The diagnostic challenge of lack of choline level elevation on 1H-MR spectroscopy in grade II-III gliomas

IF 1.5 4区医学 Q4 NEUROSCIENCES

Folia neuropathologica Pub Date : 2024-03-25 DOI:10.5114/fn.2024.136469

Barbara Bobek-Billewicz, Sylwia Heinze, Krzysztof Majchrzak, Patrycja Mazgaj, Anna Hebda

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Abstract

The accurate diagnosis of brain tumour is very important in modern neuro-oncology medicine. Magnetic resonance spectroscopy (MRS) is supposed to be a promising tool for detecting cancerous lesions. However, the interpretation of MRS data is complicated by the fact that not all cancerous lesions exhibit elevated choline (Cho) levels. The main goal of our study was to investigate the lack of Cho_lesion/Cho_ref elevation in the population of grade II-III gliomas.

89 cases of gliomas grade II and III were used for the retrospective analysis – glioma (astrocytoma or oligodendroglioma) grade II (74 out of 89 cases [83%]) and III (15 out of 89 cases [17%]) underwent conventional MRI extended by MRS before treatment. Histopathological diagnosis was obtained either by biopsy or surgical resection. Gliomas were classified to the group of no-choline elevation when the ratio of choline measured within the tumour (Cho_lesion) to choline from NABT (Cho_ref) were equal to or lower than 1. Significant differences were observed between ratios of Cho_lesion/Cr_lesion calculated for no-choline elevation and glial tumour groups as well as in the NAA_lesion/Cr_lesion ratio between the no-choline elevation group and glial tumour group. With consistent data concerning choline level elevation and slightly lower NAA value, the Cho_lesion/NAA_lesion ratio is significantly higher in the WHO II glial tumour group compared to the no-choline elevation cases (p < 0.000).

In the current study the results demonstrated possibility of lack of choline elevation in patients with grade II-III gliomas, so it is important to remember that the lack of elevated choline levels does not exclude neoplastic lesion.

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II-III 级胶质瘤 1H-MR 光谱显示胆碱水平未升高的诊断难题

在现代神经肿瘤医学中，准确诊断脑肿瘤非常重要。磁共振波谱（MRS）被认为是检测癌症病变的有效工具。然而，由于并非所有癌症病变都表现出胆碱（Cho）水平升高，因此 MRS 数据的解读变得复杂。我们研究的主要目的是调查 II-III 级胶质瘤人群中是否存在胆碱/胆红素升高的情况。 89例II级和III级胶质瘤病例被用于回顾性分析--II级胶质瘤（星形细胞瘤或少突胶质细胞瘤）（89例中有74例[83%]）和III级胶质瘤（89例中有15例[17%]）在治疗前通过MRS进行了常规磁共振成像检查。组织病理学诊断通过活检或手术切除获得。当肿瘤内测得的胆碱（Cholesion）与来自 NABT 的胆碱（Choref）之比等于或低于 1 时，胶质瘤被归入无胆碱升高组。在计算无胆碱升高组和胶质瘤组的 Cholesion/Crlesion 之比以及无胆碱升高组和胶质瘤组的 NAAlesion/Crlesion 之比时，观察到了显著差异。由于胆碱水平升高和 NAA 值略低的数据一致，WHO II 级胶质瘤组的胆碱/NAAlesion 比值明显高于无胆碱升高组（p <0.000）。目前的研究结果表明，II-III 级胶质瘤患者可能没有胆碱升高，因此，重要的是要记住，没有胆碱水平升高并不能排除肿瘤病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Folia neuropathologica 医学-病理学

CiteScore

2.50

自引率

5.00%

发文量

审稿时长

>12 weeks

期刊介绍： Folia Neuropathologica is an official journal of the Mossakowski Medical Research Centre Polish Academy of Sciences and the Polish Association of Neuropathologists. The journal publishes original articles and reviews that deal with all aspects of clinical and experimental neuropathology and related fields of neuroscience research. The scope of journal includes surgical and experimental pathomorphology, ultrastructure, immunohistochemistry, biochemistry and molecular biology of the nervous tissue. Papers on surgical neuropathology and neuroimaging are also welcome. The reports in other fields relevant to the understanding of human neuropathology might be considered.