Malignant focal brain lesions. Value of MRS tumour biomarkers in preoperative prediction of grades of malignancy

PurposeOur aim is to describe the spectrum of proton-MR spectroscopy in malignant focal brain lesions and to detect grade of malignancy using MRS tumor biomarkers.Materials and methods87 patients (63 males and 24 females) with focal brain lesion(s) are included in this study. All had a brain tumor recently diagnosed by MRI and had received no previous treatment. They were referred to MRS examination before surgical biopsy and/or resection or radiotherapy.ResultsIn malignant brain tumors, average Cho/NAA ratio was 3.3 ± 0.22, Cho/Cr ratio was 2.95 ± 0.21, MI/NAA ratio was 1.5 ± 0.12, MI/Cr was 0.53 ± 0.11 with lower MI levels and higher choline levels in more malignant tumours, lipid/lactate peak was detected in brain metastasis and high grade malignant brain tumors.ConclusionHigher Cho/NAA, Cho/Cr and MI/NAA ratios with lower MI/Cr, and high lipid/lactate peak, were most likely to be in high grade malignant brain tumors.