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Published in: European Radiology 12/2008

01-12-2008 | Magnetic Resonance

New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma

Authors: Qiang Yue, Tomonori Isobe, Yasushi Shibata, Izumi Anno, Hiraku Kawamura, Youhei Yamamoto, Shingo Takano, Akira Matsumura

Published in: European Radiology | Issue 12/2008

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Abstract

This study was aimed to clarify some ambiguities in the interpretation of proton magnetic resonance spectroscopy (1H-MRS) of meningiomas. The cases of 31 meningioma patients (27 benign and 4 nonbenign meningiomas) that underwent single-voxel 1H-MRS (PRESS sequence, TR/TE = 2,000 ms/68, 136, 272 ms) were retrospectively analyzed. To verify the findings of in-vivo study, phantoms were measured, and pathological sections of 11 patients were reviewed. All meningiomas demonstrated increased choline and decreased creatine, except for a lipomatous meningioma that only displayed a prominent lipid (Lip) peak. Alanine (Ala) and lactate (Lac) coexisted in eight cases, indicating an alternative pathway of energy metabolism in meningiomas. They partially overlapped with each other and demonstrated a triplet-like spectral pattern, which was consistent with phantom study. Glutamine/glutamate (Glx) was helpful for the recognition of meningioma when Ala was absent. N-acetyl compounds(NACs) were observed in nine cases whose voxels were completely limited within the tumors, indicating that meningiomas might have endogenous NACs. Lac was indicative of an aggressive meningioma, although not always a nonbenign one. Lip not only represented micronecrosis in nonbenign meningiomas, but also reflected microcystic changes or fatty degeneration in benign meningiomas. 1H-MRS reflects some distinctive biochemical and pathological changes of meningiomas that might be misinterpreted.
Literature
1.
go back to reference Claus EB, Bondy ML, Schildkraut JM et al (2005) Epidemiology of intracranial meningioma. Neurosurgery 57:1088–1095PubMedCrossRef Claus EB, Bondy ML, Schildkraut JM et al (2005) Epidemiology of intracranial meningioma. Neurosurgery 57:1088–1095PubMedCrossRef
2.
go back to reference Demir MK, Iplikcioglu AC, Dincer A et al (2006) Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol 60:48–55PubMedCrossRef Demir MK, Iplikcioglu AC, Dincer A et al (2006) Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol 60:48–55PubMedCrossRef
3.
go back to reference Cho YD, Choi GH, Lee SP et al (2003) (1)H-MRS metabolic patterns for distinguishing between meningiomas and other brain tumors. Magn Reson Imaging 21:663–672PubMedCrossRef Cho YD, Choi GH, Lee SP et al (2003) (1)H-MRS metabolic patterns for distinguishing between meningiomas and other brain tumors. Magn Reson Imaging 21:663–672PubMedCrossRef
4.
go back to reference Shino A, Nakasu S, Matsuda M et al (1999) Noninvasive evaluation of the malignant potential of intracranial meningiomas performed using proton magnetic resonance spectroscopy. J Neurosurg 91:928–934PubMed Shino A, Nakasu S, Matsuda M et al (1999) Noninvasive evaluation of the malignant potential of intracranial meningiomas performed using proton magnetic resonance spectroscopy. J Neurosurg 91:928–934PubMed
5.
go back to reference Buhl R, Nabavi A, Wolff S et al (2007) MR spectroscopy in patients with intracranial meningiomas. Neurol Res 29:43–46PubMedCrossRef Buhl R, Nabavi A, Wolff S et al (2007) MR spectroscopy in patients with intracranial meningiomas. Neurol Res 29:43–46PubMedCrossRef
6.
go back to reference Majós C, Alonso J, Aguilera C et al (2003) Utility of proton MR spectroscopy in the diagnosis of radiologically atypical intracranial meningiomas. Neuroradiology 45:129–136PubMed Majós C, Alonso J, Aguilera C et al (2003) Utility of proton MR spectroscopy in the diagnosis of radiologically atypical intracranial meningiomas. Neuroradiology 45:129–136PubMed
7.
