Mobile lipids and metabolic heterogeneity of brain tumours as detectable by Ex Vivo1H MR spectroscopy

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Abstract
To examine metabolic heterogeneity in primary brain tumour, multiple biopsies (one to five per tumour) from four benign meningiomas, five acoustic schwannomas, eleven glial tumours and five medulloblastomas were each subdivided into one to five samples (total = 194) and investigated using ex vivo 360 MHz 1H MR spectroscopy with histopathological correlation. Low amounts of mobile lipids were detected in meningothelial meningiomas and medulloblastomas, high amounts in some or all samples of all other tumours. The differences in non-lipid metabolites between different tumour types were less marked, with the exception of the medulloblastomas, which had high amounts of N-acetyl aspartate and cholines. The amount of mobile lipid correlated with Antoni type B areas in schwannomas and necrosis in a high grade giant cell tumour. The amount of lipid varied significantly from sample to sample in a grade 2 astrocytoma and grade 4 astrocytoma samples with 0–5% necrosis but did not correlate with the site in the tumour or histopathological characteristics. The metabolic heterogeneity occurred on a spatial scale at least as small as the size of the MR samples, i.e., ≤60 mg. These results suggest that the detection of metabolic heterogeneity and mobile lipids may have importance for the design of clinical studies.