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MR spectroscopy features of normal appearing white matter in patients with lung cancer

Adil Dogan, Ahmet Sigirci, Hilal Ermis, Zeynep Ayfer Aytemur, Tamer Baysal, Alpay Alkan, Saim Yologlu

Context: Spectroscopic imaging can be helpful to identify metabolite changes in a normal appearing brain parenchyma after MR imaging in patients with lung cancer. Aims: To detect metabolic changes in the cerebellar and cerebral normal appearing white matter with single-voxel H-MR spectroscopy (MRS) in patients with lung cancer.

Methods and material: MRS was performed in the Cerebellar White Matter (CWM) and Parietal White Matter (PWM) of patients with lung cancer (n=38; age range: 44-82 y; mean age: 66.1 ± 8.7) and an agematched control group (n=32; age range: 42-80 y; mean age: 62.9 ± 8). Biopsies of lung masses showed 25 Non-Small Cell Lung Cancer (NSCLC) and 13 Small Cell Lung Cancer (SCLC). NAA/Cr, NAA/Cho and Cho/Cr ratios were calculated. Statistical analysis used: The unpaired-t test was used for the assessment of metabolite ratio differences between patients and control subjects. Mann-Whitney U test was used among SCLC, NSCLC, and control group for the evaluation of metabolite ratio differences.

Results: The Cho/Cr ratios in the CWM were significantly lower in the patients compared to controls (p=0.03). The Cho/Cr ratio of patients with SCLC was significantly lower in PWM than both NSCLC (p=0.02) and control group (p=0.03).

Conclusion: Decreased Cho/Cr ratio possibly represents increased uptake of Cho or reduced brain function. These results may be important in assessing patients with lung cancer in order to help with treatment planning and prognosis.