A permanent neurosurgical challenge: low grade gliomas
Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of M...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Daniel Mihai Teleanu [verfasserIn] Nicolae-Stefan Bogaciu [verfasserIn] Andreea Marinescu [verfasserIn] Raluca Ioana Teleanu [verfasserIn] Adrian Balasa [verfasserIn] |
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| Format: |
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| Sprache: |
Englisch |
| Erschienen: |
2016 |
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In: Romanian Journal of Neurology - Amaltea Medical Publishing House, 2019, 15(2016), 4, Seite 160-167 |
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| Übergeordnetes Werk: |
volume:15 ; year:2016 ; number:4 ; pages:160-167 |
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Link aufrufen |
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| DOI / URN: |
10.37897/RJN.2016.4.3 |
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| Katalog-ID: |
DOAJ032482531 |
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| 520 | |a Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. | ||
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10.37897/RJN.2016.4.3 doi (DE-627)DOAJ032482531 (DE-599)DOAJd8c0c14a74ff43699c6bd882b6691da4 DE-627 ger DE-627 rakwb eng RC346-429 Daniel Mihai Teleanu verfasserin aut A permanent neurosurgical challenge: low grade gliomas 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. magnetic resonance spectroscopy low grade glioma management biopsy Medicine R Neurology. Diseases of the nervous system Nicolae-Stefan Bogaciu verfasserin aut Andreea Marinescu verfasserin aut Raluca Ioana Teleanu verfasserin aut Adrian Balasa verfasserin aut In Romanian Journal of Neurology Amaltea Medical Publishing House, 2019 15(2016), 4, Seite 160-167 (DE-627)634381792 (DE-600)2570964-1 20696094 nnns volume:15 year:2016 number:4 pages:160-167 https://doi.org/10.37897/RJN.2016.4.3 kostenfrei https://doaj.org/article/d8c0c14a74ff43699c6bd882b6691da4 kostenfrei https://rjn.com.ro/articles/2016.4/RJN_2016_4_Art-03.pdf kostenfrei https://doaj.org/toc/1843-8148 Journal toc kostenfrei https://doaj.org/toc/2069-6094 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 15 2016 4 160-167 |
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10.37897/RJN.2016.4.3 doi (DE-627)DOAJ032482531 (DE-599)DOAJd8c0c14a74ff43699c6bd882b6691da4 DE-627 ger DE-627 rakwb eng RC346-429 Daniel Mihai Teleanu verfasserin aut A permanent neurosurgical challenge: low grade gliomas 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. magnetic resonance spectroscopy low grade glioma management biopsy Medicine R Neurology. Diseases of the nervous system Nicolae-Stefan Bogaciu verfasserin aut Andreea Marinescu verfasserin aut Raluca Ioana Teleanu verfasserin aut Adrian Balasa verfasserin aut In Romanian Journal of Neurology Amaltea Medical Publishing House, 2019 15(2016), 4, Seite 160-167 (DE-627)634381792 (DE-600)2570964-1 20696094 nnns volume:15 year:2016 number:4 pages:160-167 https://doi.org/10.37897/RJN.2016.4.3 kostenfrei https://doaj.org/article/d8c0c14a74ff43699c6bd882b6691da4 kostenfrei https://rjn.com.ro/articles/2016.4/RJN_2016_4_Art-03.pdf kostenfrei https://doaj.org/toc/1843-8148 Journal toc kostenfrei https://doaj.org/toc/2069-6094 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 15 2016 4 160-167 |
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10.37897/RJN.2016.4.3 doi (DE-627)DOAJ032482531 (DE-599)DOAJd8c0c14a74ff43699c6bd882b6691da4 DE-627 ger DE-627 rakwb eng RC346-429 Daniel Mihai Teleanu verfasserin aut A permanent neurosurgical challenge: low grade gliomas 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. magnetic resonance spectroscopy low grade glioma management biopsy Medicine R Neurology. Diseases of the nervous system Nicolae-Stefan Bogaciu verfasserin aut Andreea Marinescu verfasserin aut Raluca Ioana Teleanu verfasserin aut Adrian Balasa verfasserin aut In Romanian Journal of Neurology Amaltea Medical Publishing House, 2019 15(2016), 4, Seite 160-167 (DE-627)634381792 (DE-600)2570964-1 20696094 nnns volume:15 year:2016 number:4 pages:160-167 https://doi.org/10.37897/RJN.2016.4.3 kostenfrei https://doaj.org/article/d8c0c14a74ff43699c6bd882b6691da4 kostenfrei https://rjn.com.ro/articles/2016.4/RJN_2016_4_Art-03.pdf kostenfrei https://doaj.org/toc/1843-8148 Journal toc kostenfrei https://doaj.org/toc/2069-6094 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 15 2016 4 160-167 |
