DIFFERENTIATION OF GLIOBLASTOMA-MULTIFORME FROM ASTROCYTOMAS BY IN-VITRO H-1 MRS ANALYSIS OF HUMAN BRAIN-TUMORS

In vitro high resolution H-1 NMR spectroscopy allows non-invasive meta bolic evaluation of specimens derived form surgically biopsed or resec ted brain tumors, with the aim of identifying potential markers of dif ferent malignancy grading, and improving diagnostic and therapeutic st rategies. In the present study we evaluated 36 patients affected by di fferent brain gliomas (7 well differentiated astrocytomas, 7 anaplasti c astrocytomas, 16 glioblastomas, 6 oligodendrogliomas). These analyse s allowed discrimination between well differentiated and anaplastic as trocytomas (ALL + AA) and glioblastoma multiforme (FM) samples on the basis of the ratio between the integrated choline-containing resonance (b''Cho'') and the creatine peaks (creatine (Cr) + Phosphocreatine (P Cr)). While no definite difference was found between AII and AA, signi ficantly higher values were observed for this ratio in GM. Other signa ls, derived from different metabolites, auch as Glycine (Gly) and N-ac etyl-aspartate (NAA), may also assume relevance in different tumor dia gnosis. In this study an increased [Gly]/[Cr+PCr] ratio was observed i n our tumor specimens may be explained on the basis of tumor cell infi ltration into brain adjacent tissue. Interesting, but inconclusive, ar e the data concerning oligodendrogliomas, which, also in well differen tiated forms, exhibit increased levels of b''Cho''/(Cr+PCr) ratio. The present study confims the role of MRS in the biochemical characteriza tion of neoplastic brain tissue and its potential contribution to a be tter selection of multidisciplinary treatment strategies.