Revisiting Concepts of Magnetic Resonance Spectroscopy in the Evaluation of Brain Lesions: An Institutional Experience

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Objective Magnetic resonance spectroscopy (MRS) has emerged as a technique due to its ability to characterize the metabolite constituent of any lesion. We have evaluated magnetic resonance (MR) spectral patterns in different neoplastic brain lesions, using the ability of MRS in grading of gliomas. MRS also helps in differentiating between high-grade glioma and metastases.

Method A retrospective observational study in histologically confirmed cases of brain neoplasms in which MRS was performed as a part of preoperative MR imaging. The pattern of metabolite peak was observed and means with standard deviation of different metabolite ratios (choline/creatine, choline/N-acetylaspartate [NAA], NAA/creatine) were calculated for different tumors. Analysis was done to see statistically significant differences in metabolite ratios of different grades of gliomas and to differentiate high-grade gliomas from metastases.

Result A total of 61 cases with brain tumor were included in the study. Of which, 20 cases were of gliomas, 11 metastases, 9 meningiomas, 4 dysembryoplastic neuroepithelial tumors, 6 pituitary macroadenomas, 4 trigeminal schwannomas, 3 craniopharyngiomas, 2 acoustic schwannomas, and 2 medulloblastomas. Statistically significant differences in ratios of metabolite peaks were noted between different grades of gliomas and for high-grade glioma versus metastases.

Conclusion MRS compliments the MR imaging and stands out as problem-solving method to distinguish neoplastic lesions in selected cases and also has a role in grading of gliomas and in differentiation of types of malignancies.

Keywords glioma - metastasis - MRI - MRS Ethics Approval and Consent to Participate

This study was granted Observational Study. The patients' information was kept confidential. All examinations performed in the studies involving human participants were in accordance with the ethical standards of the Institutional Ethics Committee.


Consent for Publication

Written informed consent was obtained from the patients after a full explanation of the study.


Availability of Data and Materials

The datasets analyzed during the current study are available from the corresponding author on a reasonable request.


Competing Interests

The authors declare that they have no competing interests or conflicts of interest.


Authors' Contributions

All the authors contributed to the study design, data collection, and drafting of the manuscript. All authors have contributed to manuscript revision and read the manuscript and approved its final version.


Contribution Details

Concept, design, the definition of intellectual content, literature search, clinical studies, experimental studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing: B.S.


Definition of intellectual content, statistical analysis, literature search: R.Y.


Definition of intellectual content, clinical studies: T.K.


Definition of intellectual content, statistical analysis, manuscript editing, and manuscript review: S.K.

Publication History

Article published online:
30 August 2022

© 2022. Spring Hope Cancer Foundation & Young Oncologist Group of Asia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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