Glutamine/Glutamate Metabolism Studied with Magnetic Resonance Spectroscopic Imaging for the Characterization of Adrenal Nodules and Masses

Glutamine/Glutamate Metabolism Studied with Magnetic Resonance Spectroscopic Imaging for the Characterization of Adrenal Nodules and Masses

Author Goldman, Suzan M. Autor UNIFESP Google Scholar
Nunes, Thiago F. Autor UNIFESP Google Scholar
Melo, Homero J. F. Autor UNIFESP Google Scholar
Dalavia, Claudio Autor UNIFESP Google Scholar
Szejnfeld, Denis Autor UNIFESP Google Scholar
Kater, Claudio Autor UNIFESP Google Scholar
Andreoni, Cassio Autor UNIFESP Google Scholar
Szejnfeld, Jacob Autor UNIFESP Google Scholar
Ajzen, Sergio A. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose. To assess glutamine/glutamate (Glx) and lactate (Lac) metabolism using proton magnetic resonance spectroscopic imaging (1H-MRS) in order to differentiate between adrenal gland nodules and masses (adenomas, pheochromocytomas, carcinomas, and metastases). Materials and Methods. Institutional review board approval and informed consent were obtained. A total of 130 patients (47 men) with 132 adrenal nodules/masses were prospectively assessed (54 +/- 14.8 years). A multivoxel system was used with a two-dimensional point-resolved spectroscopy/chemical-shift imaging sequence. Spectroscopic data were interpreted by visual inspection and peak amplitudes of lipids (Lip), choline (Cho), creatine (Cr), Lac, and Glx. Lac/Cr and Glx/Cr were calculated. Glx/Cr was assessed in relation to lesion size. Results. Statistically significant differences were observed in Glx/Cr results between adenomas and pheochromocytomas (P < 0.05), however, with a low positive predictive value (PPV). Glx levels were directly proportional to lesion size in carcinomas. A cutoff point of 1.44 was established for the differentiation between carcinomas larger versus smaller than 4 cm, with 75% sensitivity, 100% specificity, 100% PPV, and 80% accuracy. Lac/Cr results showed no differences across lesions. A cutoff point of -6.5 for Lac/Cr was established for carcinoma diagnosis. Conclusion. Glx levels are directly proportional to lesion size in carcinomas. A cutoff point of -6.5 Lac/Cr differentiates carcinomas from noncarcinomas.
Language English
Date 2013-01-01
Published in Biomed Research International. New York: Hindawi Publishing Corporation, 9 p., 2013.
ISSN 2314-6133 (Sherpa/Romeo, impact factor)
Publisher Hindawi Publishing Corporation
Extent 9
Origin http://dx.doi.org/10.1155/2013/835385
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000325657500001
URI http://repositorio.unifesp.br/handle/11600/35709

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