The Value of Magnetic Resonance Spectroscopy As a Supplement to MRI of the Brain in a Clinical Setting

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Nov 16

PMID 30440005

Citations 8

Authors

Jussi Hellstrom

Romina Romanos Zapata

Sylwia Libard

Johan Wikstrom

Francisco Ortiz-Nieto

Irina Alafuzoff

Raili Raininko

Affiliations

Soon will be listed here.

Abstract

Background: There are different opinions of the clinical value of MRS of the brain. In selected materials MRS has demonstrated good results for characterisation of both neoplastic and non-neoplastic lesions. The aim of this study was to evaluate the supplemental value of MR spectroscopy (MRS) in a clinical setting.

Material And Methods: MRI and MRS were re-evaluated in 208 cases with a clinically indicated MRS (cases with uncertain or insufficient information on MRI) and a confirmed diagnosis. Both single voxel spectroscopy (SVS) and chemical shift imaging (CSI) were performed in 105 cases, only SVS or CSI in 54 and 49 cases, respectively. Diagnoses were grouped into categories: non-neoplastic disease, low-grade tumour, and high-grade tumour. The clinical value of MRS was considered very beneficial if it provided the correct category or location when MRI did not, beneficial if it ruled out suspected diseases or was more specific than MRI, inconsequential if it provided the same level of information, or misleading if it provided less or incorrect information.

Results: There were 70 non-neoplastic lesions, 43 low-grade tumours, and 95 high-grade tumours. For MRI, the category was correct in 130 cases (62%), indeterminate in 39 cases (19%), and incorrect in 39 cases (19%). Supplemented with MRS, 134 cases (64%) were correct, 23 cases (11%) indeterminate, and 51 (25%) incorrect. Additional information from MRS was beneficial or very beneficial in 31 cases (15%) and misleading in 36 cases (17%).

Conclusion: In most cases MRS did not add to the diagnostic value of MRI. In selected cases, MRS may be a valuable supplement to MRI.

Citing Articles

Establishing Imaging Biomarkers of Host Immune System Efficacy during Glioblastoma Therapy Response: Challenges, Obstacles and Future Perspectives.

Candiota A, Arus C Metabolites. 2022; 12(3).

PMID: 35323686 PMC: 8950145. DOI: 10.3390/metabo12030243.

Added value of magnetic resonance spectroscopy for diagnosing childhood cerebellar tumours.

Davies N, Rose H, Manias K, Natarajan K, Abernethy L, Oates A NMR Biomed. 2021; 35(2):e4630.

PMID: 34647377 PMC: 11478925. DOI: 10.1002/nbm.4630.

Mapping of Metabolic Heterogeneity of Glioma Using MR-Spectroscopy.

Franco P, Huebschle I, Simon-Gabriel C, Dacca K, Schnell O, Beck J Cancers (Basel). 2021; 13(10).

PMID: 34067701 PMC: 8155922. DOI: 10.3390/cancers13102417.

MRI characteristics in treatment for cerebral melanoma metastasis using stereotactic radiosurgery and concomitant checkpoint inhibitors or targeted therapeutics.

Rauch M, Tausch D, Stera S, Blanck O, Wolff R, Meissner M J Neurooncol. 2021; 153(1):79-87.

PMID: 33761055 PMC: 8131338. DOI: 10.1007/s11060-021-03744-4.

Magnetic resonance spectroscopy for the study of cns malignancies.

Ruiz-Rodado V, Brender J, Cherukuri M, Gilbert M, Larion M Prog Nucl Magn Reson Spectrosc. 2021; 122:23-41.

PMID: 33632416 PMC: 7910526. DOI: 10.1016/j.pnmrs.2020.11.001.

References

Plotkin M, Eisenacher J, Bruhn H, Wurm R, Michel R, Stockhammer F . 123I-IMT SPECT and 1H MR-spectroscopy at 3.0 T in the differential diagnosis of recurrent or residual gliomas: a comparative study. J Neurooncol. 2004; 70(1):49-58. DOI: 10.1023/b:neon.0000040810.77270.68. View

Jaskolski D, Fortuniak J, Majos A, Gajewicz W, Papierz W, Liberski P . Magnetic resonance spectroscopy in intracranial tumours of glial origin. Neurol Neurochir Pol. 2013; 47(5):438-49. DOI: 10.5114/ninp.2013.32999. View

Mora P, Majos C, Castaner S, Sanchez J, Gabarros A, Muntane A . (1)H-MRS is useful to reinforce the suspicion of primary central nervous system lymphoma prior to surgery. Eur Radiol. 2014; 24(11):2895-905. DOI: 10.1007/s00330-014-3308-5. View

Garcia-Gomez J, Tortajada S, Vidal C, Julia-Sape M, Luts J, Moreno-Torres A . The effect of combining two echo times in automatic brain tumor classification by MRS. NMR Biomed. 2008; 21(10):1112-25. DOI: 10.1002/nbm.1288. View

