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<meta name="DC.Title" content="Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6287" />
<meta name="DC.Date" content="2019-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Ketogenic diets are being explored as a possible treatment for several neurological diseases, but the physiologic impact on the brain is unknown. The objective of this study was to evaluate the feasibility of 3T MR spectroscopy to monitor brain ketone levels in patients with high-grade gliomas who were on a ketogenic diet (a modified Atkins diet) for 8 weeks.

MATERIALS AND METHODS: Paired pre- and post-ketogenic diet MR spectroscopy data from both the lesion and contralateral hemisphere were analyzed using LCModel software in 10 patients.

RESULTS: At baseline, the ketone bodies acetone and β-hydroxybutyrate were nearly undetectable, but by week 8, they increased in the lesion for both acetone (0.06 ± 0.03 ≥ 0.27 ± 0.06 IU, P = .005) and β-hydroxybutyrate (0.07 ± 0.07 ≥ 0.79 ± 0.32 IU, P = .046). In the contralateral brain, acetone was also significantly increased (0.041 ± 0.01 ≥ 0.16 ± 0.04 IU, P = .004), but not β-hydroxybutyrate. Acetone was detected in 9/10 patients at week 8, and β-hydroxybutyrate, in 5/10. Acetone concentrations in the contralateral brain correlated strongly with higher urine ketones ( r = 0.87, P = .001) and lower fasting glucose ( r = –0.67, P = .03). Acetoacetate was largely undetectable. Small-but-statistically significant decreases in NAA were also observed in the contralateral hemisphere at 8 weeks.

CONCLUSIONS: This study suggests that 3T MR spectroscopy is feasible for detecting small cerebral metabolic changes associated with a ketogenic diet, provided that appropriate methodology is used.

AcAc
:   acetoacetate
Ace
:   acetone
bHB
:   β-hydroxybutyrate
IU
:   institutional units
Lac
:   lactate
KD
:   ketogenic diet
WHO
:   World Health Organization" />
<meta name="DC.Contributor" content="A. Berrington" />
<meta name="DC.Contributor" content="K.C. Schreck" />
<meta name="DC.Contributor" content="B.J. Barron" />
<meta name="DC.Contributor" content="L. Blair" />
<meta name="DC.Contributor" content="D.D.M. Lin" />
<meta name="DC.Contributor" content="A.L. Hartman" />
<meta name="DC.Contributor" content="E. Kossoff" />
<meta name="DC.Contributor" content="L. Easter" />
<meta name="DC.Contributor" content="C.T. Whitlow" />
<meta name="DC.Contributor" content="Y. Jung" />
<meta name="DC.Contributor" content="F.-C. Hsu" />
<meta name="DC.Contributor" content="M.C. Cervenka" />
<meta name="DC.Contributor" content="J.O. Blakeley" />
<meta name="DC.Contributor" content="P.B. Barker" />
<meta name="DC.Contributor" content="R.E. Strowd" />
<meta name="article:published_time" content="2019-11-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Ketogenic diets are being explored as a possible treatment for several neurological diseases, but the physiologic impact on the brain is unknown. The objective of this study was to evaluate the feasibility of 3T MR spectroscopy to monitor brain ketone levels in patients with high-grade gliomas who were on a ketogenic diet (a modified Atkins diet) for 8 weeks.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Paired pre- and post-ketogenic diet MR spectroscopy data from both the lesion and contralateral hemisphere were analyzed using LCModel software in 10 patients.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;At baseline, the ketone bodies acetone and β-hydroxybutyrate were nearly undetectable, but by week 8, they increased in the lesion for both acetone (0.06 ± 0.03 ≥ 0.27 ± 0.06 IU, &lt;i&gt;P&lt;/i&gt; = .005) and β-hydroxybutyrate (0.07 ± 0.07 ≥ 0.79 ± 0.32 IU, &lt;i&gt;P&lt;/i&gt; = .046). In the contralateral brain, acetone was also significantly increased (0.041 ± 0.01 ≥ 0.16 ± 0.04 IU, &lt;i&gt;P&lt;/i&gt; = .004), but not β-hydroxybutyrate. Acetone was detected in 9/10 patients at week 8, and β-hydroxybutyrate, in 5/10. Acetone concentrations in the contralateral brain correlated strongly with higher urine ketones (&lt;i&gt;r&lt;/i&gt; = 0.87, &lt;i&gt;P&lt;/i&gt; = .001) and lower fasting glucose (&lt;i&gt;r&lt;/i&gt; = –0.67, &lt;i&gt;P&lt;/i&gt; = .03). Acetoacetate was largely undetectable. Small-but-statistically significant decreases in NAA were also observed in the contralateral hemisphere at 8 weeks.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;This study suggests that 3T MR spectroscopy is feasible for detecting small cerebral metabolic changes associated with a ketogenic diet, provided that appropriate methodology is used.&lt;/p&gt;" />
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<meta name="twitter:title" content="Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Ketogenic diets are being explored as a possible treatment for several neurological diseases, but the physiologic impact on the brain is unknown. The objective of this study was to evaluate the feasibility of 3T MR spectroscopy to monitor brain ketone levels in patients with high-grade gliomas who were on a ketogenic diet (a modified Atkins diet) for 8 weeks.

