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A new approach for analyzing proton magnetic resonance spectroscopic images of brain tumors: nosologic images

Nature Medicine volume 6, pages 1287–1289 (2000)Cite this article

The histopathological characterization of brain tumors requires the use of biopsy, which is an invasive surgical procedure. However, a biopsy does not always show the real grade of the tumor because of tumor heterogeneity. Many studies have been done to assess the utility of in vivo proton magnetic resonance spectroscopic imaging (1H MRSI) in noninvasive diagnosis of brain tumors1,2,3,4,5,6,7,8,9,10,11,12,13. The earliest studies2,3,4,5,8 used single-voxel spectroscopy (acquisition of a spectrum for one volume of interest inside the tumor) and classification into histopathological groups based on the study of peak ratios. More recently, pattern recognition techniques have been used to improve the classification of the different brain tumor types6,7,9,10,12,13. These techniques allow an automatic classification of spectra based on an analysis of the whole spectrum after digitization or of a profile extracted from selected peak intensities14,15. Promising results have been obtained, with accuracy rates of 55–100%. However, individual variability, mainly due to the heterogeneity of the tissue within a voxel, results in a substantial overlap between different brain tumor types2 and between high- and low-grade glial tumors8.

Here we present a new approach for extracting information about brain tumor types and grades from 1H MRSI data. We sought to design a tool that could be used routinely and easily by radiologists for assessing the potential of 1H MRSI for brain tumor diagnosis, studying heterogeneity, stereotactic biopsy guidance and therapy follow-up. Each voxel of a spectroscopic image was assigned to a histopathological class. The spectroscopic data were then summarized in a single image in which each pixel was colored according to the assigned histopathological class. The image obtained was called a 'nosologic image'.

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Figure 1: 1H MR spectroscopic imaging information.
Figure 2: Anatomic T2-weighted MRI for 15 patients and overlay of the nosologic images corresponding to the areas within the rectangles outlined in red and the morphologic images.

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Acknowledgements

We thank B. Pasquier and D. Hoffmann for their help in this study, and D. Downes and J. Coles for their advice on the manuscript. This work was supported by the Ministère de la Santé 1993.

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Authors and Affiliations

  1. Unité mixte INSERM-Université Joseph Fourier, U438, LRC CEA, CHU de Grenoble, 38043 Grenoble Cedex 9, BP 217, France

    Fabien Szabo De Edelenyi, Christophe Rubin, François Estève, Sylvie Grand, Michel Décorps, Jean-François Le Bas & Chantal Rémy

  2. Unité IRM, Centre Hospitalier Universitaire de Grenoble, 38043 Grenoble Cedex 9, BP 217, France

    Fabien Szabo De Edelenyi, François Estève, Sylvie Grand & Jean-François Le Bas

  3. Service de Neuroradiologie, Centre Hospitalier Universitaire de Grenoble, 38043 Grenoble Cedex 9, BP 217, France

    Virgine Lefournier

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  1. Fabien Szabo De Edelenyi
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De Edelenyi, F., Rubin, C., Estève, F. et al. A new approach for analyzing proton magnetic resonance spectroscopic images of brain tumors: nosologic images. Nat Med 6, 1287–1289 (2000). https://doi.org/10.1038/81401

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