Open AccessRole of magnetic resonance spectroscopy in grading of primary brain tumors
Author(s) -
Radwa Kamel Abdel Naser,
Afaf A. Hassan,
Amr Mohamed Shabana,
Nagwa M. Omar
Publication year - 2016
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2016.03.011
Subject(s) - creatine , grading (engineering) , metabolite , nuclear medicine , choline , diagnostic accuracy , in vivo magnetic resonance spectroscopy , medicine , histopathology , nuclear magnetic resonance , chemistry , pathology , magnetic resonance imaging , radiology , biology , physics , ecology
ObjectiveTo assess the usefulness of MR spectroscopy (MRS) in grading of primary brain tumors.MethodsMRS was performed in 22 patients with primary brain tumors. Metabolite ratios of Choline (Cho)/N-acetylaspartate (NAA), Cho/Creatine (Cr), Cho+Cr/NAA as well as lipids and lactate (LL)/Cr were calculated at short and intermediate echo times (TEs). Additionally, myo-inositol (mI)/Cr was calculated at short TE. Tumors were subdivided into low grades and high grade on the basis of histopathology. Receiver operating characteristic analysis of metabolite ratios was performed to find cutoff values between high and low grade tumors. The resulting sensitivity, specificity and accuracy were calculated.ResultsAt intermediate TE, Cho/NAA, Cho+Cr/NAA and Cho/Cr were significantly higher in high grade tumors than in low grade tumor. At short TE, Cho/Cr and LL/Cr ratios were significantly higher in high grade tumors than in low grade tumor. The diagnostic accuracy of metabolite ratios at intermediate TE was 86% whereas at short TE, the diagnostic accuracy was 75%. Combination of both TEs revealed a diagnostic accuracy of 88%.ConclusionCho/NAA, Cho+Cr/NAA and Cho/Cr are reliable in determining the tumor grade. LL/Cr is highly related to high grade tumors. Combination of both short and intermediate TEs provides better accuracy, in grading of brain neoplasm, compared to that when using each TE separately