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Metabolic Changes in Cerebral Gliomas Within Hours of Treatment With Intra-Arterial BCNU Demonstrated by Phosphorus Magnetic Resonance Spectroscopy

Published online by Cambridge University Press:  18 September 2015

Douglas L. Arnold ,
Eric A. Shoubridge ,
William Feindel  and
Jean-Guy Villemure
Douglas L. Arnold*
Affiliation:
Montreal Neurological Institute and Hospital, and the Department of Neurology and Neurosurgery, McGill University, Montreal
Eric A. Shoubridge
Affiliation:
Montreal Neurological Institute and Hospital, and the Department of Neurology and Neurosurgery, McGill University, Montreal
William Feindel
Affiliation:
Montreal Neurological Institute and Hospital, and the Department of Neurology and Neurosurgery, McGill University, Montreal
Jean-Guy Villemure*
Affiliation:
Montreal Neurological Institute and Hospital, and the Department of Neurology and Neurosurgery, McGill University, Montreal
*
Montreal Neurological Institute, 3801 University Street, 3B - Webster Pavilion, Montreal, Quebec, Canada H3A 2B4
Montreal Neurological Institute, 3801 University Street, 3B - Webster Pavilion, Montreal, Quebec, Canada H3A 2B4
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Abstract:

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A 40-year-old female with a recurrent mixed astrocytoma/oligodendroglioma was treated with intraarterial BCNU at six week intervals. Phosphorus magnetic resonance spectroscopy was performed before, and on two occasions after her third treatment.

Before treatment, phosphodiesters were 25% less than normal and intracellular pH was 7.14 (normal 6.97 ± 0.02). Eight hours following treatment phosphocreatine and phosphodiesters were reduced by ∼40% and pHi increased to 7.24. Thirty-two hours after treatment, phosphocreatine and phosphodiesters had reversed their decline, but pHi had increased further to 7.35. MRI and x-ray CT scans did not show any change during this period.

This study demonstrates that chemical changes can be observed in a glioma by magnetic resonance spectroscopy shortly after chemotherapy in a clinical setting and before changes are observable by imaging modalities. This approach evidently offers a possible means of monitoring the acute metabolic response of tumours to chemotherapy or other forms of treatment by a non-invasive repeatable quantitative method.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 14 , Issue 4 , November 1987 , pp. 570 - 575
Copyright
Copyright © Canadian Neurological Sciences Federation 1987

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