Detection of metabolic heterogeneity of human intracranial tumors in vivo by 1H NMR spectroscopic imaging.

Patients with intracranial tumors (gliomas) were examined by means of localized water-suppressed 1H NMR single volume spectroscopy and spectroscopic imaging. The 1H NMR spectra of the tumors exhibit signal intensities of the N-acetyl aspartate, choline compounds, and creatine plus phosphocreatine resonance lines that are different from the corresponding intensities observed on normal brain tissue. Also, for 6 out of the 10 patients examined so far, lactate resonance lines were detected in the tumor spectra. For one patient, abnormal 1H NMR spectra were obtained of a hemisphere which appeared normal with 1H NMR imaging. Metabolic heterogeneity of the tumorous regions could be demonstrated with 1H NMR spectroscopic imaging, using a spatial resolution in the order of 1 cm. These results suggest a spectrum of metabolic observations that may ultimately provide an important means for characterizing brain tumors.

1H image-guided localized 31P MR spectroscopy of human brain: quantitative analysis of 31P MR spectra measured on volunteers and on intracranial tumor patients.

1H image-guided 31P MR spectra of normal human brain and of intracranial tumors have been analyzed quantitatively. Tumor types examined include prolactinoma, lymphoma, and various grade gliomas. The experimental signals were processed by means of a time-domain least-square fitting procedure, which yields the spectral parameters, as well as a prediction of the standard deviations. Significant spectral variations are observed within both populations of normal brain and of intracranial tumor 31P MR spectra. The metabolic ratios derived from the glioma 31P MR spectra and from corresponding uninfiltrated brain tissue do not differ significantly. Significant differences are, however, observed between the metabolic ratios of prolactinoma and uninfiltrated tissue 31P MR spectra. Alkaline pH values are found for the prolactinoma and the high-grade gliomas. Furthermore, spectral differences are observed between the patient's uninfiltrated tissue 31P MR spectra and those of an unmatched population of volunteers. This underscores the necessity for control measurements on the uninfiltrated tissue of the patient and for controls from a matched population of healthy individuals.

MR image-guided P-31 MR spectroscopy in the evaluation of brain tumor treatment.

Magnetic resonance (MR) image-guided phosphorus-31 MR spectra have been obtained from in situ brain tumors. The volumes of interest used for spectroscopy were defined from hydrogen-1 MR images. Direct comparisons were possible between normal and abnormal tissue, since P-31 spectra from different parts of the brain could be measured in a single examination. P-31 MR spectra of the tumors often showed abnormally high concentrations of phosphomonoesters and low concentrations of phosphocreatines. The effects of pharmacotherapy and radiation therapy were studied in three patients; in each of these cases changes were observed in the P-31 spectra of the tumor. The correlation between MR imaging and P-31 MR spectroscopy was essential for the interpretations of these results.