MATERIALS AND METHODS: Paired pre- and post-ketogenic diet MR spectroscopy data from both the lesion and contralateral hemisphere were analyzed using LCModel software in 10 patients.

RESULTS: At baseline, the ketone bodies acetone and β-hydroxybutyrate were nearly undetectable, but by week 8, they increased in the lesion for both acetone (0.06 ± 0.03 ≥ 0.27 ± 0.06 IU, P = .005) and β-hydroxybutyrate (0.07 ± 0.07 ≥ 0.79 ± 0.32 IU, P = .046). In the contralateral brain, acetone was also significantly increased (0.041 ± 0.01 ≥ 0.16 ± 0.04 IU, P = .004), but not β-hydroxybutyrate. Acetone was detected in 9/10 patients at week 8, and β-hydroxybutyrate, in 5/10. Acetone concentrations in the contralateral brain correlated strongly with higher urine ketones ( r = 0.87, P = .001) and lower fasting glucose ( r = –0.67, P = .03). Acetoacetate was largely undetectable. Small-but-statistically significant decreases in NAA were also observed in the contralateral hemisphere at 8 weeks.

CONCLUSIONS: This study suggests that 3T MR spectroscopy is feasible for detecting small cerebral metabolic changes associated with a ketogenic diet, provided that appropriate methodology is used.

AcAc
:   acetoacetate
Ace
:   acetone
bHB
:   β-hydroxybutyrate
IU
:   institutional units
Lac
:   lactate
KD
:   ketogenic diet
WHO
:   World Health Organization" />
<meta name="og-title" property="og:title" content="Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/11/1908" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Ketogenic diets are being explored as a possible treatment for several neurological diseases, but the physiologic impact on the brain is unknown. The objective of this study was to evaluate the feasibility of 3T MR spectroscopy to monitor brain ketone levels in patients with high-grade gliomas who were on a ketogenic diet (a modified Atkins diet) for 8 weeks.

MATERIALS AND METHODS: Paired pre- and post-ketogenic diet MR spectroscopy data from both the lesion and contralateral hemisphere were analyzed using LCModel software in 10 patients.

RESULTS: At baseline, the ketone bodies acetone and β-hydroxybutyrate were nearly undetectable, but by week 8, they increased in the lesion for both acetone (0.06 ± 0.03 ≥ 0.27 ± 0.06 IU, P = .005) and β-hydroxybutyrate (0.07 ± 0.07 ≥ 0.79 ± 0.32 IU, P = .046). In the contralateral brain, acetone was also significantly increased (0.041 ± 0.01 ≥ 0.16 ± 0.04 IU, P = .004), but not β-hydroxybutyrate. Acetone was detected in 9/10 patients at week 8, and β-hydroxybutyrate, in 5/10. Acetone concentrations in the contralateral brain correlated strongly with higher urine ketones ( r = 0.87, P = .001) and lower fasting glucose ( r = –0.67, P = .03). Acetoacetate was largely undetectable. Small-but-statistically significant decreases in NAA were also observed in the contralateral hemisphere at 8 weeks.

CONCLUSIONS: This study suggests that 3T MR spectroscopy is feasible for detecting small cerebral metabolic changes associated with a ketogenic diet, provided that appropriate methodology is used.

