Ravindra Bhimrao Kamble1, Jayakumar Peruvumba N2, Ravishankar Shivashankar3. 1. Head of Department, Department of Radiology, Bangalore, Karnataka, India . 2. Head of Department, Department of Radiology, Muscat, Oman . 3. Consultant Radiologist, Department of Radiology, Baltimore, Maryland .
Abstract
AIM: Intracranial space occupying lesions can be infective or tumour. There are various advanced Magnetic resonance imaging techniques like perfusion, diffusion and proton spectroscopy which can differentiate between them. However, (31) Phosphorus spectroscopy studies the energy status and the metabolism pattern of various tissues and can be used potentially to differentiate between them depending on their Metabolism pattern. Thus, we aimed to study energy status of various intracranial lesions and try to differentiate between them including grades of gliomas. MATERIALS AND METHODS: (31)PMRS was done in 1.5T MRI in 43 patients prior to surgery or through/via stereo-tactic biopsy, of which 25 were men and 18 women with mean age 41.34 y ranging from 7-71 y. Single voxel phosphorus spectroscopy was done from the solid portion of the lesions and data was analysed and post processed. RESULTS: Study includes Lymphoma (n=6), Grade 1 and 2 glioma (n=5), grade 3 glioma (n=9), grade 4 glioma(n=6), metastases (n=5), tuberculoma (n=7) and pyogenic abscesses (n=5). The integral values of PME, Pi, PDE, γ-ATP, α-ATP, β-ATP with reference to the position of PCr were calculated along with various ratios. Integral values of Pi and PDE were significantly increased in metastases but decreased in gliomas grade 1-2 compared to other pathologic conditions. Mean integral values of LEP (low energy phosphates) and total phosphates were significantly decreased in gliomas grades 1 and 2 and increased in metastases when compared with other pathologic conditions. PCr /Pi was increased in glioma grades 1, 2 and 3 but decreased in metastases; the significance was observed only in gliomas grade 3 and metastases. Metabolic ratios of PDE/β ATP and Pi/βATP were decreased in glioma grades 1 and 2 and increased in metastases with statistical significance. CONCLUSION: (31)PMRS may help in differentiating primary from secondary lesions and assess grades of gliomas.
AIM: Intracranial space occupying lesions can be infective or tumour. There are various advanced Magnetic resonance imaging techniques like perfusion, diffusion and proton spectroscopy which can differentiate between them. However, (31) Phosphorus spectroscopy studies the energy status and the metabolism pattern of various tissues and can be used potentially to differentiate between them depending on their Metabolism pattern. Thus, we aimed to study energy status of various intracranial lesions and try to differentiate between them including grades of gliomas. MATERIALS AND METHODS: (31)PMRS was done in 1.5T MRI in 43 patients prior to surgery or through/via stereo-tactic biopsy, of which 25 were men and 18 women with mean age 41.34 y ranging from 7-71 y. Single voxel phosphorus spectroscopy was done from the solid portion of the lesions and data was analysed and post processed. RESULTS: Study includes Lymphoma (n=6), Grade 1 and 2 glioma (n=5), grade 3 glioma (n=9), grade 4 glioma(n=6), metastases (n=5), tuberculoma (n=7) and pyogenic abscesses (n=5). The integral values of PME, Pi, PDE, γ-ATP, α-ATP, β-ATP with reference to the position of PCr were calculated along with various ratios. Integral values of Pi and PDE were significantly increased in metastases but decreased in gliomas grade 1-2 compared to other pathologic conditions. Mean integral values of LEP (low energy phosphates) and total phosphates were significantly decreased in gliomas grades 1 and 2 and increased in metastases when compared with other pathologic conditions. PCr /Pi was increased in glioma grades 1, 2 and 3 but decreased in metastases; the significance was observed only in gliomas grade 3 and metastases. Metabolic ratios of PDE/β ATP and Pi/βATP were decreased in glioma grades 1 and 2 and increased in metastases with statistical significance. CONCLUSION: (31)PMRS may help in differentiating primary from secondary lesions and assess grades of gliomas.
Entities:
Keywords:
Brain; Mass lesions; Phosphorus spectroscopy
Authors: Mark J Albers; Mark D Krieger; Ignacio Gonzalez-Gomez; Floyd H Gilles; J Gordon McComb; Marvin D Nelson; Stefan Blüml Journal: Magn Reson Med Date: 2005-01 Impact factor: 4.668
Authors: Kirstie S Opstad; Mary M Murphy; Peter R Wilkins; B Anthony Bell; John R Griffiths; Franklyn A Howe Journal: J Magn Reson Imaging Date: 2004-08 Impact factor: 4.813
Authors: Sung Ki Cho; Dong Gyu Na; Jae Wook Ryoo; Hong Gee Roh; Chan Hong Moon; Hong Sik Byun; Jong Hyun Kim Journal: Korean J Radiol Date: 2002 Jul-Sep Impact factor: 3.500
Authors: Daniel Pinggera; Ruth Steiger; Marlies Bauer; Johannes Kerschbaumer; Markus Luger; Ronny Beer; Andreas Rietzler; Astrid E Grams; Elke R Gizewski; Claudius Thomé; Ondra Petr Journal: Neurocrit Care Date: 2021-04 Impact factor: 3.210
Authors: Malik Galijasevic; Ruth Steiger; Stephanie Mangesius; Julian Mangesius; Johannes Kerschbaumer; Christian Franz Freyschlag; Nadja Gruber; Tanja Janjic; Elke Ruth Gizewski; Astrid Ellen Grams Journal: Cancers (Basel) Date: 2022-06-29 Impact factor: 6.575
Authors: Astrid Ellen Grams; Stephanie Mangesius; Ruth Steiger; Ivan Radovic; Andreas Rietzler; Lisa Maria Walchhofer; Malik Galijašević; Julian Mangesius; Martha Nowosielski; Christian Franz Freyschlag; Johannes Kerschbaumer; Elke Ruth Gizewski Journal: Curr Oncol Date: 2021-12-01 Impact factor: 3.677