go back to reference Kinoshita Y, Yokota A (1997) Absolute concentrations of metabolites in human brain tumors using in vitro proton magnetic resonance spectroscopy. NMR Biomed 10:2–12PubMedCrossRef Kinoshita Y, Yokota A (1997) Absolute concentrations of metabolites in human brain tumors using in vitro proton magnetic resonance spectroscopy. NMR Biomed 10:2–12PubMedCrossRef
8.
go back to reference Lehnhardt FG, Rohn G, Ernestus RI et al (2001) 1H- and (31)P-MR spectroscopy of primary and recurrent human brain tumors in vitro: malignancy-characteristic profiles of water soluble and lipophilic spectral components. NMR Biomed 14:307–317PubMedCrossRef Lehnhardt FG, Rohn G, Ernestus RI et al (2001) 1H- and (31)P-MR spectroscopy of primary and recurrent human brain tumors in vitro: malignancy-characteristic profiles of water soluble and lipophilic spectral components. NMR Biomed 14:307–317PubMedCrossRef
9.
go back to reference Howe FA, Barton SJ, Cudlip SA et al (2003) Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy. Magn Reson Med 49:223–232PubMedCrossRef Howe FA, Barton SJ, Cudlip SA et al (2003) Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy. Magn Reson Med 49:223–232PubMedCrossRef
10.
go back to reference Castillo M, Kwock L, Mukherji SK (1996) Clinical applications of proton MR spectroscopy. AJNR Am J Neuroradiol 17:1–15PubMed Castillo M, Kwock L, Mukherji SK (1996) Clinical applications of proton MR spectroscopy. AJNR Am J Neuroradiol 17:1–15PubMed
11.
go back to reference Negendank WG, Sauter R, Brown TR et al (1996) Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study. J Neurosurg 84:449–458PubMed Negendank WG, Sauter R, Brown TR et al (1996) Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study. J Neurosurg 84:449–458PubMed
12.
go back to reference Lehnhardt FG, Bock C, Rohn G et al (2005) Metabolic differences between primary and recurrent human brain tumors: a 1H NMR spectroscopic investigation. NMR Biomed 18:371–382PubMedCrossRef Lehnhardt FG, Bock C, Rohn G et al (2005) Metabolic differences between primary and recurrent human brain tumors: a 1H NMR spectroscopic investigation. NMR Biomed 18:371–382PubMedCrossRef
13.
go back to reference Ryner LN, Sorenson JA, Thomas MA (1995) Localized 2D J-resolved 1H MR spectroscopy: strong coupling effects in vitro and in vivo. Magn Reson Imaging 13:853–869PubMedCrossRef Ryner LN, Sorenson JA, Thomas MA (1995) Localized 2D J-resolved 1H MR spectroscopy: strong coupling effects in vitro and in vivo. Magn Reson Imaging 13:853–869PubMedCrossRef
14.
go back to reference Alvarez F, Roda JM, Perez Romero M et al (1987) Malignant and atypical meningiomas: a reappraisal of clinical, histological, and computed tomographic features. Neurosurgery 20:688–694PubMedCrossRef Alvarez F, Roda JM, Perez Romero M et al (1987) Malignant and atypical meningiomas: a reappraisal of clinical, histological, and computed tomographic features. Neurosurgery 20:688–694PubMedCrossRef
15.
go back to reference New PF, Hesselink JR, O’Carroll CP et al (1982) Malignant meningiomas: CT and histologic criteria, including a new CT sign. AJNR Am J Neuroradiol 3:267–276PubMed New PF, Hesselink JR, O’Carroll CP et al (1982) Malignant meningiomas: CT and histologic criteria, including a new CT sign. AJNR Am J Neuroradiol 3:267–276PubMed
16.
go back to reference Falini A, Calabrese G, Origgi D et al (1996) Proton magnetic resonance spectroscopy and intracranial tumours: clinical perspectives. J Neurol 243:706–714PubMedCrossRef Falini A, Calabrese G, Origgi D et al (1996) Proton magnetic resonance spectroscopy and intracranial tumours: clinical perspectives. J Neurol 243:706–714PubMedCrossRef
17.
go back to reference Hazany S, Hesselink JR, Healy JF et al (2007) Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis of meningiomas. Neuroradiology 49:121–127PubMedCrossRef Hazany S, Hesselink JR, Healy JF et al (2007) Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis of meningiomas. Neuroradiology 49:121–127PubMedCrossRef
18.
go back to reference Manton DJ, Lowry M, Blackband SJ et al (1994) Quantitative proton MRS of brain tumors reveals increased cholineT2 in meningiomas. MAGMA 2:361–363CrossRef Manton DJ, Lowry M, Blackband SJ et al (1994) Quantitative proton MRS of brain tumors reveals increased cholineT2 in meningiomas. MAGMA 2:361–363CrossRef
