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Abstract
Introduction. High-grade gliomas (Grade 3–4 according to the WHO classification, 2021) are the most infiltrative brain tumors. The prevalence of these tumors in developed countries is approximately 5.9 cases per 100,000 population, with a mortality rate of 4.0 cases per 100,000 [1]. Despite advances in neurosurgery, chemotherapy protocols, and radiation therapy, the median survival of patients with glioblastoma remains low at approximately 14–16 months [2–5].
Aim. To conduct a pilot study assessing metabolic changes in the tumor and perifocal zone of high-grade gliomas, with the aim of incorporating proton magnetic resonance spectroscopy (¹H-MRS) data into the diagnostic protocol.
Materials and Methods. A prospective pilot study was conducted in patients with suspected glial brain tumors. The study group included men and women aged 18 to 70 years. Spectroscopy voxel positioning was performed using reference MRI images with a multivoxel spectroscopy matrix (chemical shift imaging — CSI). The region of interest was selected within this matrix.
Results. ¹H-MRS performed in 27 patients with glial tumors revealed significant metabolic changes in the tumor nodule and perifocal zone compared with intact brain tissue. Comparison of metabolic parameters between histological subtypes showed that Cho/NAA values were 35–50 % higher in IDH-wildtype glioblastomas than in IDH-mutant astrocytomas (p < 0.05).
Conclusion. This pilot study confirmed that ¹H-MRS is a highly informative technique for assessing metabolic changes in high-grade gliomas.
References
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