Diagnostic Accuracy of Magnetic Resonance Spectroscopy (Mrs) In Differentiating Neoplastic and Non-Neoplastic Brain Lesions
Maryam Rauf, Aliya Ahmed
Keywords: Brain lesions, neoplastic, spectroscopy, diagnostic accuracy
ABSTRACT
Introduction: Magnetic Resonance Spectroscopy (MRS) is one of the tools used to determine the molecular structures of compounds or to detect the presence. MR Spectroscopy can help in differentiating neoplastic from non-neoplastic lesions. Lesions can be classified as neoplastic or non-neoplastic based on specific criteria, including the choline-to-creatine (Cho/Cr) ratio, the choline-to-N-acetyl aspartate (Cho/NAA) ratio, and the presence of choline (Cho) and N-acetyl aspartate (NAA) peaks on MRS.
Objective: To determine the diagnostic accuracy of magnetic resonance spectroscopy in differentiating neoplastic from non-neoplastic brain lesions.
Methods: A total of 191 patients aged 30 to 60 years with focal brain lesions detected on conventional Magnetic Resonance Imaging (MRI) were included in the study, regardless of gender. Patients with a history of previous brain surgery, pregnant or breast-feeding females, claustrophobia, and contraindication to MRS were excluded. All the patients then underwent MRS and were looked for Choline peak, NAA/ Cr Ratio, NAA/ Cho Ratio, and Cho/ Cr Ratio for neoplastic or non-neoplastic lesions, and findings were correlated with histopathology.
Results: The Mean age was 47.93 ± 8.13 years. Out of these 191 patients, 112 (58.64%) were male and 79 (41.36%) were female, with a ratio of 1.4:1. In 108 MRS-positive patients, 95 were true positives and 13 were false positives. Among 83 MRS negative patients, 09 were false negatives, whereas 74 were true negatives (p=0.680). The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of MRS in differentiating neoplastic from non-neoplastic brain lesions were 91.35%, 85.06%, 87.96%, 89.16%, and 88.48%, respectively.
Conclusion: This study concluded that magnetic resonance spectroscopy (MRS) is the non-invasive modality of choice with high diagnostic accuracy in differentiating neoplastic from non-neoplastic brain lesions.
Keywords: Brain lesions, neoplastic, spectroscopy, diagnostic accuracy