622 / 1311
Spectroscopy
[ppm]
4.0 3.0 2.0 1.0
[ppm]
4.0 3.0 2.0 1.0
[ppm]
4.0 3.0 2.0 1.0
[ppm]
4.0 3.0 2.0 1.0
Lactate
Lipids
Cho
Cho Cr
NAA
1
H SI
Spectroscopic imaging
•
Glioma
Progression
Radionecrosis
Lipids
NAA
Cho
Lipids
NAA
Schlemmer et al. AJNR 2001
MR Spectroscopy
Pseudoreponse
RANO* Response criteria in CNS tumors
Criterion
CR
PR
SD
PD
T1 Gd-enhancing
disease
None
≥50% decrease <50% decrease
but <25%
increase
≥25% incrase
T2/FLAIR lesion Stable or
decreased
Stable or
decreased
Stable or
decreased
Increased
New lesion
None
None
None
Present
Corticosteroids
needed
None
Stable or less
Stable or less
N/Aor more
Clinical status Stable or
improved
Stable or
improved
Stable or
improved
Deteriorated
Requirement for
response
All
All
All
Any
Wen PN et al. JCO 28:1963-1972 (2010)
* RANO = Response assessment in neuro-oncology
Grosu et al. Strahlenther Onkol 2005
PET and PET/CT
•
Grading: Characterization by different
tracers
–
11C-methionine (MET),
–
18F-fluoroethyl-L-tyrosine (FET)