%0 Journal Article
%T Lack of choline elevation on proton magnetic resonance spectroscopy in grade I每III gliomas
%A Arastoo Vossough
%A Elias R Melhem
%A Jaroslaw Krejza
%A MacLean Nasrallah
%A S Ali Nabavizadeh
%A Sanjeev Chawla
%A Seung-Cheol Lee
%A Sumei Wang
%A Suyash Mohan
%J The Neuroradiology Journal
%@ 2385-1996
%D 2019
%R 10.1177/1971400919846509
%X Elevated levels of choline are generally emphasized as marker of increased cellularity and cell membrane turnover in gliomas. In this study, we investigated the incidence rate of lack of choline/creatine and choline/water elevation in a population of grade I每III gliomas. A cohort of 41 patients with histopathologically confirmed gliomas underwent multi-voxel proton magnetic resonance spectroscopy on a 3ˋT magnetic resonance system prior to treatment. Peak areas for choline and myoinositol were measured from all voxels that exhibited hyperintensity on fluid-attenuated inversion recovery images and were normalized to creatine and unsuppressed water from each voxel. The average metabolite/creatine and metabolite/water ratios from these voxels were then computed. Similarly, average metabolite ratios were computed from normal brain parenchyma. Gliomas were considered for lack of choline elevation when choline/creatine and choline/water ratios from neoplastic regions were less than those from normal brain parenchyma regions. Six of 41 (14.6%) grade I每III gliomas showed lack of elevation for choline/creatine and choline/water ratios compared to normal brain parenchyma. Four of these six gliomas also demonstrated elevated levels of myoinositol/creatine ratio. All other gliomas (nˋ=ˋ35) had elevated choline levels from neoplastic regions relative to normal parenchyma. The sensitivity of choline/creatine or choline/water in determining a grade I每III glioma was 85.4%. These findings suggest that a lack of choline/creatine or choline/water elevation may be seen in some gliomas and low choline levels should not prevent us from considering the possibility of a grade I每III glioma
%K Glioma
%K proton magnetic resonance spectroscopy
%K choline
%K myoinositol
%U https://journals.sagepub.com/doi/full/10.1177/1971400919846509