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MR spectroscopy of 65-year-old with glioblastoma

Case Study
Van Cauter, Sofie, M.D. University Hospitals Leuven • Belgium

Patient history

A 65-year-old woman was admitted to the hospital after a first epileptic seizure.

MR examination

The Achieva 3.0T TX was used.

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Images

 T2W TIW + Gd
T2W
TIW + Gd
A 65-year-old woman was admitted to the hospital after a first epileptic seizure.
 Cho + NAA + Lipids
Cho + NAA + Lipids


Conventional MR shows a large contrast-enhancing heterogeneous lesion in the left parietal lobe. MR Spectroscopy in the enhancing portion of the lesion shows an elevated Cho/NAA ratio as could be expected in rapidly proliferating tumoral tissue with neuronal loss. The MR spectrum in the peri-lesion edema shows elevated choline, suggestive of infiltrating tumor. Tumor infiltration is a characteristic of a glioblastoma multiforme. As the edematous regions in metastases are purely vasogenic, increased choline is not expected. The differentiation between a solitary metastasis and a glioblastoma can possibly be made by the spectroscopic features in the peritumoral edema rather than the spectra from enhancing tumoral tissue.

Diagnosis

Glioblastoma.

Clinical impact of 3.0T MR spectroscopy

Applying SENSE in two directions has allowed the Leuven team to dramatically shorten the scan time of MR spectroscopic imaging (MRSI) in the brain to about three and a half minutes without loss of spectral or spatial resolution, while maintaining sufficient SNR. These shorter scan times make it practical to include MR spectroscopy in routine brain MR exams.



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Sep 20, 2011

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Case Study
Achieva 3.0T
Glioblastoma, Spectroscopy
 

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