AcAc
:   acetoacetate
Ace
:   acetone
bHB
:   β-hydroxybutyrate
IU
:   institutional units
Lac
:   lactate
KD
:   ketogenic diet
WHO
:   World Health Organization" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node71301--7" data-node-nid="71301" id="top-node-71301--8222604645" data-pisa="ajnr;40/11/1908" data-pisa-master="ajnr;ajnr.A6287" data-apath="/ajnr/40/11/1908.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Adult Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Berrington</span>, <span class="highwire-citation-author" data-delta="1">K.C. Schreck</span>, <span class="highwire-citation-author" data-delta="2">B.J. Barron</span>, <span class="highwire-citation-author" data-delta="3">L. Blair</span>, <span class="highwire-citation-author" data-delta="4">D.D.M. Lin</span>, <span class="highwire-citation-author" data-delta="5">A.L. Hartman</span>, <span class="highwire-citation-author" data-delta="6">E. Kossoff</span>, <span class="highwire-citation-author" data-delta="7">L. Easter</span>, <span class="highwire-citation-author" data-delta="8">C.T. Whitlow</span>, <span class="highwire-citation-author" data-delta="9">Y. Jung</span>, <span class="highwire-citation-author" data-delta="10">F.-C. Hsu</span>, <span class="highwire-citation-author" data-delta="11">M.C. Cervenka</span>, <span class="highwire-citation-author" data-delta="12">J.O. Blakeley</span>, <span class="highwire-citation-author" data-delta="13">P.B. Barker</span> and <span class="highwire-citation-author" data-delta="14">R.E. Strowd</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1908-1915; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6287 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-71301--8222604645" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Berrington </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Russell H. Morgan Departments of Radiology and Radiological Science (A.B., D.D.M.L., P.B.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BBerrington%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Berrington%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BBerrington%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1207-8193" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Berrington</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">K.C. Schreck </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.C.%2BSchreck%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schreck%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.C.%2BSchreck%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7181-3269" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K.C. Schreck</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">B.J. Barron </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Institute of Clinical and Translational Research (B.J.B.), Johns Hopkins University School of Medicine, Baltimore, Maryland</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.J.%2BBarron%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Barron%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.J.%2BBarron%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5390-794X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B.J. Barron</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L. Blair </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Pediatrics (L.B., A.L.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BBlair%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Blair%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BBlair%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7335-4537" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Blair</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">D.D.M. Lin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Russell H. Morgan Departments of Radiology and Radiological Science (A.B., D.D.M.L., P.B.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.D.M.%2BLin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lin%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.D.M.%2BLin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6001-2383" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.D.M. Lin</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">A.L. Hartman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Pediatrics (L.B., A.L.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.L.%2BHartman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hartman%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.L.%2BHartman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5672-3409" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.L. Hartman</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">E. Kossoff </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.%2BKossoff%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kossoff%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.%2BKossoff%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5260-5314" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E. Kossoff</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">L. Easter </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Clinical and Translational Science Institute (L.E., R.E.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BEaster%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Easter%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BEaster%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4591-9411" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Easter</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">C.T. Whitlow </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Departments of Radiology (C.T.W., Y.J.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.T.%2BWhitlow%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Whitlow%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.T.%2BWhitlow%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2392-8293" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.T. Whitlow</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">Y. Jung </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Departments of Radiology (C.T.W., Y.J.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BJung%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jung%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.%2BJung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7236-8897" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Jung</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">F.-C. Hsu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Biostatistics and Data Science (F.-C.H.), Division of Public Health Sciences</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.-C.%2BHsu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hsu%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.-C.%2BHsu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3310-184X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.-C. Hsu</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">M.C. Cervenka </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.C.%2BCervenka%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Cervenka%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.C.%2BCervenka%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4760-857X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.C. Cervenka</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">J.O. Blakeley </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.O.%2BBlakeley%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Blakeley%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.O.%2BBlakeley%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1049-0993" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.O. Blakeley</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">P.B. Barker </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Russell H. Morgan Departments of Radiology and Radiological Science (A.B., D.D.M.L., P.B.B.)</div><div class='author-affiliation'><span class='nlm-sup'>i</span>F. M. Kirby Research Center for Functional Brain Imaging (P.B.B., R.E.S.), Kennedy Krieger Institute, Baltimore, Maryland</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.B.%2BBarker%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Barker%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.B.%2BBarker%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6410-7793" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.B. Barker</a></li></ul></div><div class="author-tooltip-14"><div class="author-tooltip-name">R.E. Strowd </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Clinical and Translational Science Institute (L.E., R.E.S.)</div><div class='author-affiliation'><span class='nlm-sup'>h</span>Departments of Neurology, Hematology and Oncology (R.E.S.), Wake Forest School of Medicine, Winston-Salem, North Carolina</div><div class='author-affiliation'><span class='nlm-sup'>i</span>F. M. Kirby Research Center for Functional Brain Imaging (P.B.B., R.E.S.), Kennedy Krieger Institute, Baltimore, Maryland</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.E.%2BStrowd%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strowd%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.E.%2BStrowd%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6651-5267" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.E. 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">vol. 40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">no. 11 </span><span  class="highwire-cite-metadata-page-string highwire-cite-metadata">1908-1915 </span></div>
  