19.
go back to reference Harting I, Jost G, Hacke N et al (2005) Magnetic resonance spectroscopy of brain tumours. Nervenarzt 76:403–417PubMedCrossRef Harting I, Jost G, Hacke N et al (2005) Magnetic resonance spectroscopy of brain tumours. Nervenarzt 76:403–417PubMedCrossRef
20.
go back to reference Poptani H, Gupta RK, Jain VK et al (1995) Cystic intracranial mass lesions: possible role of in vivo MR spectroscopy in its differential diagnosis. Magn Reson Imaging 13:1019–1029PubMedCrossRef Poptani H, Gupta RK, Jain VK et al (1995) Cystic intracranial mass lesions: possible role of in vivo MR spectroscopy in its differential diagnosis. Magn Reson Imaging 13:1019–1029PubMedCrossRef
21.
go back to reference Akutsu H, Matsumura A, Isobe T et al (2002) Chronological change of brain abscess in (1)H magnetic resonance spectroscopy. Neuroradiology 44:574–578PubMedCrossRef Akutsu H, Matsumura A, Isobe T et al (2002) Chronological change of brain abscess in (1)H magnetic resonance spectroscopy. Neuroradiology 44:574–578PubMedCrossRef
22.
go back to reference Christiansen P, Henriksen O, Stubgaard M et al (1993) In vivo quantification of brain metabolites by 1H-MRS using water as an internal standard. Magn Reson Imaging 11:107–118PubMedCrossRef Christiansen P, Henriksen O, Stubgaard M et al (1993) In vivo quantification of brain metabolites by 1H-MRS using water as an internal standard. Magn Reson Imaging 11:107–118PubMedCrossRef
23.
go back to reference Majós C, Alonso J, Aguilera C et al (2003) Proton magnetic resonance spectroscopy ((1)H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization. Eur Radiol 13:582–591PubMed Majós C, Alonso J, Aguilera C et al (2003) Proton magnetic resonance spectroscopy ((1)H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization. Eur Radiol 13:582–591PubMed
24.
go back to reference Miller BL (1991) A review of chemical issues in 1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed 4:47–52PubMedCrossRef Miller BL (1991) A review of chemical issues in 1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed 4:47–52PubMedCrossRef
25.
go back to reference Bruhn H, Frahm J, Gyngell ML et al (1989) Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology 172:541–548PubMed Bruhn H, Frahm J, Gyngell ML et al (1989) Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology 172:541–548PubMed
26.
go back to reference Barba I, Moreno A, Martinez-Perez I et al (2001) Magnetic resonance spectroscopy of brain hemangiopericytomas: high myoinositol concentrations and discrimination from meningiomas. J Neurosurg 94:55–60PubMedCrossRef Barba I, Moreno A, Martinez-Perez I et al (2001) Magnetic resonance spectroscopy of brain hemangiopericytomas: high myoinositol concentrations and discrimination from meningiomas. J Neurosurg 94:55–60PubMedCrossRef
27.
go back to reference Kinoshita Y, Kajiwara H, Yokota A et al (1994) Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35:606–613PubMedCrossRef Kinoshita Y, Kajiwara H, Yokota A et al (1994) Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35:606–613PubMedCrossRef
28.
go back to reference Kugel H, Heindel W, Ernestus RI et al (1992) Human brain tumors: spectral patterns detected with localized H-1 MR spectroscopy. Radiology 183:701–709PubMed Kugel H, Heindel W, Ernestus RI et al (1992) Human brain tumors: spectral patterns detected with localized H-1 MR spectroscopy. Radiology 183:701–709PubMed
29.
go back to reference Holowenko D, Peeling J, Sutherland G (1992) 1H NMR properties of N-acetylaspartylglutamate in extracts of nervous tissue of the rat. NMR Biomed 5:43–47PubMedCrossRef Holowenko D, Peeling J, Sutherland G (1992) 1H NMR properties of N-acetylaspartylglutamate in extracts of nervous tissue of the rat. NMR Biomed 5:43–47PubMedCrossRef
30.
go back to reference Gadian DG, Bates TE, Williams SR et al (1991) Approaches to editing, assignment and interpretation of proton spectra. NMR Biomed 4:85–89PubMedCrossRef Gadian DG, Bates TE, Williams SR et al (1991) Approaches to editing, assignment and interpretation of proton spectra. NMR Biomed 4:85–89PubMedCrossRef
