Proton magnetic resonance spectroscopy predicts proliferative activity in diffuse low-grade gliomas

被引:54
作者
Guillevin, Remy [1 ,4 ,7 ]
Menuel, Carole [1 ]
Duffau, Hugues [2 ,4 ,7 ]
Kujas, Michel [3 ]
Capelle, Laurent [4 ,7 ]
Aubert, Agnes
Taillibert, Sophie [5 ]
Idbaih, Ahmed [5 ]
Pallud, Joan
Demarco, Giovanni [6 ]
Costalat, Robert
Hoang-Xuan, Khe [5 ]
Chiras, Jacques [1 ]
Vallee, Jean-Noel [6 ]
机构
[1] Hop La Pitie Salpetriere, Dept Neuroradiol, F-75651 Paris, France
[2] CHU Gui Chauliac, Dept Neurosurg, Montpellier, France
[3] Hop La Pitie Salpetriere, Dept Pathol, F-75651 Paris, France
[4] Hop La Pitie Salpetriere, Dept Neurosurg, F-75651 Paris, France
[5] Hop La Pitie Salpetriere, Dept Neurooncol, F-75651 Paris, France
[6] Amiens Hosp, Dept Neuroradiol, Amiens, France
[7] Univ Paris 06, INSERM, U678, Lab Imagerie Fonctionnelle, Paris, France
关键词
magnetic resonance spectroscopy; KI-67 labeling index; low-grade glioma;
D O I
10.1007/s11060-007-9508-y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The aim of the study was to investigate the ability of (HMRS)-H-1 to reflect proliferative activity of diffuse low-grade gliomas (WHO grade II). Between November 2002 and March 2007, a prospective study was performed on consecutive patients with suspected supratentorial hemispheric diffuse low-grade tumors. All the patients underwent MR examination using uniform procedures, and then surgical resection or biopsy within 2 weeks of the MR examination. Proliferative activity of the tumors was assessed by Ki-67 immunochemistry (Mb-1) on paraffin embedded tumor sections. Spectroscopic data was compared with Ki-67 labeling index and other histologic data such as histological subtype, cellular atypia, cellular density using univariate and multivariate analysis. 82 of 97 consecutive patients had histologically confirmed WHO grade 2 gliomas. Ki-67 proliferation index (PI) was correlated with specific spectral patterns: (1) low PI (< 4%) was associated with increased Cho/Cr and absence of both free lipids or lactates; (2) intermediate PI (4-8%) was associated with resonance of lactates; and (3) high PI (> 8%) was characterized by a resonance of free lipids. On multivariate analysis, resonance of lactates and resonance of free lipids appeared as independent predictors of intermediate PI (P < 0.001) and high PI (P < 0.001), respectively; moreover, free lipids resonance was correlated with cellular atypia (P < 0.05). This study suggests that (HMRS)-H-1 is a reliable tool to evaluate the proliferation activity of WHO grade 2 glioma and to identify potentially more aggressive clinical behavior.
引用
收藏
页码:181 / 187
页数:7
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