Study of Correlation between Magnetic Resonance Spectroscopy Metabolites and Glioma Grading

Abstract

Gliomas are among the most common primary neoplasms in children and adults. Management plan for gliomas greatly depends on their grade. Based on their grade, pre or post-surgical radiation or chemotherapy may be advocated. The objective of our study was to evaluate the role of Magnetic Resonance Spectroscopy in differentiating grades of glioma and to assess the relationship of brain metabolite ratios. Material and methods: Magnetic Resonance Spectroscopy was performed in 27 patients with gliomas which were histologically proven. Brain metabolite ratios were calculated at intermediate / long Echo Time. Tumours were graded as low grade or high grade gliomas by experienced radiologist based on Magnetic resonance imaging and Magnetic Resonance Spectroscopy findings. Post-surgery, the histologic grade of glioma was correlated with that of imaging grade. Results: Overall sensitivity, specificity, positive and negative predictive values for classifying glioma into grades using Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy was found to be 83%, 66%, 66% and 83% respectively. Among the metabolite ratios, Choline-to-Creatine was found to be most useful in grading gliomas as low and high grade. Conclusion: Magnetic Resonance Spectroscopy is a useful tool in diagnosing gliomas. Various metabolite ratios can be used in grading gliomas by considering the peri tumoral spread and nature of tumour composition. Further studies on Magnetic Resonance Spectroscopy metabolites are required to improve the sensitivity and specificity of the diagnosing tools in grading gliomas.