Grading of Brain Tumors using MR Spectroscopy: Diagnostic value at Short and Long TE
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Objectives: To evaluate the usefulness of MR spectroscopy (MRS) in grading of brain tumors as well to evaluate which metabolite values/ratios could provide better classification/grading of brain tumors when using, short or long TE. Methods: MRS was performed in 128 patients with brain tumors. Metabolite NAA,Cho,Cr lactates and lipids and metabolite ratios of Choline (Cho)/N-acetylaspartate (NAA), Cho/Creatine (Cr), /NAA/ Cr were calculated at short and long echo time (TEs). Tumors were subdivided into grades on the basis of radiologist results and the standard WHO values. Characteristic analysis of metabolites was performed to find the values in each tumor. The correlations between the metabolite values and grading were calculated. Long TE as (1500/144ms) where the signal from most metabolites in the brain is lost except that of choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), and lactate,and short TEs of (2000/35ms) that allow for identification of many other metabolites Lipids, lactate, ala, myoinositol, glutamate, and glutamine were applied. Results: NAA, Cho, Cr, NAA/ Cr, Lactate and Lipids metabolic values showed no significant relation between the values to be increased or decreased according to grading therefore the dependency of grading should be based upon the Cho/ NAA and Cho/ Cr .From this account and metabolic ratios; the study suggested to diagnose, differentiate and grade gliomas after evaluating the Cho/ NAA and Cho/ Cr. Conclusion :MRS metabolic ratios (Cho/Cr and Cho/NAA) can be used to grade and differentiate gliomas. Ratios less than 1.5 were suggested to be considered as normal values, ratios from 1.5 to 2 were suggested to subsist as low grade glioma and ratios higher than 2 were suggested to be high grade glioma or metastasis. Meningioma can be diagnosed by conventional MRI images. MRS should be added to routine MR imaging studies as it provides greater information concerning tissue characterization than what is possible with MR imaging studies alone.
Authors and Affiliations
Sabri Adulrahman Ibrahim Hamed, Caroline Edward Ayad
Keywords
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- EP ID EP244099
- DOI 10.9790/0853-1610078793
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