  
  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">A. Berrington</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">K.C. Schreck</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-3"><span class="name">B.J. Barron</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-4"><span class="name">L. Blair</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-5"><span class="name">D.D.M. Lin</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-6"><span class="name">A.L. Hartman</span><a id="xref-aff-2-3" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-3-2" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-7"><span class="name">E. Kossoff</span><a id="xref-aff-2-4" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-8"><span class="name">L. Easter</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-9"><span class="name">C.T. Whitlow</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-10"><span class="name">Y. Jung</span><a id="xref-aff-6-2" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-11"><span class="name">F.-C. Hsu</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a>, </li><li class="contributor" id="contrib-12"><span class="name">M.C. Cervenka</span><a id="xref-aff-2-5" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-13"><span class="name">J.O. Blakeley</span><a id="xref-aff-2-6" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-14"><span class="name">P.B. Barker</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-9-1" class="xref-aff" href="#aff-9">i</a> and </li><li class="last" id="contrib-15"><span class="name">R.E. Strowd</span><a id="xref-aff-2-7" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-5-2" class="xref-aff" href="#aff-5">e</a><span class="xref-sep">,</span><a id="xref-aff-8-1" class="xref-aff" href="#aff-8">h</a><span class="xref-sep">,</span><a id="xref-aff-9-2" class="xref-aff" href="#aff-9">i</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Russell H. Morgan Departments of Radiology and Radiological Science (A.B., D.D.M.L., P.B.B.)</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Neurology (K.C.S., L.B., A.L.H., E.K., M.C.C., J.O.B., R.E.S.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Pediatrics (L.B., A.L.H.)</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Institute of Clinical and Translational Research (B.J.B.), Johns Hopkins University School of Medicine, Baltimore, Maryland</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Clinical and Translational Science Institute (L.E., R.E.S.)</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Departments of Radiology (C.T.W., Y.J.)</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Biostatistics and Data Science (F.-C.H.), Division of Public Health Sciences</address></li><li class="aff"><a id="aff-8" name="aff-8"></a><address><sup>h</sup>Departments of Neurology, Hematology and Oncology (R.E.S.), Wake Forest School of Medicine, Winston-Salem, North Carolina</address></li><li class="aff"><a id="aff-9" name="aff-9"></a><address><sup>i</sup>F. M. Kirby Research Center for Functional Brain Imaging (P.B.B., R.E.S.), Kennedy Krieger Institute, Baltimore, Maryland</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Peter B. Barker, PhD, <span class="addr-line">Department of Radiology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Park 367B, Baltimore, MD 21287</span>; e-mail: <span class="em-link"><span class="em-addr">pbarker2{at}jhmi.edu</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/11/1908.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 40</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2019 </div></div>
      
      
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      <div class="highwire-cite-title">Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Berrington</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">K.C.</span> <span class="nlm-surname">Schreck</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">B.J.</span> <span class="nlm-surname">Barron</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Blair</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.D.M.</span> <span class="nlm-surname">Lin</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.L.</span> <span class="nlm-surname">Hartman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Kossoff</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Easter</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">C.T.</span> <span class="nlm-surname">Whitlow</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Jung</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">F.-C.</span> <span class="nlm-surname">Hsu</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Cervenka</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">J.O.</span> <span class="nlm-surname">Blakeley</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">P.B.</span> <span class="nlm-surname">Barker</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">R.E.</span> <span class="nlm-surname">Strowd</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1908-1915; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6287 </span></div>
  
  
  
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      <div class="highwire-cite-title">Cerebral Ketones Detected by 3T MR Spectroscopy in Patients with High-Grade Glioma on an Atkins-Based Diet</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Berrington</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">K.C.</span> <span class="nlm-surname">Schreck</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">B.J.</span> <span class="nlm-surname">Barron</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Blair</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">D.D.M.</span> <span class="nlm-surname">Lin</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.L.</span> <span class="nlm-surname">Hartman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Kossoff</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Easter</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">C.T.</span> <span class="nlm-surname">Whitlow</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Jung</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">F.-C.</span> <span class="nlm-surname">Hsu</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">M.C.</span> <span class="nlm-surname">Cervenka</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">J.O.</span> <span class="nlm-surname">Blakeley</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">P.B.</span> <span class="nlm-surname">Barker</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">R.E.</span> <span class="nlm-surname">Strowd</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1908-1915; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6287 </span></div>
  
  
  
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