Opstad K, Murphy M, Wilkins P, Bell B, Griffiths J, Howe F . Differentiation of metastases from high-grade gliomas using short echo time 1H spectroscopy. J Magn Reson Imaging. 2004; 20(2):187-92. DOI: 10.1002/jmri.20093. View

Devos A, Lukas L, Suykens J, Vanhamme L, Tate A, Howe F . Classification of brain tumours using short echo time 1H MR spectra. J Magn Reson. 2004; 170(1):164-75. DOI: 10.1016/j.jmr.2004.06.010. View

Bulakbasi N, Kocaoglu M, Ors F, Tayfun C, Ucoz T . Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors. AJNR Am J Neuroradiol. 2003; 24(2):225-33. PMC: 7974143. View

Norfray J, Tomita T, Byrd S, Ross B, Berger P, Miller R . Clinical impact of MR spectroscopy when MR imaging is indeterminate for pediatric brain tumors. AJR Am J Roentgenol. 1999; 173(1):119-25. DOI: 10.2214/ajr.173.1.10397111. View

Lin A, Bluml S, Mamelak A . Efficacy of proton magnetic resonance spectroscopy in clinical decision making for patients with suspected malignant brain tumors. J Neurooncol. 2000; 45(1):69-81. DOI: 10.1023/a:1006387703127. View

10.

Graves E, Nelson S, Vigneron D, Chin C, Verhey L, McDermott M . A preliminary study of the prognostic value of proton magnetic resonance spectroscopic imaging in gamma knife radiosurgery of recurrent malignant gliomas. Neurosurgery. 2000; 46(2):319-26; discussion 326-8. DOI: 10.1097/00006123-200002000-00011. View

11.

Grand S, Passaro G, Ziegler A, Esteve F, Boujet C, Hoffmann D . Necrotic tumor versus brain abscess: importance of amino acids detected at 1H MR spectroscopy--initial results. Radiology. 1999; 213(3):785-93. DOI: 10.1148/radiology.213.3.r99dc10785. View

12.

Garcia-Gomez J, Luts J, Julia-Sape M, Krooshof P, Tortajada S, Robledo J . Multiproject-multicenter evaluation of automatic brain tumor classification by magnetic resonance spectroscopy. MAGMA. 2008; 22(1):5-18. PMC: 2797843. DOI: 10.1007/s10334-008-0146-y. View

13.

Majos C, Julia-Sape M, Alonso J, Serrallonga M, Aguilera C, Acebes J . Brain tumor classification by proton MR spectroscopy: comparison of diagnostic accuracy at short and long TE. AJNR Am J Neuroradiol. 2004; 25(10):1696-704. PMC: 8148728. View

14.

Server A, Kulle B, Gadmar O, Josefsen R, Kumar T, Nakstad P . Measurements of diagnostic examination performance using quantitative apparent diffusion coefficient and proton MR spectroscopic imaging in the preoperative evaluation of tumor grade in cerebral gliomas. Eur J Radiol. 2010; 80(2):462-70. DOI: 10.1016/j.ejrad.2010.07.017. View

15.

Murphy M, Loosemore A, Clifton A, Howe F, Tate A, Cudlip S . The contribution of proton magnetic resonance spectroscopy (1HMRS) to clinical brain tumour diagnosis. Br J Neurosurg. 2002; 16(4):329-34. DOI: 10.1080/0268869021000007687. View

16.

Paulus W, PEIFFER J . Intratumoral histologic heterogeneity of gliomas. A quantitative study. Cancer. 1989; 64(2):442-7. DOI: 10.1002/1097-0142(19890715)64:2<442::aid-cncr2820640217>3.0.co;2-s. View

17.

Guzman-De-Villoria J, Mateos-Perez J, Fernandez-Garcia P, Castro E, Desco M . Added value of advanced over conventional magnetic resonance imaging in grading gliomas and other primary brain tumors. Cancer Imaging. 2015; 14:35. PMC: 4300038. DOI: 10.1186/s40644-014-0035-8. View

18.

Ando K, Ishikura R, Nagami Y, Morikawa T, Takada Y, Ikeda J . [Usefulness of Cho/Cr ratio in proton MR spectroscopy for differentiating residual/recurrent glioma from non-neoplastic lesions]. Nihon Igaku Hoshasen Gakkai Zasshi. 2004; 64(3):121-6. View

19.

Shiroishi M, Panigrahy A, Moore K, Nelson Jr M, Gilles F, Gonzalez-Gomez I . Combined MRI and MRS improves pre-therapeutic diagnoses of pediatric brain tumors over MRI alone. Neuroradiology. 2015; 57(9):951-6. PMC: 4936898. DOI: 10.1007/s00234-015-1553-1. View

20.

Louis D, Ohgaki H, Wiestler O, Cavenee W, Burger P, Jouvet A . The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007; 114(2):97-109. PMC: 1929165. DOI: 10.1007/s00401-007-0243-4. View