Contrast/Noise Ratio on Conventional MRI and Choline/Creatine Ratio on Proton MRI Spectroscopy Accurately Discriminate Low-Grade From High-Grade Cerebral Gliomas

The intensity of contrast enhancement measured with the CNR, the choline/creatine ratio, and the presence of lactate were the most powerful variables to predict malignancy in brain tumors. The CNR is a simple, objective, and useful tool in the initial assessment of gliomas and metastases.