MRS Imaging as Complement to MRI in the Post-treatment Follow-up of Glial Brain Tumors

Pablo Moreno-acosta; Gina Malaver; Cesar Rodriguez; Oscar Gamboa; Carla Singh; German D. Diaz; Wafa Bouleftour; Trinidad González Padin; Josep Balart; Cristian Caicedo; Camilo Zubieta; Pedro Penagos; Nicolas Magné

doi:10.21873/cdp.10478

MRS Imaging as Complement to MRI in the Post-treatment Follow-up of Glial Brain Tumors

Pablo Moreno-acosta
, Gina Malaver
, Cesar Rodriguez
, Oscar Gamboa
, Carla Singh
, German D. Diaz
, Wafa Bouleftour
, Trinidad González Padin
, Josep Balart
, Cristian Caicedo
, Camilo Zubieta
, Pedro Penagos
, Nicolas Magné

Research output: Contribution to journal › Article › peer-review

Abstract

Background/Aim: Central nervous system tumors have a very low incidence worldwide. However, they represent a significant cause of mortality and morbidity. Magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopy imaging (MRSI) techniques provide metabolic information complementary to anatomical alterations. The aim of this study was to characterize different metabolic patterns and determine treatment outcomes in glial brain tumors. Patients and Methods: Forty-four previously treated patients participated in this prospective study, including 20 cases of low-grade (LG) and 24 high-grade (HG), gliomas. All patients underwent conventional MRI combined with MRS and MRSI using a 1.5 Tesla (T) magnet. Results: Distinct metabolic profiles were observed via MRS and MRSI compared to normal brain tissue. Among the LG tumors, 10 remained stable with mean choline (Cho)/ N-Acetyl Aspartate (NAA) and NAA/creatine (Cr) ratios of 1.49 (p=0.036) and 0.92 (p=0.038), respectively, while the other 10 progressed to HG, with Cho/NAA and Cho/Cr ratios of 2.24 (p=0.026) and 4.48 (p=0.016). Among HG tumors, 17 remained stable with similar metabolic profiles, while seven showed progression. Gliosis was identified in 21 cases, characterized by a Cho/NAA ratio of 1.57 (p=0.028) and NAA/Cr ratio of 1.36 (p=0.026). Radiation necrosis was observed in 14 tumors, with significant spectroscopic changes including Cho/Cr ratios of 2.14 (p=0.02) and 1.9 (p=0.003), and NAA/Cr ratios of 1.28 (p=0.001) and 0.49 (p=0.001) across SV-MRS and MV-MRSI modalities. Tumor recurrence was detected in 20 cases based on MRSI metabolic maps. Conclusion: MRS and MRSI provide valuable metabolic information that complements MRI in the post-treatment evaluation of glial brain tumors. These techniques enhance the detection of tumor recurrence, progression, and radiation necrosis, thereby supporting clinical decision-making and optimizing patient management.

Original language	English
Pages (from-to)	625-633
Number of pages	9
Journal	Cancer Diagnosis and Prognosis
Volume	5
Issue number	5
DOIs	https://doi.org/10.21873/cdp.10478
State	Published - 2025
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Brain tumors of glial origin
magnetic resonance spectroscopy
magnetic resonance spectroscopy imaging

Access to Document

10.21873/cdp.10478

Cite this

@article{0f35a092f76e47629869c27646e870b1,

title = "MRS Imaging as Complement to MRI in the Post-treatment Follow-up of Glial Brain Tumors",

abstract = "Background/Aim: Central nervous system tumors have a very low incidence worldwide. However, they represent a significant cause of mortality and morbidity. Magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopy imaging (MRSI) techniques provide metabolic information complementary to anatomical alterations. The aim of this study was to characterize different metabolic patterns and determine treatment outcomes in glial brain tumors. Patients and Methods: Forty-four previously treated patients participated in this prospective study, including 20 cases of low-grade (LG) and 24 high-grade (HG), gliomas. All patients underwent conventional MRI combined with MRS and MRSI using a 1.5 Tesla (T) magnet. Results: Distinct metabolic profiles were observed via MRS and MRSI compared to normal brain tissue. Among the LG tumors, 10 remained stable with mean choline (Cho)/ N-Acetyl Aspartate (NAA) and NAA/creatine (Cr) ratios of 1.49 (p=0.036) and 0.92 (p=0.038), respectively, while the other 10 progressed to HG, with Cho/NAA and Cho/Cr ratios of 2.24 (p=0.026) and 4.48 (p=0.016). Among HG tumors, 17 remained stable with similar metabolic profiles, while seven showed progression. Gliosis was identified in 21 cases, characterized by a Cho/NAA ratio of 1.57 (p=0.028) and NAA/Cr ratio of 1.36 (p=0.026). Radiation necrosis was observed in 14 tumors, with significant spectroscopic changes including Cho/Cr ratios of 2.14 (p=0.02) and 1.9 (p=0.003), and NAA/Cr ratios of 1.28 (p=0.001) and 0.49 (p=0.001) across SV-MRS and MV-MRSI modalities. Tumor recurrence was detected in 20 cases based on MRSI metabolic maps. Conclusion: MRS and MRSI provide valuable metabolic information that complements MRI in the post-treatment evaluation of glial brain tumors. These techniques enhance the detection of tumor recurrence, progression, and radiation necrosis, thereby supporting clinical decision-making and optimizing patient management.",

keywords = "Brain tumors of glial origin, magnetic resonance spectroscopy, magnetic resonance spectroscopy imaging",

author = "Pablo Moreno-acosta and Gina Malaver and Cesar Rodriguez and Oscar Gamboa and Carla Singh and Diaz, \{German D.\} and Wafa Bouleftour and Padin, \{Trinidad Gonz{\'a}lez\} and Josep Balart and Cristian Caicedo and Camilo Zubieta and Pedro Penagos and Nicolas Magn{\'e}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Anticancer Research is published by the International Institute of Anticancer Research.",

year = "2025",

doi = "10.21873/cdp.10478",

language = "English",

volume = "5",

pages = "625--633",

journal = "Cancer Diagnosis and Prognosis",

issn = "2732-7787",

publisher = "International Institute of Anticancer Research",

number = "5",

}

TY - JOUR

T1 - MRS Imaging as Complement to MRI in the Post-treatment Follow-up of Glial Brain Tumors

