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Neurosciences: NeurologyNeurology Posters |
1 Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; 2 Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
960
Objectives: Chemotherapy and stereotactic radiation for treatment of brain tumor recurrence benefit from accurate assessment of tumor grade and viability. Single voxel spectral analysis hamper correlation between PET and MR. We compared 3D MRSI color coded Choline(Ch) maps with PET in 7 patients who previously had therapy and presented with symptoms of tumor recurrence.
Methods: MRSI was performed on the GE MAGNETOM Trio to provide 3D maps of Ch over Creatine(Cr) at 3T. Fusion maps provided correlation of Ch change to MR. Patients also underwent F-18 FDG PET. Intensity of FDG uptake was rated 0 (no uptake), 1(low = WM), 2 (moderate), 3 (high=GM), 4 (intense > GM). MRSI signal intensity was presented on a rainbow color scale where blue-green was normal background Ch/Cr, to bright red if Ch/Cr was greatly elevated, and co-registered with FDG PET. Images were rated by 2 observers for abnormal FDG uptake and Ch/Cr ratios. Results were compared with surgical pathology.
Results: Two patients(pts) with high grade tumor recurrence showed grade 3 or 4 FDG uptake but only 1 had high Ch/Cr. In 3 pts with low grade viable tumors, FDG uptake was grade 0 or 1 but Ch/Cr was greatly elevated in 2. Two pts with necrosis had FDG uptake grade 0, but Ch/Cr was elevated in 1.
Conclusions: 3D co-registered MRSI maps provide complementary information to FDG PET for assessment of tumor recurrence. In low grade tumors, MRSI was more convincingly abnormal in regions of low FDG PET uptake.
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