Τίτλος:
Characterization of peripheral nerve sheath tumors with 3T proton MR spectroscopy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
BACKGROUND AND PURPOSE: The characterization of peripheral nerve sheath tumors is challenging. The purpose here was to investigate the diagnostic value of quantitative proton MR spectroscopy at 3T for the characterization of peripheral nerve sheath tumors as benign or malignant, compared with PET. MATERIALS AND METHODS: Twenty participants with 24 peripheral nerve sheath tumors underwent MR spectroscopy by use of a point-resolved sequence (TE, 135 ms). Six voxels were placed in 4 histologically proven malignant peripheral nerve sheath tumors and 22 voxels in 20 benign peripheral nerve sheath tumors (9 histologically proven, 11 with documented stability). The presence or absence of a trimethylamine signal was evaluated, the trimethylamine concentration estimated by use of phantom replacement methodology, and the trimethylamine fraction relative to Cr measured. MR spectroscopy results for benign and malignant peripheral nerve sheath tumors were compared by use of a Mann-Whitney test, and concordance or discordance with PET findings was recorded. RESULTS: In all malignant tumors and in 9 of 18 benign peripheral nerve sheath tumors, a trimethylamine peak was detected, offering the presence of trimethylamine as a sensitive (100%), but not specific (50%), marker of malignant disease. Trimethylamine concentrations (2.2 ± 2.8 vs 6.6 ± 5.8 institutional units; P < .049) and the trimethylamine fraction (27 ± 42 vs 88 ± 22%; P < .012) were lower in benign than malignant peripheral nerve sheath tumors. A trimethylamine fraction threshold of 50% resulted in 100% sensitivity (95% CI, 58.0%-100%) and 72.2% (95% CI, 59.5%-75%) specificity for distinguishing benign from malignant disease. MR spectroscopy and PET results were concordant in 12 of 16 cases, (2 false-positive results for MR spectroscopy and PET each). CONCLUSIONS: Quantitative measurement of trimethylamine concentration by use ofMRspectroscopy is feasible in peripheral nerve sheath tumors and shows promise as a method for the differentiation of benign and malignant lesions. Trimethylamine presence within a peripheral nerve sheath tumor is a sensitive marker of malignant disease, but quantitative measurement of trimethylamine content is required to improve specificity.
Συγγραφείς:
Fayad, L.M.
Wang, X.
Blakeley, J.O.
Durand, D.J.
Jacobs, M.A.
Demehri, S.
Subhawong, T.K.
Soldatos, T.
Barker, P.B.
Περιοδικό:
AJNR - AMERICAN JOURNAL OF NEURORADIOLOGY
Εκδότης:
American Society of Neuroradiology
Λέξεις-κλειδιά:
trimethylamine; methylamine; trimethylamine; tumor marker, adolescent; adult; aged; article; benign tumor; child; clinical article; concentration (parameters); diagnostic accuracy; diagnostic value; female; human; image analysis; male; malignant neoplastic disease; malignant peripheral nerve sheath tumor; neurilemoma; neurofibroma; neurofibromatosis; nuclear magnetic resonance scanner; positron emission tomography; proton nuclear magnetic resonance; quantitative analysis; school child; sensitivity and specificity; algorithm; chemistry; clinical trial; computer assisted diagnosis; middle aged; Nerve Sheath Neoplasms; procedures; proton nuclear magnetic resonance; reproducibility; young adult; Article; benign tumor; clinical decision making; clinical feature; controlled study; diagnostic test accuracy study; false positive result; histology; malignant peripheral nerve sheath tumor; malignant transformation; nerve sheath tumor; neurilemoma; neurofibromatosis type 1; neurofibromatosis type 2; nuclear magnetic resonance imaging; nuclear magnetic resonance spectroscopy; peripheral nerve sheath tumor; peripheral nerve tumor; predictive value; radiology phantom, Adolescent; Adult; Aged; Algorithms; Child; Diagnosis, Computer-Assisted; Female; Humans; Male; Methylamines; Middle Aged; Nerve Sheath Neoplasms; Proton Magnetic Resonance Spectroscopy; Reproducibility of Results; Sensitivity and Specificity; Tumor Markers, Biological; Young Adult
