Despite their uniform histologic appearance, pediatric lowgrade astrocytomas (LGA) often exhibit a rather unpredictable clinical course. It is presently unclear whether certain specific genetic, immunologic and/or metabolic features underlie these observed variations. In order to address this question we examined the tumor distribution of choline compounds (Cho), creatine (Cr) and N-acetyl aspartate (NAA) in seven children with midline LGA by means of proton magnetic resonance spectroscopy imaging (H-MRSI). Studies were performed with a 1.5 T GE Signa Scanner equipped with the standard head coil; nominal voxel size was 7.5×7.5×15 mm. This spatial resolution allowed us to select and independently evaluate multiple regions of interest (ROI) in the tumor as well as in areas of normal brain from the same individual. Normalized values of the observed signal intensities demonstrated a lower NAA and Cr content in the tumors than in the surrounding normal brain. Intratumoral Cho signals were also below normal values in all but one patient. The average Cho: NAA ratio was consistently higher in the tumor than in the normal brain. However, there was a wide variation (up to fourfold) in the Cho: NAA ratios of different ROIs, even within the same tumor. Our results clearly indicate that pediatric LGAs are metabolically heterogeneous, a feature that may be relevant to the understanding of their variable biologic behavior. Inasmuch as unique metabolic patterns were observed in some LGAs, we believe that systematic HMRSI studies of these patients may help define subsets within the group with specific therapeutic requirements.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Anderson JH, Strandberg JD, Wong DF, Conti PS, Barker PB, Blackband SJ, Hilton J, Natarajan TK, Dannals RF, Samphilipo MA, Magee CA, Burckhardt DD (1994) Multimodality correlative study of canine brain tumors. Proton magnetic resonance spectroscopy, positron emission tomography, and histology. Invest Radiol 29:597–605
Demaerel P, Johannik K, Van Hecke P, Van Ongeval C, Verellen S, Marchal G, Wilms G, Plets C, Goffin J, Van Calenbergh F, Lammens M, Baert A (1991) Localized 1 NMR spectroscopy in fifty cases of newly diagnosed intracranial tumors. J Comput Assist Tomogr 15:67–76
Dirks PB, Jay V, Becker L, Drake JM, Humphreys RP, Hoffman HJ, Rutka JT (1994) Development of anaplastic changes in low-grade astrocytomas of childhood. Neurosurgery 34:68–78
Fulham MJ, Bizzi A, Dietz MJ, Shih HHL, Raman R, Sobering GS, Frank JA, Dwyer AJ, Alger JR, Di Chiro G (1992) Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance. Radiology 185:675–686
Gill SS, Thomas DGT, Bruggen N van, Gadian DG, Peden CJ, Bell JD, Cox J, Menon DK, Iles RA, Bryant DJ, Coutts GA (1990) Proton MR spectroscopy of intracranial tumours: in vitro and in vivo studies. J Comput Assist Tomogr 14:497–504
Hoffman HJ, Solonuk DS, Humphreys RP, Drake JM, Becker LE, De Lima BO, Piatt JH (1993) Management and outcome of low-grade astrocytomas in the midline in children: a retrospective review. Neurosurgery 33:964–971
Jacobson M (1991) Developmental neurobiology, 3rd edn. Plenum Press, New York
Kauppinen RA, Williams SR (1994) Nuclear magnetic resonance spectroscopy studies of the brain. Prog Neurobiol 44:87–118
Kugel H, Heindel W, Ernestus RI (1992) Human brain tumors: spectral patterns detected with localized 1H MRS spectroscopy. Radiology 183:701–709
Miller BL (1991) A review of chemical issues in 1H NMR spectroscopy: N-acetyl-1-aspartate, creatine and choline. NMR Biomed 4:47–52
Nadler JV, Cooper JR (1972) N-acetyl-1-aspartatic acid content of human neural tumors and bovine peripheral nervous tissues. J Neurochem 19:313–319
Nagendak W (1992) Studies of human tumors by MRS: a review. MRS Biomed 5:303–324
Piepmeier JM, Fried I, Makuch R (1993) Low-grade astrocytomas may arise from different astrocyte lineages. Neurosurgery 33:627–632
Sutton LN, Wang Z, Gusnard D, Lange B, Perilongo G, Bogdan A, Detre J, Rorke L, Zimmerman RA (1992) Proton magnetic resonance spectroscopy of pediatric brain tumors. Neurosurgery 31:195–202
Urenjak J, Williams S, Gadian DG, Noble M (1993) Proton nuclear magnetic resonance spectroscopy unambiguosly identifies different neural cell types. J Neurosci 13:981–989
Warburg O (1956) On the origin of the cancer cells. Science 123:309–314
About this article
Cite this article
Lazareff, J.A., Olmstead, C., Bockhorst, K.H.J. et al. Proton magnetic resonance spectroscopic imaging of pediatric low-grade astrocytomas. Child's Nerv Syst 12, 130–135 (1996). https://doi.org/10.1007/BF00266813
- Brain tumor