Objective: To determine diagnostic accuracy of MRS for diagnosis of malignant brain lesions taking histopathology as gold standard. Study Design: Cross Sectional Validation study. Setting: Department of Radiology, Lahore General Hospital, Lahore. Material & Methods: A total number of 127 patients who were referred for the diagnosis of focal brain lesions were included. In all patients, MRS was done by consultant radiologist to diagnose malignancy. All patients underwent surgery in the neurosurgery department and after surgery biopsy specimen were taken for diagnosis of malignancy using histopathology findings. Results: Mean age of patients was 40.88±11.37 years. There were 88 (69.29%) males and 39 (30.71%) female patients. On MRS, malignancy was diagnosed in 99 (77.95%) patients and on histopathology malignancy was diagnosed in 102 (80.31%) patients. Regarding diagnostic accuracy, MRS was 97.00% sensitive, 94.10% specific, with PPV of 78.60% and NPV of 88.00%. Conclusion: Magnetic resonance spectroscopy (MRS) has good sensitivity and specificity in differentiating neoplasm from non-neoplastic focal brain lesions.
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