Monitoring individual response to brain-tumour chemotherapy: proton MR spectroscopy in a patient with recurrent glioma after stereotactic radiotherapy

Neuroradiology. 2004 Feb;46(2):126-9. doi: 10.1007/s00234-003-1116-8. Epub 2003 Dec 18.

Abstract

Since antineoplastic activity varies, sensitive methods for individual assessment of efficacy are needed. We demonstrate the clinical value of MR spectroscopy in monitoring chemotherapy in a patient with recurrent glioma after stereotactic radiotherapy. Diagnostic imaging before and after chemotherapy included contrast-enhanced MRI, single-voxel proton MR spectroscopy ((1)H MRS), (1)H MR spectroscopic imaging ((1)H SI), and fluorodeoxyglucose (FDG) positron-emission tomography (PET). A significant decrease in choline signal intensity was observed 2 months after chemotherapy indicating tumour chemosensitivity, in line with tumour shrinkage on MRI and decreased uptake of FDG. Assessment of early response by MRS may help to improve treatment protocols in other patients.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Astrocytoma / drug therapy*
  • Astrocytoma / surgery
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Choline / metabolism
  • Creatine / metabolism
  • Energy Metabolism / drug effects*
  • Humans
  • Image Processing, Computer-Assisted*
  • Lomustine / administration & dosage
  • Magnetic Resonance Spectroscopy*
  • Male
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neurologic Examination / drug effects
  • Procarbazine / administration & dosage
  • Radiosurgery*
  • Temporal Lobe / drug effects*
  • Temporal Lobe / pathology
  • Tomography, Emission-Computed
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Aspartic Acid
  • Procarbazine
  • Vincristine
  • Lomustine
  • N-acetylaspartate
  • Creatine
  • Choline