Value of proton MR spectroscopy in grading of oligodendroglial tumors

Dr Pham Chu Hoang1, Dr Nguyen Duy Hung1, Dr Nguyen Duy Hue1
1 Imaging dept, Vietnam-Germany Hospital; School Ha Noi medical university

Main Article Content

Abstract

Objective of this study is to describe the value of Proton MR Spectroscopy in predicting preoperative oligodendroglioma
grading. Between 05/2015and 04/2016, a cross-sectional study involved 31 patients (15 high-grade oligodendroglioma
and 16 low-grade oligodendroglioma) underwent preoperative conventional MR Imaging, Proton MR Spectroscopy and
histopathologically determined oligodendrogliomas after stereotactic biopsy or resection. Receiver operating characteristic
(ROC) curve was used to determine the accuracy of Cho/NAA, Cho/Cr and NAA/Cr ratios, the area under the curve of whom
is largest is chosen to obtain cut-off value. Cho/NAA ratio was measured as 2.32 ± 1.06 and 5.85 ± 5.42 in low-grade and highgrade oligodendrogliomas, respectively. The Cho/NAA ratio from high-grade oligodendrogliomas was statistically different
from those of low-grade oligodendrogliomas (p<0.001). The cut-off value was taken as 3.057 in the Cho/NAA ratio provided
sensitivity, specificity, PPV and NPV of 73.33%; 75%; 73.33% and 75%, respectively. Inconclusion, Spectroscopy MRI is useful
in the preoperative assessment of the histopathological grade of oligodendrogliomas.

Article Details

References

1. Engelhard, H.H., A. Stelea, and E.J. Cochran (2002), Oligodendroglioma: pathology and molecular biology. Surgical neurology. 58(2), 111-117.
2. Shaw, E.G., et al. (1992), Oligodendrogliomas: the Mayo clinic experience. Journal of neurosurgery. 76(3), 428-434.
3. Koeller, K.K. and E.J. Rushing (2005),Oligodendroglioma and Its Variants: Radiologic-Pathologic Correlation 1. Radiographics. 25(6), 1669-1688.
4. Cairncross, J.G., D.R. Macdonald, and D.A. Ramsay (1992), Aggressive oligodendroglioma: a chemosensitive tumor. Neurosurgery. 31(1), 78-82.
5. Law, M., et al. (2003), Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol. 24(10), 1989-98.
6. Lê Văn Phước (2012), Vai trò cộng hưởng từ phổ và cộng hưởng từ khuyếch tán trong chẩn đoán u sao bào trước phẫu thuật Luận văn tiến sĩ Y học. Đại học Y Dược thành phố Hồ Chí Minh.
7. Spampinato, M.V., et al. (2007), Cerebral blood volume measurements and proton MR spectroscopy in grading of oligodendroglial tumors. American Journal of Roentgenology. 188(1), 204-212.
8. Hoang-Xuan, K., et al. (2004), Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and
correlation with chromosome 1p deletions. Journal of Clinical Oncology. 22(15), 3133-3138.
9. Aprile, I., et al. (2012), High-Grade Cerebral Glioma Characterization: Usefulness of MR Spectroscopy and Perfusion Imaging Associated
Evaluation. Neuroradiol J. 25(1), 57-66.