Siyah Mansoory Meysam, Faramarzi Ayob, Khoshgard Karim, Mozafari Hadi
Department of Biomedical Engineering, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Avicenna J Med Biotechnol. 2020 Apr-Jun;12(2):107-115.
Glioblastoma Multiforme (GBM) is the most common and deadly type of primary brain tumor in adults. Magnetic Resonance Spectroscopy (MRS) is a noninvasive imaging technique used to study metabolic changes in the brain tumors. Some metabolites such as Phosphocholine, Creatine, NAA/Cr, and Pcho/Cr have been proven to show a diagnostic role in GBM. The present study was conducted to analyze important metabolites using MRS multivoxel in GBM tumor.
In this study, information was collected from 8 individuals diagnosed with GBM using Siemens multivoxel MRS with a magnetic field strength of 3 T. Data were obtained by Point-Resolved Spectroscopy (PRESS) protocol with TE=135 and TR=1570 . NAA, Pcho, Cr, Ala, Gln, Gly, Glu, Lac, NAAG, and Tau metabolites were extracted and evaluated statistically.
Given total number of normal voxels and total number of all voxels, levels of Cr, Glu, NAA, NAAG, and Gly/Tau ratio in healthy voxels were significantly higher than tumoral voxels (p=0.005, p=0.03, p<0.001, p<0.001 and p=0.041, respectively). In contrast, levels of Gly, Gln, Tau, Lac/Cr, Pcho/Cr, Pcho/NAA, Lac/NAA, and Gln/Glu ratios in tumoral voxels were significantly more than healthy voxels (p=0.001, p= 0.037, p<0.001, p=0.010, p<0.001, p<0.001, and p=0.024, respectively). However, levels of Lac and Pcho had no significant difference in the two types of voxels.
In summary, compared to patients with glioblastoma with H-MRS, the Pcho/Cr and Pcho/NAA ratios, and NAAG are the most important parameters to differentiate between tumoral and normal voxels.
多形性胶质母细胞瘤（GBM）是成人中最常见且致命的原发性脑肿瘤类型。磁共振波谱（MRS）是一种用于研究脑肿瘤代谢变化的非侵入性成像技术。一些代谢物，如磷酸胆碱、肌酸、NAA/Cr和Pcho/Cr，已被证明在GBM中具有诊断作用。本研究旨在使用MRS多体素分析GBM肿瘤中的重要代谢物。
在本研究中，收集了8例经西门子3T磁场强度的多体素MRS诊断为GBM的患者的信息。数据通过点分辨波谱（PRESS）协议获得，TE=135，TR=1570。提取并对NAA、Pcho、Cr、Ala、Gln、Gly、Glu、Lac、NAAG和Tau代谢物进行统计学评估。
考虑到正常体素总数和所有体素总数，健康体素中Cr、Glu、NAA、NAAG和Gly/Tau比值水平显著高于肿瘤体素（分别为p=0.005、p=0.03、p<0.001、p<0.001和p=0.041）。相反，肿瘤体素中Gly、Gln、Tau、Lac/Cr、Pcho/Cr、Pcho/NAA、Lac/NAA和Gln/Glu比值水平显著高于健康体素（分别为p=0.001、p=0.037、p<0.001、p=0.010、p<0.001、p<0.001和p=0.024）。然而，Lac和Pcho水平在两种体素中无显著差异。
总之，与H-MRS的胶质母细胞瘤患者相比，Pcho/Cr和Pcho/NAA比值以及NAAG是区分肿瘤体素和正常体素的最重要参数。
