Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery

Background/Aim. High-grade glioma (HGG) is an interstitial cell-derived primary tumor of the nervous system. The current guidelines for the diagnosis and treatment of glioma recommend the maximum safe range of tumor resection for treatment methods. Adjuvant concurrent chemoradiotherapy is recommende...

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Main Authors: Gao Yu, Yan Wen-Ming, Wang Hong-Wei, Li Xin-Hong, Zhang Ru-Tao, Dong Yu-Bo, Zhang Wei-Han, Guo Qi-Wei
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2024-01-01
Series:Vojnosanitetski Pregled
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Online Access:https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400041G.pdf
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author Gao Yu
Yan Wen-Ming
Wang Hong-Wei
Li Xin-Hong
Zhang Ru-Tao
Dong Yu-Bo
Zhang Wei-Han
Guo Qi-Wei
author_facet Gao Yu
Yan Wen-Ming
Wang Hong-Wei
Li Xin-Hong
Zhang Ru-Tao
Dong Yu-Bo
Zhang Wei-Han
Guo Qi-Wei
author_sort Gao Yu
collection DOAJ
description Background/Aim. High-grade glioma (HGG) is an interstitial cell-derived primary tumor of the nervous system. The current guidelines for the diagnosis and treatment of glioma recommend the maximum safe range of tumor resection for treatment methods. Adjuvant concurrent chemoradiotherapy is recommended after surgery, followed by six cycles of single-drug chemotherapy, temozolomide. Evaluation of the early efficacy of concurrent chemoradio-therapy after HGG surgery, especially for patients with a high risk of recurrence, is a crucial step in enhancing the treatment efficiency for patients diagnosed with HGG. In this study, we investigated the clinical utility of magnetic resonance (MR) spectroscopy (MRS) in assessing the early curing impact of concurrent chemoradiotherapy following HGG surgery. Methods. A total of 50 patients with incomplete resection or suspected residual postoperative HGG, treated in the radiotherapy department of our hospital between January 2016 and June 2021, were selected for routine concurrent chemoradiotherapy. Conventional MR imaging and MRS were performed one week prior to treatment and one month after treatment to assess changes in specific brain metabolites. All 50 patients were followed up for 6 to 12 months. Based on the follow-up results, the patients were divided into two groups: the tumor recurrence group and the tumor suppression group. One month after the end of the treatment, the differences in levels of brain metabolites between the two groups were analyzed using MRS. Results. The levels of N-acetylaspartate (NAA) and creatine (Cr) increased after radiotherapy, while choline (Cho) peak value, and Cho/Cr, NAA/Cr, and Cho/NAA ratios decreased compared to pre-treatment levels. There were statistically significant differences in the NAA peak value, and Cho/Cr, and Cho/NAA ratios in the tumor enhancement area before and after treatment (p < 0.05). There were also statistically significant differences in Cho/Cr ratio in the peritumoral edema area before and after treatment (p < 0.05). Conclusion. After concurrent chemoradiotherapy, MRS can be used to detect early metabolic changes in the tumor enhancement and peritumoral edema areas of HGG.
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spelling doaj-art-bf05624566d84846a2ecd3f53ab47ff22025-08-20T03:24:44ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202024-01-0181740741310.2298/VSP240109041G0042-84502400041GClinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgeryGao Yu0Yan Wen-Ming1Wang Hong-Wei2Li Xin-Hong3Zhang Ru-Tao4Dong Yu-Bo5Zhang Wei-Han6Guo Qi-Wei7The Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaThe Affiliated Hospital of Inner Mongolia Medical University, Department of Radiotherapy, Hohhot, ChinaTogtoh County Hospital, Department of Radiotherapy, Hohhot, ChinaBackground/Aim. High-grade glioma (HGG) is an interstitial cell-derived primary tumor of the nervous system. The current guidelines for the diagnosis and treatment of glioma recommend the maximum safe range of tumor resection for treatment methods. Adjuvant concurrent chemoradiotherapy is recommended after surgery, followed by six cycles of single-drug chemotherapy, temozolomide. Evaluation of the early efficacy of concurrent chemoradio-therapy after HGG surgery, especially for patients with a high risk of recurrence, is a crucial step in enhancing the treatment efficiency for patients diagnosed with HGG. In this study, we investigated the clinical utility of magnetic resonance (MR) spectroscopy (MRS) in assessing the early curing impact of concurrent chemoradiotherapy following HGG surgery. Methods. A total of 50 patients with incomplete resection or suspected residual postoperative HGG, treated in the radiotherapy department of our hospital between January 2016 and June 2021, were selected for routine concurrent chemoradiotherapy. Conventional MR imaging and MRS were performed one week prior to treatment and one month after treatment to assess changes in specific brain metabolites. All 50 patients were followed up for 6 to 12 months. Based on the follow-up results, the patients were divided into two groups: the tumor recurrence group and the tumor suppression group. One month after the end of the treatment, the differences in levels of brain metabolites between the two groups were analyzed using MRS. Results. The levels of N-acetylaspartate (NAA) and creatine (Cr) increased after radiotherapy, while choline (Cho) peak value, and Cho/Cr, NAA/Cr, and Cho/NAA ratios decreased compared to pre-treatment levels. There were statistically significant differences in the NAA peak value, and Cho/Cr, and Cho/NAA ratios in the tumor enhancement area before and after treatment (p < 0.05). There were also statistically significant differences in Cho/Cr ratio in the peritumoral edema area before and after treatment (p < 0.05). Conclusion. After concurrent chemoradiotherapy, MRS can be used to detect early metabolic changes in the tumor enhancement and peritumoral edema areas of HGG.https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400041G.pdfbiomarkerschemoradiotherapychemotherapyadjuvantgliomamagnetic resonance spectroscopyprognosissurgery
spellingShingle Gao Yu
Yan Wen-Ming
Wang Hong-Wei
Li Xin-Hong
Zhang Ru-Tao
Dong Yu-Bo
Zhang Wei-Han
Guo Qi-Wei
Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
Vojnosanitetski Pregled
biomarkers
chemoradiotherapy
chemotherapy
adjuvant
glioma
magnetic resonance spectroscopy
prognosis
surgery
title Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
title_full Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
title_fullStr Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
title_full_unstemmed Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
title_short Clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high-grade glioma surgery
title_sort clinical value of magnetic resonance spectroscopy in assessment of early curing impact of concurrent chemoradiotherapy after high grade glioma surgery
topic biomarkers
chemoradiotherapy
chemotherapy
adjuvant
glioma
magnetic resonance spectroscopy
prognosis
surgery
url https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400041G.pdf
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