Inverse Correlation Between Choline Magnetic Resonance Spectroscopy Signal Intensity and the Apparent Diffusion

Magnetic resonance spectroscopy and diffusion magnetic reso-nance imaging (MRI) characteristics of human intracranial glioma were studied. Present knowledge suggests a hypothetical in-verse relationship between the characteristic choline signal intensity elevation and the apparent diffusion coefficient (ADC) in glioma. Twenty cases of glioma were examined with diffusion-weighted echoplanar imaging and proton magnetic resonance spectroscopic imaging (1H-MRSI). A statistically significant in-verse correlation between the choline signal intensity and the ADC was found (P 5 0.0004) in radiologically defined tumor-containing regions. This study is the first in which diffusion MRI and 1H-MRSI were used to evaluate human intracranial glioma jointly. It provides insight into how to interpret choline signal intensity elevation in terms of tumor cellularity and proliferative potential when ADC images are also available. Magn Reso