Title: Application of Magnetic Resonance Spectroscopy in the Differentiation of High-Grade Brain Neoplasm and Inflammatory Brain Lesions

Authors: Prafulla Kumar Dash, Bararuchi Dash, Goguldeep V, P V Mohan

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.184

Abstract

This study aims at evaluating the application of magnetic resonance spectroscopy (MRS) in the differential diagnosis of brain tumors and inflammatory brain lesions. The examinations of 81 individuals, who performed brain MRS and were retrospectively analyzed. The patients with ages between 10 and 80 years old, were divided into two groups. Group A consisted of 42 individuals with diagnoses of cerebral tuberculomas, brain abscess and Group B was formed of 39 individuals with diagnosis of glial neoplasms. On analyzing the ROC curve, the discriminatory boundary for the Cho/Cr ratio between inflammatory lesions and tumors was 1.97 and for the NAA/Cr ratio it was 1.12. RMS is an important method useful in the distinction of inflammatory brain lesions and high-degree tumors when the Cho/Cr ratio is greater than 1.97 and the NAA/Cr ratio is less than 1.12. And so this method is important in the planning of treatment and monitoring of the therapeutic efficiency.

Key Words: magnetic resonance image, spectroscopy, brain, neoplasm, inflammatory lesion.

References

  1. Cousing JP. Clinical MR spectroscopy fundamentals, current applications and future potentials. AJR 1995;164:1337-1347.
  2. Katz DS, Fatouros PP, Weissman JL, Eyler WR, Siegelman SS. Brain abscesses: etiologic categorization with in vivo proton MR spectroscopy. Radiology 2004;230:519-527.
  3. Chang L, Miller BL, McBride D, et al. Brain lesions in patients with AIDS: H-1 MR spectroscopy. Radiology 1995;197:525-531.
  4. Chinn RJ, Wilkinson ID, Hall-Craggs MA, et al. Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectro-scopy. Radiology 1995;197:649-654.
  5. Simone IL, Federico F, Tortorella C, et al. Localised 1H-MR spectroscopy for metabolic characterisation of diffuse and focal brain lesions in patients infected with HIV. J NeurolNeurosurg Psychiatry 1998;64:516-523.
  6. Yamagata NT, Miller BL, McBride D, et al. In vivo proton spectroscopy of intracranial infections and neoplasms. J Neuroimaging 1994;4:23-28.
  7. Cortsen ME, Skot J, Skriver EB. Cerebral toxoplasmosis primarily diagnosed as a tumor. UgeskrLaeger 1992;154:645-646.
  8. Roricht S, Meyer BU, Grafin von EH, Sander B. A solitary toxoplasmosis focus simulating a brain tumor as the first manifestation of AIDS. Rofo 1997;167:201-203.
  9. Luyten PR, Marien AJ, Heindel W, et al. Metabolic imaging of patients with intracranial tumors: H-1 MR spectroscopic imaging and PET. Radiology 1990;176:791-799.
  10. Al-Okaili RN, Krejza J, Wang S, Woo JH, Melhem ER. Advanced MR imaging techniques in the diagnosis of intraaxial brain tumors in adults.Radiographics 2006;26(Suppl 1):S173-S189.
  11. Harting I, Hartmann M, Jost G, et al. Differentiating primary central nervous system lymphoma from glioma in humans using localised proton magnetic resonance spectroscopy. NeurosciLett 2003;342:163-166.
  12. Law M, Yang S, Wang H, et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compare with conventional MR imaging. AJNR 2003;24:1989-1998.
  13. Fayed N, Modrego PJ. The contribution of magnetic resonance spectroscopy and echoplanar perfusion-weighted MRI in the initial assessment of brain tumours. J Neurooncol 2005;72:261-265.
  14. Fayed N, Dávila J, Medrano J, Olmos S. Malignancy assessment of brain tumours with magnetic resonance spectroscopy and dynamic susceptibility contrast MRI. Eur J Radiol. 2008; 427-433.
  15. Fayed N, Morales H, Modrego PJ, Pina MA. Contrast/Noise ratio on conventional MRI and choline/creatine ratio on proton MRI spectroscopy accurately discriminate low-grade from high-grade cerebral gliomas. AcadRadiol. 2006;13:728-737.

Corresponding Author

Goguldeep V

PG resident, VIMSAR, Burla, India

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