Magnetic Resonance Spectroscopy in Diagnosing Brain Tumours? Is it Worth Doing

Abstract

Introduction: Magnetic Resonance Spectroscopy (MRS) is a non-invasive diagnostic method useful in providing information about specific metabolites in brain tissue that can indicate the presence of tumour, necrotic tissue and other pathologic entities. Aim: To evaluate the diagnostic performance of MRS in detecting, differentiating and grading brain tumours and to determine the diagnostic value of MRS. Materials and Methods: Prospective study was performed on 31 patients falling in the sampling frame. Patients were subjected to conventional MRI followed by MR Spectroscopy using 1.5 Tesla machine. Findings of conventional MRI brain and MRS were compared and correlated with the histopathological data in every case. Statistical analysis was done using SPSS version 21. The data represented as number, percentage and mean±SD. Independent sample t-test was used to analyse the data. A p-value less than 0.05 was considered significant. Results: The study demonstrated correlation agreement of 83.87% (in diagnosing brain tumours) between conventional MRI and histopathological diagnosis while correlation agreement of 90.3% between MRI combined with MRS diagnosis and histopathological diagnosis. Mean Cho/Crand Cho/NAA levels showed a significant association with histopathological diagnosis with p-value <0.001 for Cho/Cr Ratio and p-value=0.002. Conclusion: MRS is a useful aid to routine MRI in characterization of brain tumours and helps to differentiate among different histopathological diagnoses. Mean Cho/Cr and Cho/NAA levels showed significant association with histopathological diagnosis. Mean Cho/Cr and Cho/NAA levels were minimum in low grade tumours and maximum in meningioma/ metastasis cases.

Keywords

• choline
• creatine
• cho/cr (choline/creatine) ratio
• cho/naa (choline/n-acetyl aspartate) ratio