3T proton MR spectroscopy evaluation of spinal cord lesions

Abstract

Objective:The objective of this study was to evaluate intramedullary spinal cord lesions using magnetic resonance spectroscopy and correlate the results with histo-pathological examination (HPE).Materials and Methods:Approval for this study was obtained from our institute ethical committee. Overall, 50 patients were recruited (29 male and 21 female), with a maximum age of 53 years and minimum age of 7 years. The mean age group of the study was 33 years. Standard magnetic resonance imaging (MRI) spine was done on a Siemens Skyra 3Tesla MRI scanner. MR Spectroscopy (MRS) was performed for all patients with intramedullary spinal lesions after getting written consent. It was performed using single-voxel method. The change in the metabolite peak was observed in each case and the results were compared with HPE. These collected data were analyzed using SPSS 16.0 version. Descriptive statistics, frequency analysis, and percentage analysis were used for categorical variables; and for continuous variables, mean and standard deviation were analyzed. McNemar's test was used to find the significance between conventional MRI MRS. In the above statistical tool, the probability value 0.05 is considered as significant level.Results:From our study, we observed that by applying routine MRI sequences alone, we could only detect around 58% of the cases correctly. However, when MRS was done along with the conventional MR imaging, the number of cases detected significantly increased to 84%. By applying McNemar's test and comparing the conventional MRI and MRS with HPE, it was found that statistically significant difference exists with P value of 0.007.Conclusion:MRS of the spinal cord is a promising tool for research and diagnosis because it can provide additional information complementary to other non-invasive imaging methods. It is an emerging tool and adds new biomarker information for characterization of spinal cord tumors, to differentiate benign from malignant lesions and to prevent unnecessary biopsies and surgeries.

<p>Differentiation of Intraspinal Tuberculosis and Metastatic Cancer Using Magnetic Resonance Imaging</p>

“…Lipid peak was thought to be radiological biomarker of tuberculoma while evaluated choline peak was thought to be specific for the metastasis, but the result was affected by many factors such as strong susceptibility artifacts and small size of intramedullary nodule for single-voxel placement, and it is not straightforward for the application of MR spectroscopy in intraspinal lesions, so the differentiation of intraspinal lesions may mainly rely on the MRI findings. 27,28 Limitations There were certain limitations to this study. Given its small sample size, it was difficult to extrapolate the results to a large population.…”

Role of proton MR spectroscopy in spinal cord lesions: A guarded espousal

“…I read with great interest the article titled “3T proton MR spectroscopy evaluation of spinal cord lesions” by Sathyanathan et al published in the July–September, 2018 issue of the Indian Journal of Radiology and Imaging . [1] The manuscript is well written and informative. The authors have narrated the MR spectroscopy (MRS) protocol and patterns in various intramedullary spinal lesions in a very efficient manner.…”

“…The present study[1] defines the changes in the metabolites in different spinal lesions based on the deviation in their peak values from the normal spectra. In the previous few studies,[45] the results have been expressed in terms of metabolite ratios, which is an absolute quantification method.…”

“…High signal-to-noise ratio is addressed in the present study[1] by the use of high magnetic field strength (3 T). However, there are spectral reliability indices such as Cramér–Rao lower bounds of each metabolite, mean, and standard deviation of the spectral line width, the coefficient of variations of the measurements, and the group average of the spectra.…”