Mapping of brain tumor metabolites with proton MR spectroscopic imaging: Clinical relevance

Michael J. Fulham, Alberto Bizzi, Mark J. Dietz, Henry H L Shih, Ramesh Raman, Geoffrey S. Sobering, Joseph A. Frank, Andrew J. Dwyer, Jeffry R. Alger, Giovanni Di Chiro

Research output: Contribution to journalArticlepeer-review


Brain tumor metabolism was studied with hydrogen-1 magnetic resonance spectroscopy and positron emission tomography with fluorine-18 fluorodeoxyglucose in 50 patients. N-acetylaspartate (NAA) was generally decreased in tumors and radiation necrosis but was somewhat preserved at neoplasm margins. Choline was increased in most solid tumors. Solid high-grade gliomas had higher normalized choline values than did solid low-grade gliomas (P <.02), but the normalized choline value was not a discriminator of tumor grade, since necrotic high-grade lesions had reduced choline values. Serial studies in one case showed an increase in choline as the glioma underwent malignant degeneration. Choline values were lower in chronic radiation necrosis than in solid anaplastic tumors (P <.001). In two cases studied before and after treatment, clinical improvement and a reduction in choline followed therapy. Lactate is more likely to be found in high-grade gliomas, but its presence is not a reliable indicator of malignancy.

Original languageEnglish
Pages (from-to)675-686
Number of pages12
Issue number3
Publication statusPublished - Dec 1992


  • Brain neoplasms, CT, 13.1211
  • Brain neoplasms, MR, 13.1214
  • Brain neoplasms, therapeutic radiology, 13.47
  • Brain, effects of irradiation on, 13.47
  • Emission CT, 13.1211
  • Magnetic resonance (MR), spectroscopy, 13.1219

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology


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