Clinical application of proton magnetic resonance spectroscopy in the diagnosis of intracranial mass lesions

Möller-Hartmann, W.; Herminghaus, S.; Krings, Timo; Marquardt, Gerhard; Lanfermann, Heinrich; Pilatus, Ulrich; Fe, Zanella

doi:10.1007/s00234-001-0760-0

Cited by 359 publications

(269 citation statements)

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“…One recommendation was that MRS studies should be evaluated either in terms of their incremental diagnostic value over standard-of-care MRI or on the basis of the overall diagnostic accuracy of the combination of MRI and MRS. The authors suggested that the article by Moller-Hartmann et al 190 provides a good example to follow. They also recommended that, in addition to diagnostic accuracy, MRS should be evaluated in terms of its diagnostic impact.…”

Section: Brain Tumorsmentioning

confidence: 99%

Recent Advances in Magnetic Resonance Neurospectroscopy

Rosen

Lenkinski

2007

Neurotherapeutics

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Summary:Over the past two decades, proton magnetic resonance spectroscopy (proton MRS) of the brain has made the transition from research tool to a clinically useful modality. In this review, we first describe the localization methods currently used in MRS studies of the brain and discuss the technical and practical factors that determine the applicability of the methods to particular clinical studies. We also describe each of the resonances detected by localized solvent-suppressed proton MRS of the brain and discuss the metabolic and biochemical information that can be derived from an analysis of their concentrations. We discuss spectral quantitation and summarize the reproducibility of both single-voxel and multivoxel methods at 1.5 and 3-4 T. We have selected three clinical neurologic applications in which there has been a consensus as to the diagnostic value of MRS and summarize the information relevant to clinical applications. Finally, we speculate about some of the potential technical developments, either in progress or in the future, that may lead to improvements in the performance of proton MRS.

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Section: Brain Tumorsmentioning

confidence: 99%

Recent Advances in Magnetic Resonance Neurospectroscopy

Rosen

Lenkinski

2007

Neurotherapeutics

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“…To decrease the use of an invasive biopsy, which is very stressful for the patient, the usefulness of proton magnetic resonance spectroscopy (MRS) for tumor typing is under investigation. [1][2][3] Proton MRS provides completely different information as compared with imaging tools, but can be performed with most MRI instruments used in routine radiology. Proton MR spectra contain information from important brain metabolites like glutamate, myo-inositol, choline, creatine, N-acetyl aspartate (NAA), lactate and fatty acids.…”

Section: Introductionmentioning

confidence: 99%

Combination of feature-reduced MR spectroscopic and MR imaging data for improved brain tumor classification

et al. 2005

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The purpose of this paper is to evaluate the effect of the combination of magnetic resonance spectroscopic imaging (MRSI) data and magnetic resonance imaging (MRI) data on the classification result of four brain tumor classes. Suppressed and unsuppressed short echo time MRSI and MRI were performed on 24 patients with a brain tumor and four volunteers. Four different feature reduction procedures were applied to the MRSI data: simple quantitation, principal component analysis, independent component analysis and LCModel. Water intensities were calculated from the unsuppressed MRSI data. Features were extracted from the MR images which were acquired with four different contrasts to comply with the spatial resolution of the MRSI. Evaluation was performed by investigating different combinations of the MRSI features, the MRI features and the water intensities. For each data set, the isolation in feature space of the tumor classes, healthy brain tissue and cerebrospinal fluid was calculated and visualized. A test set was used to calculate classification results for each data set. Finally, the effect of the selected feature reduction procedures on the MRSI data was investigated to ascertain whether it was more important than the addition of MRI information. Conclusions are that the combination of features from MRSI data and MRI data improves the classification result considerably when compared with features obtained from MRSI data alone. This effect is larger than the effect of specific feature reduction procedures on the MRSI data. The addition of water intensities to the data set also increases the classification result, although not significantly. We show that the combination of data from different MR investigations can be very important for brain tumor classification, particularly if a large number of tumors are to be classified simultaneously.

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“…Of the sixteen studies included in this systematic review, only six provided enough details to determine sensitivity and specificity, suggesting that there is a need for better reporting of FET-PET study results. By comparison, MRI had a diagnostic accuracy of 55 %, which increased to 71 % when MRS was added in one large study (N = 176) [38], a value that is still lower than the AUC of 0.81 (0.78-0.85) reported in this updated meta-analysis. This finding confirms our previous results that seemed to show that the ability of FET-PET to assess the tumoral nature of isolated brain lesions was superior to that of MRI alone [12].…”

Section: Study Characteristicsmentioning

confidence: 57%

Diagnostic accuracy of F-18-fluoroethyltyrosine PET and PET/CT in patients with brain tumor

Dunet

Prior

2013

Clin Transl Imaging

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Positron emission tomography with 18 F-fluoroethyltyrosine (FET-PET) is increasingly used for the initial evaluation of patients with primary brain tumors (PBTs). This article provides an up-to-date systematic review and meta-analysis of FET-PET diagnostic performances in patients with suspected PBTs. The PubMed and EMBASE databases were searched for studies published in the period January 1977-September 2012. Inclusion criteria were: (1) use of FET-PET for assessment of newly diagnosed brain lesions; (2) no radiotherapy, surgery or chemotherapy prior to FET-PET and (3) use of histology as gold standard. A per-patient meta-analysis was performed, as well as a receiver operating characteristics (ROC) analysis of pooled patients to determine optimal tumor-tobackground ratio (TBR) of FET uptake. In total, 16 studies (641 patients) were included. . ROC analysis showed a meanTBR threshold C1.6 and a maxTBR C2.2 to have the best diagnostic value for differentiating PBTs from non-tumoral lesions. This meta-analysis confirms the excellent performances of FET-PET used for the diagnosis of PBTs. For FET-PET to become a relevant tool for improving patient management, prospective multicenter studies with standardized acquisition protocols should investigate its added value over current magnetic resonance imaging and the optimal combination of FET-PET and MRI.

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Clinical application of proton magnetic resonance spectroscopy in the diagnosis of intracranial mass lesions

Cited by 359 publications

References 0 publications

Recent Advances in Magnetic Resonance Neurospectroscopy

Recent Advances in Magnetic Resonance Neurospectroscopy

Combination of feature-reduced MR spectroscopic and MR imaging data for improved brain tumor classification

Diagnostic accuracy of F-18-fluoroethyltyrosine PET and PET/CT in patients with brain tumor

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