Proton spectroscopy of suprasellar tumors in pediatric patients

Leslie N. Sutton, Zhiyue J. Wang, Suzanne L. Wehrli, Sunil Marwaha, Patricia Molloy, Peter C. Phillips, Robert A. Zimmerman

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: Magnetic resonance imaging and computed tomography provide good anatomic detail of suprasellar tumors in pediatric patients but are not able to predict histology in many cases. Proton magnetic resonance spectroscopy provides metabolic data that may add to diagnostic specificity. We preoperatively performed localized proton magnetic resonance spectroscopy on pediatric patients with suprasellar tumors and correlated the results with the histological findings. Cyst fluid obtained from patients with craniopharyngiomas was studied with high-resolution magnetic resonance spectroscopy to better understand the in vivo data. METHODS: Nineteen patients aged 1 to 21 years underwent spectroscopy. Surgical pathological samples were obtained from 14 patients. In each of five patients, the presence of a solid chiasmatic mass in addition to clinical evidence of neurofibromatosis Type I allowed the presumptive diagnosis of chiasmatic astrocytoma. Thus, the study population included 6 patients with craniopharyngiomas, 10 with chiasmatic/hypothalamic astrocytomas, and 3 with pituitary adenomas. The data obtained were compared with those of healthy brain from age-matched participants. RESULTS: Spectroscopy was specific for the diagnosis. All craniopharyngiomas showed a dominant peak at 1 to 2 ppm, consistent with lactate or lipids, with trace amounts of other metabolites. This was confirmed using high-resolution spectroscopy. Chiasmatic gliomas showed a profile of choline, N-acetylaspartate, and creatine, and the choline:N-acetylaspartate ratio was 2.6 ± 1.3, compared with 0.7 ± 0.3 for samples of healthy brain (t test, P = 0.0003). Pituitary adenomas showed only a choline peak or no metabolites at all. CONCLUSION: Proton spectroscopy may be helpful in supplementing standard imaging for the preoperative diagnosis of three types of suprasellar tumors that are common in pediatric patients.

Original languageEnglish (US)
Pages (from-to)388-395
Number of pages8
JournalNeurosurgery
Volume41
Issue number2
DOIs
StatePublished - Aug 1997

Fingerprint

Protons
Spectrum Analysis
Pediatrics
Craniopharyngioma
Neoplasms
Choline
Astrocytoma
Pituitary Neoplasms
Cyst Fluid
Neurofibromatosis 1
Creatine
Brain
Glioma
Lactic Acid
Histology
Magnetic Resonance Spectroscopy
Tomography
Magnetic Resonance Imaging
Lipids
Population

Keywords

  • Brain Tumor
  • Craniopharyngioma
  • Pituitary
  • Sellar
  • Spectroscopy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Sutton, L. N., Wang, Z. J., Wehrli, S. L., Marwaha, S., Molloy, P., Phillips, P. C., & Zimmerman, R. A. (1997). Proton spectroscopy of suprasellar tumors in pediatric patients. Neurosurgery, 41(2), 388-395. https://doi.org/10.1097/00006123-199708000-00009

Proton spectroscopy of suprasellar tumors in pediatric patients. / Sutton, Leslie N.; Wang, Zhiyue J.; Wehrli, Suzanne L.; Marwaha, Sunil; Molloy, Patricia; Phillips, Peter C.; Zimmerman, Robert A.

In: Neurosurgery, Vol. 41, No. 2, 08.1997, p. 388-395.

Research output: Contribution to journalArticle

Sutton, LN, Wang, ZJ, Wehrli, SL, Marwaha, S, Molloy, P, Phillips, PC & Zimmerman, RA 1997, 'Proton spectroscopy of suprasellar tumors in pediatric patients', Neurosurgery, vol. 41, no. 2, pp. 388-395. https://doi.org/10.1097/00006123-199708000-00009
Sutton LN, Wang ZJ, Wehrli SL, Marwaha S, Molloy P, Phillips PC et al. Proton spectroscopy of suprasellar tumors in pediatric patients. Neurosurgery. 1997 Aug;41(2):388-395. https://doi.org/10.1097/00006123-199708000-00009
Sutton, Leslie N. ; Wang, Zhiyue J. ; Wehrli, Suzanne L. ; Marwaha, Sunil ; Molloy, Patricia ; Phillips, Peter C. ; Zimmerman, Robert A. / Proton spectroscopy of suprasellar tumors in pediatric patients. In: Neurosurgery. 1997 ; Vol. 41, No. 2. pp. 388-395.
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