Mello; M Moraes Valenca Journal: AJNR Am J Neuroradiol Date: 2014-04-03 Impact factor: 3.825
Authors: Karen Manias; Simrandip K Gill; Niloufar Zarinabad; Paul Davies; Martin English; Daniel Ford; Lesley MacPherson; Ina Nicklaus-Wollenteit; Adam Oates; Guirish Solanki; Jenny Adamski; Martin Wilson; Andrew C Peet Journal: Neurooncol Pract Date: 2017-05-13