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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">As Magnetic Resonance Spectroscopy is one of the most powerful methods to obtain a non-invasive view of brain metabolism we&#44; as others&#44; judge it a promising tool for tumor grading&#46; We investigated 8 patients harbouring astrocytomas &#40;histologically confirmed via stereotactic serial biopsy&#41; of different malignity with single voxel &#40;PRESS&#41; 1 H MRS techniques&#46; The measurements were also repeated after interstitial radiosurgery using 125 Iodine&#44; when this treatment modality was deemed indicated&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Apart from the decrease of NAA &#40;N-acetyl-L-aspartate&#41;&#44; the tumor spectra show the presence of lactate &#40;Lac&#41; which however does not correlate to the tumor grade&#46; More interesting for this and confirmed in our initial trial is the fact that choline &#40;Cho&#41; varies from almost normal concentrations in low-grade astrocytomas to a fourfould increase in the high-grade lesions with strong correlation to the tumor malignity&#46; After stereotactic radiosurgical treatment&#44; a decrease of the previously increased choline signal is observed&#46; The reduction of choline seems to be dose related&#46;</p>"
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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Considerando que la espectroscopia magn&#233;tica nuclear &#40;MRS&#41; es uno de los m&#233;todos m&#225;s eficaces para obtener una imagen no-invasiva del metabolismo cerebral&#44; juzgamos esta t&#233;cnica muy prometedora para la diferenciaci&#243;n &#40;graduaci&#243;n&#41; tumoral&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Examinamos ocho pacientes con astrocitomas &#40;his tol&#243;gicamente confirmados por medio de biopsia estereot&#225;ctica seriada&#41; de diferente grado de malignidad con t&#233;cnica single voxel &#40;PRESS&#41; 1 H MRS&#46; Los estudios fueron repetidos despu&#233;s de radiocirug&#237;a intersticial usando I125 en aquellos pacientes en los cuales esta modalidad de tratamiento parec&#237;a indicada&#46; Aparte de la disminuci&#243;n de NAA &#40;N-acetil-L-aspartato&#41;&#44; los espectra de los tumores muestran la presencia de lactato &#40;Lac&#41; lo cual&#44; no obstante&#44; no est&#225; en correlaci&#243;n con la graduaci&#243;n histol&#243;gica de la lesi&#243;n&#46; M&#225;s interesante y confirmado por nuestros estudios iniciales&#44; es el hecho que la cholina &#40;Cho&#41; var&#237;a de una concentraci&#243;n casi normal en astrocitomas de bajo grado a un incremento cuadruple en las lesiones de alto grado con una fuerte correlaci&#243;n con el grado de malignidad del tumor&#46; Despu&#233;s de un tratamiento radioquir&#250;rgico se observa una disminuci&#243;n de la se&#241;al de cholina que previamente hab&#237;a aumentado&#46; La reducci&#243;n de cholina parece ser relacionada a la dosis&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pudimos confirmar los valores obtenidos en an&#225;lisis in vitro y consideramos que una graduaci&#243;n tumoral no-invasiva de astrocitomas es posible por medio de la relaci&#243;n &#40;ratio&#41; entre cholina-creatina&#46; No obstante&#44; ser&#225; necesario un colectivo de pacientes m&#225;s grande para verificar nuestros resultados y evaluar la sensitividad de MRS en el monitoring terap&#233;utico a corto y largo plazo&#46;</p>"
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Vol. 8. Núm. 3.
Páginas 171-177 (enero 1997)
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Vol. 8. Núm. 3.
Páginas 171-177 (enero 1997)
Grading and therapy monitoring of astrocytomas with 1H spectroscopy
Grado de diferenciación y control terapéutico de astrocitomas mediante lH espectroscopía
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W. Bini
Dept. of Neurosurgery, Neurozentrum MR Hochfeld, University of Freiburg, Freiburg-Germany
O. Speck*, Th. Thiel*, J. Hennig*
* Dept. of Radiology, MR Hochfeld, University of Freiburg, Freiburg-Germany
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Abstract

As Magnetic Resonance Spectroscopy is one of the most powerful methods to obtain a non-invasive view of brain metabolism we, as others, judge it a promising tool for tumor grading. We investigated 8 patients harbouring astrocytomas (histologically confirmed via stereotactic serial biopsy) of different malignity with single voxel (PRESS) 1 H MRS techniques. The measurements were also repeated after interstitial radiosurgery using 125 Iodine, when this treatment modality was deemed indicated.

Apart from the decrease of NAA (N-acetyl-L-aspartate), the tumor spectra show the presence of lactate (Lac) which however does not correlate to the tumor grade. More interesting for this and confirmed in our initial trial is the fact that choline (Cho) varies from almost normal concentrations in low-grade astrocytomas to a fourfould increase in the high-grade lesions with strong correlation to the tumor malignity. After stereotactic radiosurgical treatment, a decrease of the previously increased choline signal is observed. The reduction of choline seems to be dose related.

Key words:
Non-invasive tissue characterization
MR spectroscopy
Astrocytomas
Therapy monitoring
Resumen

Considerando que la espectroscopia magnética nuclear (MRS) es uno de los métodos más eficaces para obtener una imagen no-invasiva del metabolismo cerebral, juzgamos esta técnica muy prometedora para la diferenciación (graduación) tumoral.

Examinamos ocho pacientes con astrocitomas (his tológicamente confirmados por medio de biopsia estereotáctica seriada) de diferente grado de malignidad con técnica single voxel (PRESS) 1 H MRS. Los estudios fueron repetidos después de radiocirugía intersticial usando I125 en aquellos pacientes en los cuales esta modalidad de tratamiento parecía indicada. Aparte de la disminución de NAA (N-acetil-L-aspartato), los espectra de los tumores muestran la presencia de lactato (Lac) lo cual, no obstante, no está en correlación con la graduación histológica de la lesión. Más interesante y confirmado por nuestros estudios iniciales, es el hecho que la cholina (Cho) varía de una concentración casi normal en astrocitomas de bajo grado a un incremento cuadruple en las lesiones de alto grado con una fuerte correlación con el grado de malignidad del tumor. Después de un tratamiento radioquirúrgico se observa una disminución de la señal de cholina que previamente había aumentado. La reducción de cholina parece ser relacionada a la dosis.

Pudimos confirmar los valores obtenidos en análisis in vitro y consideramos que una graduación tumoral no-invasiva de astrocitomas es posible por medio de la relación (ratio) entre cholina-creatina. No obstante, será necesario un colectivo de pacientes más grande para verificar nuestros resultados y evaluar la sensitividad de MRS en el monitoring terapéutico a corto y largo plazo.

Palabras clave:
Caracterización tisular no-invasiva. Espectroscopia magnética nuclear. Astrocitomas. Monitoring terapéutico

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