Role of magnetic resonance spectroscopy in adequately differentiating neoplastic from non-noplastic and low-grade from high-grade lesions in brain masses

Abstract

Objective: The aim of this study was to provide objective data on the clinical utility of MRS in difference diagnosis of brain lesion and also to provide metabolite ratios neoplastic from non-neoplastic lesion and low-grade from high-grade neoplasms. Method: A prospective study conducted at Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore and Department of Radiology after approval from the ethical and research committee. The duration of this study was June 2018 to July 2020. A total of 102 patients (age range 21-60 years) Who were found to have cerebral mass lesion by computed tomography (CT) and convention MRI and from whom high quality MRS imaging data were obtained, were prospectively assessed and included in this study.Result: The mean age was 53.5±3.15 (range 28-70 years). Majority of the patients in the study were males forming 70 (68.6%) and females 32 (31.3%). Various spectroscopy ratios like Cho/Cr, Cho/NAA, Cho+Cr/NAA, NAA/Cr were calculated with the help of MRS. Conclusion: MRS gives information about the biochemical changes in tissues, which appear earlier than the structural changes, and so, in recent times, MRS has been used as a noninvasive method for the diagnosis and grading of brain tumors. All neoplastic lesion showed increase Cho and decreased NAA and this was more prominent in high-grade neoplasms. While we did not detect any LL peak in all 27 low-grade neoplasms, but 60 high-grade neoplasms showed an LL peak.