Proton magnetic resonance spectroscopy (1H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization

Abstract

Our objective was to evaluate the usefulness of proton magnetic resonance spectroscopy ( 1 H MRS) in categorizing brain tumours. In vivo single-voxel 1 H MRS at an echo time of 136 ms was performed in 108 patients with brain neoplasms that included 29 meningiomas (MEN), 15 low-grade astrocytomas (LGA), 12 anaplastic astrocytomas (AA), 25 glioblastomas (GBM) and 27 metastases (MET). Time-domain fitted areas of nine resonances were evaluated in all spectra. Twenty-five additional tumours were prospectively included as independent test set. Differences in at least two resonances were found in all pairwise comparisons of tumour groups except in GBM vs MET. Large lipid resonance at 1.30 ppm was found to be characteristic of GBM and MET, and alanine was characteristic of MEN. Significant differences were found between LGA and AA in choline-containing compounds and total creatine resonances. When implemented in a stepwise algorithm, these findings correctly classified 84% (21 of 25) tumours in the independent test set.Some additional utility was found in glycine/myo-inositol at 3.55 ppm for bilateral differentiation between GBM and MET (9 of 11, 82% correct classification in the test set). 1 H MRS provides useful information to categorize the most common brain tumours that can be implemented in clinical practice with satisfactory results.

High-resolution magic angle spinning magnetic resonance spectroscopy detects glycine as a biomarker in brain tumors

“…Our results showing that we can differentiate brain tumor types based on the amount of Gly and Myo they contain are in agreement with prior observations (31–33). Indeed, the examined tumor types were characterized by differential relative amounts of Gly and Myo (Fig.…”

“…A low Gly:Myo ratio also distinguishes MT from other tumors, especially GBM, which had the highest ratio of all tumor types examined in this study. The ability to distinguish high-grade gliomas such as GBM from other tumor types (33), especially MT tumors, is clinically important given that our ability to make this distinction is currently inadequate (35). This distinction was not made successfully in a previous study in which GBM and MT were combined into a single group; the authors concluded that a reliable separation between high-grade brain tumors and metastasized tumors cannot be confidently achieved using single voxel 1 H MRS spectroscopy alone (24–26,35).…”

Development of a transplantable glioma tumour model from genetically engineered mice: MRI/MRS/MRSI characterisation

“…In this respect, Magnetic Resonance Imaging (MRI) is the most used technique for diagnosis and management of brain tumours, providing detailed anatomic information [14,15]. This can be supported by Magnetic Resonance Spectroscopy (MRS) and Spectroscopic Imaging (MRSI), which allow collecting non-invasive biomarkers, that may provide important clues about tumour biology and response to treatment [16,17]. Single voxel (SV) MRS measures the average metabolic information of a tumour [16,17], whereas multivoxel acquisition MRSI provides spatially resolved metabolic information [18][19][20], which may be superimposed to anatomical acquisitions.…”

Intracranial parafalcine chondroma in a pregnant patient

“…[28] Meningioma should have a distinctive elevation in the resonance peak for alanine, which was not the case for this patient. [22] The presence of a significant NAA peak in the current lesion is evidence against the diagnosis of a meningioma or an abscess. The ratio of Cho/NAA ratio was more suggestive of low-grade growth.…”