AU - Moreno-acosta, Pablo

AU - Malaver, Gina

AU - Rodriguez, Cesar

AU - Gamboa, Oscar

AU - Singh, Carla

AU - Diaz, German D.

AU - Bouleftour, Wafa

AU - Padin, Trinidad González

AU - Balart, Josep

AU - Caicedo, Cristian

AU - Zubieta, Camilo

AU - Penagos, Pedro

AU - Magné, Nicolas

PY - 2025

Y1 - 2025

N2 - Background/Aim: Central nervous system tumors have a very low incidence worldwide. However, they represent a significant cause of mortality and morbidity. Magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopy imaging (MRSI) techniques provide metabolic information complementary to anatomical alterations. The aim of this study was to characterize different metabolic patterns and determine treatment outcomes in glial brain tumors. Patients and Methods: Forty-four previously treated patients participated in this prospective study, including 20 cases of low-grade (LG) and 24 high-grade (HG), gliomas. All patients underwent conventional MRI combined with MRS and MRSI using a 1.5 Tesla (T) magnet. Results: Distinct metabolic profiles were observed via MRS and MRSI compared to normal brain tissue. Among the LG tumors, 10 remained stable with mean choline (Cho)/ N-Acetyl Aspartate (NAA) and NAA/creatine (Cr) ratios of 1.49 (p=0.036) and 0.92 (p=0.038), respectively, while the other 10 progressed to HG, with Cho/NAA and Cho/Cr ratios of 2.24 (p=0.026) and 4.48 (p=0.016). Among HG tumors, 17 remained stable with similar metabolic profiles, while seven showed progression. Gliosis was identified in 21 cases, characterized by a Cho/NAA ratio of 1.57 (p=0.028) and NAA/Cr ratio of 1.36 (p=0.026). Radiation necrosis was observed in 14 tumors, with significant spectroscopic changes including Cho/Cr ratios of 2.14 (p=0.02) and 1.9 (p=0.003), and NAA/Cr ratios of 1.28 (p=0.001) and 0.49 (p=0.001) across SV-MRS and MV-MRSI modalities. Tumor recurrence was detected in 20 cases based on MRSI metabolic maps. Conclusion: MRS and MRSI provide valuable metabolic information that complements MRI in the post-treatment evaluation of glial brain tumors. These techniques enhance the detection of tumor recurrence, progression, and radiation necrosis, thereby supporting clinical decision-making and optimizing patient management.

AB - Background/Aim: Central nervous system tumors have a very low incidence worldwide. However, they represent a significant cause of mortality and morbidity. Magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopy imaging (MRSI) techniques provide metabolic information complementary to anatomical alterations. The aim of this study was to characterize different metabolic patterns and determine treatment outcomes in glial brain tumors. Patients and Methods: Forty-four previously treated patients participated in this prospective study, including 20 cases of low-grade (LG) and 24 high-grade (HG), gliomas. All patients underwent conventional MRI combined with MRS and MRSI using a 1.5 Tesla (T) magnet. Results: Distinct metabolic profiles were observed via MRS and MRSI compared to normal brain tissue. Among the LG tumors, 10 remained stable with mean choline (Cho)/ N-Acetyl Aspartate (NAA) and NAA/creatine (Cr) ratios of 1.49 (p=0.036) and 0.92 (p=0.038), respectively, while the other 10 progressed to HG, with Cho/NAA and Cho/Cr ratios of 2.24 (p=0.026) and 4.48 (p=0.016). Among HG tumors, 17 remained stable with similar metabolic profiles, while seven showed progression. Gliosis was identified in 21 cases, characterized by a Cho/NAA ratio of 1.57 (p=0.028) and NAA/Cr ratio of 1.36 (p=0.026). Radiation necrosis was observed in 14 tumors, with significant spectroscopic changes including Cho/Cr ratios of 2.14 (p=0.02) and 1.9 (p=0.003), and NAA/Cr ratios of 1.28 (p=0.001) and 0.49 (p=0.001) across SV-MRS and MV-MRSI modalities. Tumor recurrence was detected in 20 cases based on MRSI metabolic maps. Conclusion: MRS and MRSI provide valuable metabolic information that complements MRI in the post-treatment evaluation of glial brain tumors. These techniques enhance the detection of tumor recurrence, progression, and radiation necrosis, thereby supporting clinical decision-making and optimizing patient management.

KW - Brain tumors of glial origin

KW - magnetic resonance spectroscopy

KW - magnetic resonance spectroscopy imaging

UR - https://www.scopus.com/pages/publications/105015373902

U2 - 10.21873/cdp.10478

DO - 10.21873/cdp.10478

M3 - Article

AN - SCOPUS:105015373902

SN - 2732-7787

VL - 5

SP - 625

EP - 633

JO - Cancer Diagnosis and Prognosis

JF - Cancer Diagnosis and Prognosis

IS - 5

ER -

MRS Imaging as Complement to MRI in the Post-treatment Follow-up of Glial Brain Tumors

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