31.
go back to reference Usenius JP, Kauppinen RA, Vainio PA et al (1994) Quantitative metabolite patterns of human brain tumors: detection by 1H NMR spectroscopy in vivo and in vitro. J Comput Assist Tomogr 18:705–713PubMedCrossRef Usenius JP, Kauppinen RA, Vainio PA et al (1994) Quantitative metabolite patterns of human brain tumors: detection by 1H NMR spectroscopy in vivo and in vitro. J Comput Assist Tomogr 18:705–713PubMedCrossRef
32.
go back to reference Ott D, Hennig J, Ernst T (1993) Human brain tumors: assessment with in vivo proton MR spectroscopy. Radiology 186:745–752PubMed Ott D, Hennig J, Ernst T (1993) Human brain tumors: assessment with in vivo proton MR spectroscopy. Radiology 186:745–752PubMed
33.
go back to reference Opstad KS, Provencher SW, Bell BA et al (2003) Detection of elevated glutathione in meningiomas by quantitative in vivo 1H MRS. Magn Reson Med 49:632–637PubMedCrossRef Opstad KS, Provencher SW, Bell BA et al (2003) Detection of elevated glutathione in meningiomas by quantitative in vivo 1H MRS. Magn Reson Med 49:632–637PubMedCrossRef
34.
go back to reference Roda JM, Pascual JM, Carceller F et al (2000) Nonhistological diagnosis of human cerebral tumors by 1H magnetic resonance spectroscopy and amino acid analysis. Clin Cancer Res 6:3983–3993PubMed Roda JM, Pascual JM, Carceller F et al (2000) Nonhistological diagnosis of human cerebral tumors by 1H magnetic resonance spectroscopy and amino acid analysis. Clin Cancer Res 6:3983–3993PubMed
35.
go back to reference Cheng LL, Ma MJ, Becerra L et al (1997) Quantitative neuropathology by high resolution magic angle spinning proton magnetic resonance spectroscopy. Proc Natl Acad Sci USA 94:6408–6413PubMedCrossRef Cheng LL, Ma MJ, Becerra L et al (1997) Quantitative neuropathology by high resolution magic angle spinning proton magnetic resonance spectroscopy. Proc Natl Acad Sci USA 94:6408–6413PubMedCrossRef
36.
go back to reference Pfisterer WK, Hendricks WP, Scheck AC et al (2007) Fluorescent in situ hybridization and ex vivo 1H magnetic resonance spectroscopic examinations of meningioma tumor tissue: is it possible to identify a clinically-aggressive subset of benign meningiomas? Neurosurgery 61:1048–1059PubMed Pfisterer WK, Hendricks WP, Scheck AC et al (2007) Fluorescent in situ hybridization and ex vivo 1H magnetic resonance spectroscopic examinations of meningioma tumor tissue: is it possible to identify a clinically-aggressive subset of benign meningiomas? Neurosurgery 61:1048–1059PubMed
37.
go back to reference Cerda-Nicolas M, Lopez-Gines C, Perez-Bacete M et al (2000) Histopathological and cytogenetic findings in benign, atypical and anaplastic human meningiomas: a study of 60 tumors. J Neurooncol 47:99–108PubMedCrossRef Cerda-Nicolas M, Lopez-Gines C, Perez-Bacete M et al (2000) Histopathological and cytogenetic findings in benign, atypical and anaplastic human meningiomas: a study of 60 tumors. J Neurooncol 47:99–108PubMedCrossRef
38.
go back to reference Schober R, Himuro H, Wechsler W (1988) Cystic changes and vascular permeability in meningiomas. Clin Neuropathol 7:16–21PubMed Schober R, Himuro H, Wechsler W (1988) Cystic changes and vascular permeability in meningiomas. Clin Neuropathol 7:16–21PubMed
39.
go back to reference Roncaroli F, Scheithauer BW, Laeng RH et al (2001) Lipomatous meningioma: a clinicopathologic study of 18 cases with special reference to the issue of metaplasia. Am J Surg Pathol 25:769–775PubMedCrossRef Roncaroli F, Scheithauer BW, Laeng RH et al (2001) Lipomatous meningioma: a clinicopathologic study of 18 cases with special reference to the issue of metaplasia. Am J Surg Pathol 25:769–775PubMedCrossRef
Metadata
Title
New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma
Authors
Qiang Yue
Tomonori Isobe
Yasushi Shibata
Izumi Anno
Hiraku Kawamura
Youhei Yamamoto
Shingo Takano
Akira Matsumura
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
European Radiology / Issue 12/2008
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-1079-6

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