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. 2018 Mar 29;5:20. doi: 10.3389/fnut.2018.00020

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Copyright © 2018 Elsakka, Bary, Abdelzaher, Elnaggar, Kalamian, Mukherjee and Seyfried.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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(A) Comparison between tumor metabolism over 20 months. Choline indicates cell membrane turnover and reflects tumorigenesis. N-acetylaspartate (NAA) is a marker for neuronal integrity that decreases with brain malignancy and radio necrosis. Creatine is a marker for cellular energy that decreases significantly with malignancy and radio necrosis. Hunter angle (blue arrow) reflects the choline/NAA ratio. (B) Comparison between tumor size and midline shift (red line) over 20 months.