YES, WE CAN Monitor the Growth of Gliomas by NIRS

In near future, it might become possible to monitor by NIRS the therapeutic effect of anti-PAK1 drugs such as Bio 30 in glioma and NF patients.


Intra-operative characterization of gliomas by near-infrared spectroscopy
(NIRS): possible association with prognosis.

Asgari S, R・rborn HJ, Engelhorn T, Stolke D. (2003)

Department of Neurosurgery, University Hospital, Essen, Germany. siamek.asgari@uni-
essen.de

BACKGROUND: Growth and expansion of gliomas are highly dependent on vascular
neogenesis. An association of microvascular density and tumour energy metabolism
is assumed in most human gliomas. The purpose of this investigation was
to characterize a series of gliomas by intra-operative NIRS, and to elucidate
the relationship between microvascular blood volume (BV), oxygen saturation
(SaO(2)), histology and patient survival.

METHOD: The study included 13 patients with gliomas, in whom complete tumour
resection according to postoperative MRI criteria was achieved. Intra-operatively,
one low grade astrocytoma, five anaplastic astrocytomas and seven glioblastomas
with the ipsilateral cortex were investigated by NIRS revealing capillary
BV (total haemoglobin) and SaO(2). Intratumoural BV (tBV) and SaO(2) (tSaO(2)
) were additionally used in relation to histology and survival.

FINDINGS: The mean tBV of the astrocytomas was 4.96 mg/ml compared to 18.40
mg/ml in the glioblastoma group. Mean tSaO(2) was 36% in the astrocytoma
group and 52% in the glioblastomas, respectively. Both tBV and tSaO(2) were
significantly higher (p<0.01) in the glioblastoma group.

Median survival time was shortest for patients with glioblastoma (12.5 months)
, with tBV >10/mg/ml (10 months), and tSaO(2) >50% (10 months). Longest
median survival times were observed in the astrocytoma group (32.5 months),
in patients with Tbv <10/mg/ml (30 months), and tSaO(2) <50% (27.5 months).
The differences were highly significant (p<0.01).

INTERPRETATION: Intra-operative characterization of gliomas by NIRS is feasible.
High tBV represents extensive angiogenetic activity of the tumour, whereas
high tSaO(2) may be result of non-oxidative glucose metabolism with less
oxygen extraction from the capillary bed of the tumour. However, the extent
of tBV and tSaO(2) are both of possible prognostic value thus resulting
in additional information about the tumour.