Magnetic Resonance Spectroscopy in the Diagnostic Evaluation of Brainstem Lesions in Alexander Disease

Abstract

Alexander disease is a progressive neurodegenerative disease, which can present with brainstem lesions with imaging characteristics similar to multifocal low-grade glioma, thus presenting a diagnostic dilemma. The authors report a 6-year-old child presenting with multifocal brainstem lesions subsequently diagnosed to have Alexander disease. In vivo magnetic resonance spectroscopy generated a metabolite profile of the lesion allowing differentiation from low-grade glioma. Magnetic resonance spectroscopy is a powerful tool in the assessment of brainstem lesions and is a useful adjunct to conventional magnetic resonance imaging in the assessment and diagnosis of atypical brain lesions.

Stereotactic biopsy for adult brainstem lesions: A surgical approach and its diagnostic value according to the 2016 World Health Organization Classification

“… 5 , 18 , 19 Additional information provided by magnetic resonance spectroscopy, another non‐invasive tool, can also help in discriminating brainstem lesions. 20 , 21 , 22 , 23 …”

“…5,18,19 Additional information provided by magnetic resonance spectroscopy, another non-invasive tool, can also help in discriminating brainstem lesions. [20][21][22][23] However, other studies argue that diagnosis of brainstem lesions made by radiological examination alone is unreliable. Rachinger et al reported that the specificity of MRI was 46.6% and sensitivity was 62.5% in patients with low grade gliomas (WHO grades I and II), and the specificity was 61.7% and sensitivity was 58.3% in patients with high-grade gliomas (WHO grades III and IV).…”

Application of pattern recognition techniques for classification of pediatric brain tumors by in vivo 3T 1H‐MR spectroscopy—A multi‐center study

“…MRI techniques have significantly advanced in recent years with new imaging techniques being able to provide information on tissue properties, structure, and basic metabolic processes. Amongst these new techniques, 1 H-MR spectroscopy (MRS) has the ability to provide non-invasive measurements of metabolite profiles with the potential to aid diagnosis and improve the characterization of pediatric brain tumors (3)(4)(5)(6)(7)(8).…”

Multiclass imbalance learning: Improving classification of pediatric brain tumors from magnetic resonance spectroscopy

“…They comprise approximately 25% of all pediatric cancers and are the leading cause of cancer death in children (1). 1 H-magnetic resonance spectroscopy (MRS) has been used as a noninvasive diagnostic tool for a variety of pathologies (2)(3)(4) and there are number of studies on the significant contribution of MRS for the characterization of pediatric brain tumors (5)(6)(7)(8)(9). Pattern recognition based classification of brain tumors using MRS data has been investigated thoroughly for more than two decades now (6,8,10,11) and its application for discriminating childhood brain tumors has been explored in single and multicenter studies.…”