ABSTRACT

Background: Accurate diagnosis is paramount in patients presenting with intracranial tumors for optimum clinical management. Brain tumor is one of the most common causes of cancer related deaths amongst young patients of less than 35 years age in  the United States. The incidence rate of all primary central nervous system tumors (malignant or non-malignant) is 18.71 cases per 100,000 persons.

Aim: To determine the diagnostic accuracy (sensitivity and specificity) of MRS (Magnetic resonance spectroscopy) as an imaging tool in the differentiation of benign versus malignant tumors.

Study design:  Cross-sectional (validation) study.

Settings: This study was conducted in department of Diagnostic radiology, Pakistan Institute of Medial Sciences, Islamabad from June 2018 to June 2019.

Method: Patients with clinical diagnosis or CT scan based diagnosis of an intra-cranial space occupying lesion and referred to the radiology department for MRI of brain were identified. Single voxel MR spectroscopy was performed along with MRI brain. Interpretation was made with evaluation of MR spectrum  by consultant  radiologists.

Results: Total 157 patients were included in the study. Mean age of patients was 47.52 years with a standard deviation of 12.32 years. 81 (51.59%) patients were male and 76 (48.41%) patients were female. Sensitivity of MR Spectroscopy was 72.20%, specificity of MR Spectroscopy was 83.67%, positive predictive value was 90.60%, negative predictive value was 57.70% and diagnostic accuracy of MR Spectroscopy was 75.70%.

Conclusion: MRS is an important, useful ,non -invasive technique in the distinction of inflammatory brain lesions and high-degree tumors when the Choline peak is greater than other peaks. It can be used as an additional tool for characterization of tumors, prior doing a biopsy which is highly specific and sensitive.

Keywords: MR Spectroscopy, MRI, intracranial space occupying lesion, Benign and malignant intracranial tumors