We compared the value of changes in proton magnetic resonance spectroscopic imaging (1H-MRSI) with changes in clinical status and/or contrast-enhanced magnetic resonance imaging (MRI) in the monitoring of patients with suspected low-grade glioma (LGG). From June 1, 1999 till May 31, 2002, we included consecutive, neurologically intact adult patients suspected of having an LGG, demonstrating non-enhancing supratentorial lesions without edema or mass effect on MRI, and in whom all treatment (including a diagnostic biopsy) was deferred. Till January 1, 2003, patients were surveyed clinically and radiologically (contrast-enhanced MRI and 1H-MRSI). Patients who showed progression on clinical examination and/or MRI were denoted as progressive disease. Other patients were denoted as stable disease. A decrease in NAA/CHO ratio of ≥20% compared to the baseline value was considered as indicative for progression on 1H-MRSI. We included 14 patients with suspected LGG. Seven patients demonstrated progressive disease during the follow-up period, preceded or accompanied by concomitant 1H-MRSI changes in five patients. Four of these five patients were operated on within the follow-up interval. The histological diagnosis demonstrated high-grade glioma in three and LGG in one patient. In the other two patients with progressive disease, no progression was found on 1H-MRSI. The other seven patients demonstrated stable disease, but four of them showed progression on 1H-MRSI. Our data do not show convincing evidence that 1H-MRSI contributes to adequate monitoring and follow-up of patients with suspected LGG. Future research should preferably include pathological data at the time of 1H-MRSI changes.

Astrocytoma, Clinical, Low-grade glioma, Magnetic resonance spectroscopy, Monitoring
dx.doi.org/10.1007/s00234-005-1435-z, hdl.handle.net/1765/61557
Neuroradiology: a journal devoted to neuroimaging and interventional neuroradiology
Department of Neurology

Reijneveld, J.C, van der Grond, J, Ramos, L.M, Bromberg, J.E.C, & Taphoorn, M.J. (2005). Proton MRS imaging in the follow-up of patients with suspected low-grade gliomas. Neuroradiology: a journal devoted to neuroimaging and interventional neuroradiology, 47(12), 887–891. doi:10.1007/s00234-005-1435-z