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MR Spectroscopy Usi...
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Elias, Augusto E.
(author)
MR Spectroscopy Using Normalized and Non-normalized Metabolite Ratios for Differentiating Recurrent Brain Tumor from Radiation Injury
- Article/chapterEnglish2011
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LIBRIS-ID:oai:lup.lub.lu.se:3c8f9217-9a96-4bf6-a290-838d5e10c251
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https://lup.lub.lu.se/record/2187312URI
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https://doi.org/10.1016/j.acra.2011.05.006DOI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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Rationale and Objectives: To compare the ability of normalized versus non-normalized metabolite ratios to differentiate recurrent brain tumor from radiation injury using magnetic resonance spectroscopy (MRS) in previously treated patients. Materials and Methods: Twenty-five patients with previous diagnosis of primary intracranial neoplasm confirmed with biopsy/resection, previously treated with radiation therapy (range, 54-70 Gy) with or without chemotherapy and new contrast enhancing lesion on a 1.5 T magnetic resonance imaging at the site of the primary neoplasm participated in this retrospective study. After MRS, clinical, radiological, and histopathology data were used to classify new contrast-enhancing lesions as either recurrent neoplasm or radiation injury. Volume of interest included both the lesion and normal-appearing brain on the contralateral side. Non-normalized metabolic ratios were calculated from choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) spectroscopic values obtained within the contrast-enhancing lesion: Cho/Cr, NAA/Cr, and Cho/NAA. Normalized ratios were calculated using the metabolic values from the contralateral normal side: Cho/normal creatinine (nCr), Cho/normal N-acetylaspartate (nNAA), Cho/normal choline, NAA/nNAA, NAA/nCr, and Cr/nCr. Results were correlated with the final diagnosis by Wilcoxon rank-sum analysis. Results: Two of three non-normalized ratios, Cho/NAA (sensitivity 86%, specificity 90%) and NAA/Cr (sensitivity 93%, specificity 70%) significantly associated with tumor recurrence even after correcting for multiple comparisons. Of the six normalized ratios, only Cho/nNAA significantly correlated with tumor recurrence (sensitivity 73%, specificity 40%), but did not remain significant after correcting for multiple comparisons. Conclusion: Cho/NAA and NAA/Cr were the two ratios with the best discriminating ability and both had better discriminating ability than their corresponding normalized ratios (Area under the curve = 0.92 versus 0.77, AUC= 0.85 vs. 0.66), respectively.
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Carlos, Ruth C.
(author)
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Smith, Ethan A.
(author)
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Frechtling, Dan
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George, Bekris
(author)
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Maly, PavelLund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Radiology Diagnostics, Malmö,Lund University Research Groups(Swepub:lu)ront-pma
(author)
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Sundgren, PiaLund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Neuroradiologi,Radiology Diagnostics, Malmö,Lund University Research Groups,Neuroradiology,University of Michigan(Swepub:lu)med-psu
(author)
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Diagnostisk radiologi, MalmöForskargrupper vid Lunds universitet
(creator_code:org_t)
Related titles
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In:Academic Radiology: Elsevier BV18:9, s. 1101-11081878-40461076-6332
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