gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Prognostic value of 1H-spectroscopy in untreated low-grade gliomas

Prognostischer Wert der 1H-Spektroskopie bei unbehandelten niedriggradigen Gliomen

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  • corresponding author E. Hattingen - Institut für Neuroradiologie, Universitätsklinikum Frankfurt/Main
  • P. Raab - Institut für Neuroradiologie, Universitätsklinikum Frankfurt/Main
  • K. Franz - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt/Main
  • M. Setzer - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt/Main
  • R. Gerlach - Klinik für Neurochirurgie, Universitätsklinikum Frankfurt/Main
  • F. E. Zanella - Institut für Neuroradiologie, Universitätsklinikum Frankfurt/Main
  • U. Pilatus - Institut für Neuroradiologie, Universitätsklinikum Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocDI.01.13

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc152.shtml

Published: May 30, 2008

© 2008 Hattingen et al.
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Outline

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Objective: To evaluate the ability of proton magnetic resonance spectroscopy (1H-MRS) to predict survival time, tumor progression and malignant transformation in patients with WHO grade II gliomas.

Methods: 1H-MRS and MR imaging (MRI) were performed before surgery in 45 patients with histologically proven WHO grade II gliomas. Metabolite concentrations of choline-containing compounds (Cho) and creatine/phosphocreatine (tCr) were normalized to contralateral brain tissue. Also, intratumoral ratios of Cho/tCr and Cho/N-acetyl-aspartate were calculated. The extent of tumor resection; contrast enhancement, size and histopathological type of the tumor; age, gender and first neurological symptoms of the patients were analyzed. These parameters were analyzed for survival, tumor progression, and malignant transformation of the tumor for a follow-up period of 1 to 5 years.

Results: Positive predictors of malignant transformation of the tumor were the normalized tCr (p=0.038) and contrast enhancement of the tumor (p=0.013). The predictors with the lowest p values for tumor progression, but missing significance level, were the extent of resection and tumor size. All other parameters failed to predict the three endpoints. The normalized Cho and, with lower p value, patients’ age was an independent predictor for survival in the multivariate model (p=0.01; Hazard Ratio 5.6 for Cho).

Conclusions: The potential for malignant transformation is best indicated by the normalized tCr and tumor contrast media enhancement. Normalized Cho of the tumor tissue is an independent predictor for survival time in patients with low-grade gliomas without radio-chemotherapy. There is no reliable spectroscopic parameter to predict tumor progression during the follow-up surveillance.