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首页> 外文期刊>Journal of neurosurgery. >Evaluation of the response of metastatic brain tumors to stereotactic radiosurgery by proton magnetic resonance spectroscopy, 201TlCl single-photon emission computerized tomography, and gadolinium-enhanced magnetic resonance imaging.
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Evaluation of the response of metastatic brain tumors to stereotactic radiosurgery by proton magnetic resonance spectroscopy, 201TlCl single-photon emission computerized tomography, and gadolinium-enhanced magnetic resonance imaging.

机译：通过质子磁共振波谱，201TlCl单光子发射计算机断层扫描和g增强磁共振成像评估转移性脑肿瘤对立体定向放射外科手术的反应。

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OBJECT: The goal of this study was to investigate the usefulness of proton (1H) magnetic resonance (MR) spectroscopy to evaluate the response of metastatic brain tumors to stereotactic radiosurgery (SRS) in comparison with Gd-enhanced MR imaging and single-photon emission computerized tomography with administration of thallium-201 chloride (201TlCl-SPECT). METHODS: Forty patients with a total of 47 metastatic brain tumors were evaluated. The primary lesion was identified in all cases. Stereotactic radiosurgery was effective in 37 lesions. All patients were examined using Gd-enhanced MR imaging before and after SRS. Thalium-201 chloride was administered to 27 patients with 34 tumors and SPECT images were obtained. Proton MR spectroscopy was performed in 36 patients who harbored 43 tumors. On Gd-enhanced MR images, a decrease in the volume of the Gd-enhanced lesion and a change in the enhanced effect in the lesion after treatment were recognized as showing the effectiveness of SRS between 1 and 3 months or more (mean 8.54 +/- 3.58 weeks). In 201TlCl-SPECT studies, the ratio of lesion to normal brain decreased from 2 weeks to 2 months (mean 5.03 +/- 2.77 weeks) after radiosurgery. On 1H-MR spectroscopy images a high choline (Cho) peak and a lipid-dominant (Lip) peak were observed in 25 lesions and a high Cho peak and a lactate-dominant (Lac) peak were observed in 12 lesions before SRS. A decrease in the Cho peak, a disappearance of the Lac peak, and an increase in the Lip peak were observed between 1 week and 1 month (mean 2.76 +/- 1.62 weeks) after treatment. CONCLUSIONS: Based on histopathological findings obtained at autopsy or at surgery, we assume that a high Cho peak may be observed in viable tumor tissue and a Lip peak in areas of necrosis. The results indicate that 1H-MR spectroscopy is potentially a more sensitive tool in evaluating the response to SRS than 201TlCl-SPECT or Gd-enhanced MR imaging and that it can be used earlier for this purpose than those other imaging methods.
机译：目的：本研究的目的是研究质子（1H）磁共振（MR）光谱与转移性脑肿瘤对立体定向放射外科（SRS）的反应与Gd增强MR成像和单光子发射的比较的有用性计算机断层扫描，同时施用201 201氯化物（201TlCl-SPECT）。方法：对40例共47例转移性脑肿瘤患者进行了评估。在所有情况下都可以识别出原发灶。立体定向放射手术对37个病灶有效。在SRS之前和之后，均使用Gd增强MR成像检查所有患者。对27名患有34个肿瘤的患者施用201氯化chloride，并获得SPECT图像。质子磁共振波谱分析在36例中发现了43个肿瘤。在Gd增强的MR图像上，治疗后Gd增强的病变体积减小和病变增强效果的变化被认为显示SRS在1到3个月或更长时间内有效（平均8.54 + / -3.58周）。在201TlCl-SPECT研究中，放射手术后，病变与正常脑的比例从2周减少到2个月（平均5.03 +/- 2.77周）。在1H-MR光谱图上，在SRS之前，在25个病变中观察到了高胆碱（Cho）峰和脂质占优势（Lip）峰，在12个病变中观察到了高Cho峰和乳酸盐占优势（Lac）峰。在治疗后1周至1个月（平均2.76 +/- 1.62周）内，Cho峰减少，Lac峰消失，Lip峰增加。结论：根据在尸体解剖或手术中获得的组织病理学发现，我们假设可能在活的肿瘤组织中观察到高Cho峰，而在坏死区域观察到Lip峰。结果表明，与201TlCl-SPECT或Gd增强的MR成像相比，1H-MR光谱在评估对SRS的响应方面可能是更敏感的工具，并且与其他那些成像方法相比，它可以更早地用于此目的。

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