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Clinical protocols for 31P MRS of the brain and their use in evaluating optic pathway gliomas in children

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Novak, Jan, Wilson, Martin P., MacPherson, Lesley, Arvanitis, Theodoros N., Davies, Nigel P. and Peet, Andrew C. (2013) Clinical protocols for 31P MRS of the brain and their use in evaluating optic pathway gliomas in children. European Journal of Radiology, Volume 83 (Number 2). e106-e112. doi:10.1016/j.ejrad.2013.11.009

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Official URL: http://dx.doi.org/10.1016/j.ejrad.2013.11.009

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Abstract

Introduction:
In vivo 31P Magnetic Resonance Spectroscopy (MRS) measures phosphorus-containing metabolites that play an essential role in many disease processes. An advantage over 1H MRS is that total choline can be separated into phosphocholine and glycerophosphocholine which have opposite associations with tumour grade. We demonstrate 31P MRS can provide robust metabolic information on an acceptable timescale to yield information of clinical importance.

Methods:
All MRI examinations were carried out on a 3T whole body scanner with all 31P MRS scans conducted using a dual-tuned 1H/31P head coil. Once optimised on phantoms, the protocol was tested in six healthy volunteers (four male and two female, mean age: 25 ± 2.7). 31P MRS was then implemented on three children with optic pathway gliomas.

Results:
31P MRS on volunteers showed that a number of metabolite ratios varied significantly (p < 0.05 ANOVA) across different structures of the brain, whereas PC/GPC did not. Standard imaging showed the optic pathway gliomas were enhancing on T1-weighted imaging after contrast injection and have high tCho on 1H MRS, both of which are associated with high grade lesions. 31P MRS showed the phosphocholine/glycerophosphocholine ratio to be low (<0.6) which suggests low grade tumours in keeping with their clinical behaviour and the histology of most biopsied optic pathway gliomas.

Conclusion:
31P MRS can be implemented in the brain as part of a clinical protocol to provide robust measurement of important metabolites, in particular providing a greater understanding of cases where tCho is raised on 1H MRS.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Science > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH): Brain -- Tumors -- Diagnosis, Intracranial tumors in children, Magnetic resonance imaging
Journal or Publication Title: European Journal of Radiology
Publisher: Elsevier Ireland Ltd.
ISSN: 0720-048X
Official Date: 12 December 2013
Dates:
DateEvent
12 December 2013Published
2 November 2013Accepted
13 March 2013Submitted
Volume: Volume 83
Number: Number 2
Number of Pages: 7
Page Range: e106-e112
DOI: 10.1016/j.ejrad.2013.11.009
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: Birmingham Children's Hospital NHS Foundation Trust‏, Cancer Research UK (CRUK), Engineering and Physical Sciences Research Council (EPSRC), Medical Research Council (Great Britain) (MRC), Great Britain. Department of Health (DoH), Poppy Fields Charity, National Institute for Health Research (Great Britain) (NIHR)
Grant number: C7809/A10342 (MRC)
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