Spectroscopic Characterization of Gliosarcomas—Do They Differ From Glioblastomas and Metastases?

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Abstract

Objective

To evaluate the spectroscopic pattern of gliosarcomas for differentiation from glioblastomas or metastases.

Methods

1H-nuclear magnetic resonance (NMR) spectroscopic intermediate echo time data of 5 patients with histologically proven gliosarcomas were compared with data of 17 metastases and 54 glioblastomas. Specialized 1H-NMR spectroscopy analysis software was used offline. Lipid and macromolecular resonances between 0.9 ppm and 1.4 ppm were compared besides the main metabolites using the Mann-Whitney U test.

Results

Gliosarcomas showed higher lipid and macromolecule resonances and a higher lipid-choline ratio compared with glioblastomas (P < 0.024 and P < 0.036). Glioblastomas showed higher creatine concentrations compared with metastases (P < 0.007) but not compared with gliosarcomas. We found no significant differences between metastases and gliosarcomas.

Conclusions

Gliosarcomas may mimic metastases on 1H NMR spectroscopy showing high signal intensities from lipid and macromolecule resonances. This tumor type should be suspected if conventional imaging suggests an intra-axial brain neoplasm in combination with high lipids in solid tumor parts.

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