TY - JOUR
T1 - Magnetic resonance spectroscopy in posterior fossa tumours: the tumour spectroscopic signature may improve discrimination in adults among haemangioblastoma, ependymal tumours, medulloblastoma, and metastasis
AU - Mora, Paloma
AU - Pons, Albert
AU - Cos, Mónica
AU - Camins, Angels
AU - Muntané, Amadeo
AU - Aguilera, Carles
AU - Arús, Carles
AU - Majós, Carles
PY - 2019/6/1
Y1 - 2019/6/1
N2 - © 2018, European Society of Radiology. Objectives: Assessing a posterior fossa tumour in an adult can be challenging. Metastasis, haemangioblastoma, ependymal tumours, and medulloblastoma are the most common diagnostic possibilities. Our aim was to evaluate the contribution of magnetic resonance spectroscopy (MRS) in the diagnosis of these entities. Methods: We retrospectively evaluated 56 consecutive patients with a posterior fossa tumour and histological diagnosis of ependymal tumour, medulloblastoma, haemangioblastoma, and metastasis in which good-quality spectra at short (TE 30 ms) or/and intermediate (TE, 136 ms) TE were available. Spectra were compared using the Mann-Whitney U non-parametric test in order to select the spectral datapoints and the intensity ratios that showed significant differences between groups of lesions. Performance of these datapoints and their ratios were assessed with ROC curves. Results: The most characteristic signatures on spectroscopy were high choline (Cho) in medulloblastoma (p < 0.001), high myoinositol (mIns) in ependymal tumours (p < 0.05), and high lipids (LIP) in haemangioblastoma (p < 0.01) and metastasis (p < 0.01). Selected ratios between normalised intensity signals of resonances provided accuracy values between 79 and 95% for pairwise comparisons. Intensity ratio NI 3.21ppm/3.55ppm provided satisfactory discrimination between medulloblastoma and ependymal tumours (accuracy, 92%), ratio NI 2.11ppm/1.10ppm discriminated ependymal tumours from haemangioblastoma (accuracy, 94%), ratio NI 3.21ppm/1.13ppm discriminated haemangioblastoma from medulloblastoma (accuracy, 95%), and ratio NI 1.28ppm/2.02pmm discriminated haemangioblastoma from metastasis (accuracy, 83%). Conclusions: MRS may improve the non-invasive diagnosis of posterior fossa tumours in adults. Key Points: • High choline suggests a medulloblastoma in a posterior fossa tumour. • High myoinositol suggests an ependymal lesion in a posterior fossa tumour. • High lipids suggest a metastasis or a haemangioblastoma in a posterior fossa tumour.
AB - © 2018, European Society of Radiology. Objectives: Assessing a posterior fossa tumour in an adult can be challenging. Metastasis, haemangioblastoma, ependymal tumours, and medulloblastoma are the most common diagnostic possibilities. Our aim was to evaluate the contribution of magnetic resonance spectroscopy (MRS) in the diagnosis of these entities. Methods: We retrospectively evaluated 56 consecutive patients with a posterior fossa tumour and histological diagnosis of ependymal tumour, medulloblastoma, haemangioblastoma, and metastasis in which good-quality spectra at short (TE 30 ms) or/and intermediate (TE, 136 ms) TE were available. Spectra were compared using the Mann-Whitney U non-parametric test in order to select the spectral datapoints and the intensity ratios that showed significant differences between groups of lesions. Performance of these datapoints and their ratios were assessed with ROC curves. Results: The most characteristic signatures on spectroscopy were high choline (Cho) in medulloblastoma (p < 0.001), high myoinositol (mIns) in ependymal tumours (p < 0.05), and high lipids (LIP) in haemangioblastoma (p < 0.01) and metastasis (p < 0.01). Selected ratios between normalised intensity signals of resonances provided accuracy values between 79 and 95% for pairwise comparisons. Intensity ratio NI 3.21ppm/3.55ppm provided satisfactory discrimination between medulloblastoma and ependymal tumours (accuracy, 92%), ratio NI 2.11ppm/1.10ppm discriminated ependymal tumours from haemangioblastoma (accuracy, 94%), ratio NI 3.21ppm/1.13ppm discriminated haemangioblastoma from medulloblastoma (accuracy, 95%), and ratio NI 1.28ppm/2.02pmm discriminated haemangioblastoma from metastasis (accuracy, 83%). Conclusions: MRS may improve the non-invasive diagnosis of posterior fossa tumours in adults. Key Points: • High choline suggests a medulloblastoma in a posterior fossa tumour. • High myoinositol suggests an ependymal lesion in a posterior fossa tumour. • High lipids suggest a metastasis or a haemangioblastoma in a posterior fossa tumour.
KW - Magnetic resonance imaging
KW - Magnetic resonance spectroscopy
KW - Neoplasm metastasis
KW - Posterior fossa tumours
KW - Diagnosis, Differential
KW - Medulloblastoma/diagnosis
KW - Inositol/metabolism
KW - Humans
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Young Adult
KW - Choline/metabolism
KW - Magnetic Resonance Spectroscopy/methods
KW - Neoplasm Metastasis
KW - Hemangioblastoma/diagnosis
KW - Infratentorial Neoplasms/diagnosis
KW - Adult
KW - Female
KW - ROC Curve
KW - Retrospective Studies
KW - Biomarkers, Tumor/metabolism
UR - http://www.mendeley.com/research/magnetic-resonance-spectroscopy-posterior-fossa-tumours-tumour-spectroscopic-signature-improve-discr
U2 - 10.1007/s00330-018-5879-z
DO - 10.1007/s00330-018-5879-z
M3 - Article
C2 - 30569184
SN - 0938-7994
VL - 29
SP - 2792
EP - 2801
JO - European Radiology
JF - European Radiology
ER -