phosphocreatine and Adenoma

Of primary central nervous system tumors treated each year, the majority are glioma, followed by meningioma and then pituitary adenoma. While the use of magnetic resonance (MR) and computed tomographic imaging is well established in the diagnosis and management of such tumors, these techniques have a limited role in determining the metabolic state, either prior to or following therapy. Multinuclear MR spectroscopy, on the other hand, provides information on tumor metabolism and the effect of therapy on tumor viability. This paper reviews MR spectroscopic studies performed on patients with central nervous system tumors and discusses the impact that such studies have had on tumor diagnosis and management.

Topics: Adenoma; Adenosine Triphosphate; Adolescent; Adult; Aged; Blood Chemical Analysis; Brain Chemistry; Brain Neoplasms; Child; Child, Preschool; Energy Metabolism; Female; Glioma; Humans; Hydrogen-Ion Concentration; Incidence; Infant; Magnetic Resonance Spectroscopy; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Phosphocreatine; Phospholipids; Pituitary Neoplasms

In a prospective study, proton (1H) and phosphorus (31P) nuclear magnetic resonance spectroscopy were used to search for effects of brain tumor radiotherapy on normal human central nervous system. Phosphorus spectroscopy data at 1.5 T seems to suggest that any radiation induced damage that may occur as a result of therapeutic brain irradiation, does not alter the relative concentrations of phosphorus metabolites or the intracellular pH beyond the limits of normal variation (approximately +/- 20%). Proton spectroscopy, on the other hand, detects post radiation changes in the ratios of certain nuclear magnetic resonance visible metabolites following radiotherapy, particularly choline/N-acetylaspartate, and especially in regions of brain receiving high doses of radiation. Such changes may be indicative of the release of membrane bound choline during radiation induced demyelination of brain. Of interest, we have found elevated metabolite ratios of 31P in normal central nervous system prior to radiotherapy, which persisted throughout the time span of the study in both the ipsilateral and contralateral cerebral hemispheres.

Topics: Adenoma; Adenosine Triphosphate; Brain; Brain Neoplasms; Energy Metabolism; Glioma; Humans; Hydrogen; Magnetic Resonance Spectroscopy; Oligodendroglioma; Phosphates; Phosphocreatine; Phosphorus; Pituitary Neoplasms; Prospective Studies; Reference Values