Cranial ımaging findings in patients with normal lung carcinoma and early post-cranial magnetic resonance spectroscopy findings in 3 months

The aim of our study was to determine the differences in the metabolite ratios ofnormal appearing white matter between lung cancer patients who investigated at thebeginning and after 3 months of the diagnosis, without parenchymal metastatic lesions,and healthy normals with magnetic resonance spectroscopy (MRS).A total of 41consecutive patients (39 males, 2 females) having diagnosis of lungcancer were referred to deparment of radiology from department of chest medicine forimaging with computed tomography (CT) of lung and magnetic resonance imaging(MRI) of brain between September 2010 and June 2011. During study 6 patients weredied and other 6 were not participated to follow up scans. As a result, 29 patients (27males, 2 females, age range: 44-80 years, mean age: 65.8 ± 9.4) and 32 healthyvolunteers (29 males, 3 females, age range: 42-80 years, mean age: 62.8 ± 8.0) wereincluded in our study. MRI was performed on a 1.5 Tesla system (Gyroscan InteraMaster, Philips Medical Systems, Best, Netherlands). Axial T1 and T2, coronal FLAIRimages for brain were acquired. The patients having the diagnosis of lung cancerwithout cranial metastasis were imagined with single voxel MRS from the leftcerebellar and parietooccipital white matter. MRS was performed at the beginning andafter 3 months of the lung cancer diagnosis. Single voxel MRS was evaluated by using apoint-resolved spectroscopy sequence (PRESS) (TR: 2000/TE:136 ms) with 128averages; voxel sizes of 17x17x17 mm were used. Voxels were placed in the leftcerebellar and parietooccipital white matter. Peak area metabolite ratios of Nacetylaspartate(NAA)/ Creatinine (Cr), NAA/ Choline (Cho) and Cho/Cr werecalculated and compared between patients and healthy normalsThere were no significant differences between control group and patients at 3 months ofthe lung cancer and between patients at the beginning and after 3 months of thediagnosis in NAA/Cr, NAA/Cho and Cho/Cr ratios obtained from left cerebellar andparietooccipital white matters. There were also no significant differences betweenpatients at the beginning of the diagnosis and control groups in aferomentionedmetabolites obtained from mentioned white matters except the Cho/Cr ratio wassignificantly different obtained from cerebellar white matter (p=0.09).As a result, we have not found metabolic changes in the normal appearing whitematter of lung cancer patients during 3 months after diagnosis. These findings couldindicate no neuronal damage and affected metabolism of cell membrane.