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10.37897/RJN.2016.4.3 doi (DE-627)DOAJ032482531 (DE-599)DOAJd8c0c14a74ff43699c6bd882b6691da4 DE-627 ger DE-627 rakwb eng RC346-429 Daniel Mihai Teleanu verfasserin aut A permanent neurosurgical challenge: low grade gliomas 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. magnetic resonance spectroscopy low grade glioma management biopsy Medicine R Neurology. Diseases of the nervous system Nicolae-Stefan Bogaciu verfasserin aut Andreea Marinescu verfasserin aut Raluca Ioana Teleanu verfasserin aut Adrian Balasa verfasserin aut In Romanian Journal of Neurology Amaltea Medical Publishing House, 2019 15(2016), 4, Seite 160-167 (DE-627)634381792 (DE-600)2570964-1 20696094 nnns volume:15 year:2016 number:4 pages:160-167 https://doi.org/10.37897/RJN.2016.4.3 kostenfrei https://doaj.org/article/d8c0c14a74ff43699c6bd882b6691da4 kostenfrei https://rjn.com.ro/articles/2016.4/RJN_2016_4_Art-03.pdf kostenfrei https://doaj.org/toc/1843-8148 Journal toc kostenfrei https://doaj.org/toc/2069-6094 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 15 2016 4 160-167 |
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10.37897/RJN.2016.4.3 doi (DE-627)DOAJ032482531 (DE-599)DOAJd8c0c14a74ff43699c6bd882b6691da4 DE-627 ger DE-627 rakwb eng RC346-429 Daniel Mihai Teleanu verfasserin aut A permanent neurosurgical challenge: low grade gliomas 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. magnetic resonance spectroscopy low grade glioma management biopsy Medicine R Neurology. Diseases of the nervous system Nicolae-Stefan Bogaciu verfasserin aut Andreea Marinescu verfasserin aut Raluca Ioana Teleanu verfasserin aut Adrian Balasa verfasserin aut In Romanian Journal of Neurology Amaltea Medical Publishing House, 2019 15(2016), 4, Seite 160-167 (DE-627)634381792 (DE-600)2570964-1 20696094 nnns volume:15 year:2016 number:4 pages:160-167 https://doi.org/10.37897/RJN.2016.4.3 kostenfrei https://doaj.org/article/d8c0c14a74ff43699c6bd882b6691da4 kostenfrei https://rjn.com.ro/articles/2016.4/RJN_2016_4_Art-03.pdf kostenfrei https://doaj.org/toc/1843-8148 Journal toc kostenfrei https://doaj.org/toc/2069-6094 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_206 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4305 AR 15 2016 4 160-167 |
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The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. 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A permanent neurosurgical challenge: low grade gliomas |
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Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. |
| abstractGer |
Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. |
| abstract_unstemmed |
Introduction. The utilization of Magnetic Resonance Spectroscopy (MRS) brings an important piece of information to an overall MR study, thus aiding the physician in making an accurate assumption regarding the histological grade of a tumour. The purpose of this study is to verify the reliability of MRS in correctly diagnosing both the nature of tumours and their grade. Material and methods. This is an observational study that was conducted from January 2011 to June 2016 on 49 patients confirmed to be low-grade gliomas (LGG) by pathological examination, who were admitted in our Neurosurgery Department in this period. Both retrospective and prospective data were collected. Inclusion criteria comprise unique tumoral lesion at the moment of diagnosis, follow-up for at least one year. Exclusion criteria included: other types of tumours with any location, patient refusal to undergo histopathological ex-amination of the resected tissue, uncompliant and non-collaborating patients. Of all patients, 22 were subjected to an MRS study which suggested the presence of a low-grade glioma subsequently confirmed by the pathological examination. Results. MRS has been shown to provide accurate non-invasive diagnosis of LGG’s, by analysing the concentration of metabolites inside the lesions which tend to be specific for these tumours: relatively elevated levels of N-acetylaspartate and creatine with reduced levels in the concentration of choline and absent lipids and lactate. It has also been observed that pre-operative MRS assists the physician in selecting the optimal place for biopsy, so that the pathological examination provides conclusive results. Conclusions. With the increased availability of MRI technology, MRS comes as a milestone in the advancement of more accurate and patient-friendly methods of diagnostic for pathologies as LGG’s which constitute a permanent challenge for neurosurgeons. The result of this study underlines the importance of MRS as a method for follow up patients with LGG but cannot replace the need for obtaining biotic tissue for pathological examination, especially after the new grading system of WHO, which was published in June 2016. This new grading system takes into account the molecular biology in predicting the natural history of cerebral tumours. |
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