MRS of pilocytic astrocytoma: The peak at 2 ppm may not be NAA

Magn Reson Med. 2017 Aug;78(2):452-456. doi: 10.1002/mrm.26374. Epub 2016 Aug 16.

Abstract

Purpose: To determine whether the chemical shift of residual N-acetylaspartate (NAA) signal in pilocytic astrocytomas (PA) is consistent with the position of the NAA peak in controls.

Methods: MR spectra from 27 pediatric World Health Organization (WHO) grade I pilocytic astrocytoma patients, fifteen patients with WHO grade II and high-grade (III-IV) astrocytomas, and 36 controls were analyzed. All spectra were acquired with a short echo time (35 ms), single voxel point-resolved spectroscopy sequence on clinical 3 tesla scanners. Fully automated LCModel software was used for processing, which included the fitting of peak positions for NAA and creatine (Cr).

Results: The chemical shift difference between the NAA and Cr peaks was significantly smaller (by 0.016 ± 0.005 parts per million, P < 1e-10) in PAs than in controls and was also smaller than what was observed in infiltrative astrocytomas.

Conclusion: The chemical shift position of the residual NAA peak in PAs is not consistent with NAA. The signal likely originates from an N-acetyl group of one or more other chemicals such as N-acetylated sugars. Magn Reson Med 78:452-456, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Keywords: MR spectroscopy; N-acetylaspartate; Pilocytic astrocytoma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / analysis
  • Aspartic Acid / chemistry
  • Aspartic Acid / metabolism
  • Astrocytoma / diagnostic imaging*
  • Brain / diagnostic imaging*
  • Brain Neoplasms / diagnostic imaging*
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Magnetic Resonance Imaging / methods*

Substances

  • Aspartic Acid
  • N-acetylaspartate