A BSTRACT Introduction: Magnetic resonance spectroscopy (MRS) can diagnose brain lesions and aid in the management of numerous diseases. It has the benefit of distinguishing between neoplastic and nonmalignant brain lesions based on alterations in brain metabolism. The aim of the study was to distinguish between neoplastic and non-neoplastic brain lesions by utilizing standard and advanced MRS imaging technology. Materials and Methods: This prospective, observational study involved 92 patients with brain lesions evaluated on MRS. Based on the radiologic reports, the lesions were classified as neoplastic and non-neoplastic. The neoplastic lesions were further classified into low- and high-grade. The metabolite levels such as choline (Cho), creatine (Cr), N-acetyl aspartate (NAA), lactate, and lipids along with Cho/Cr as well as Cho/NAA ratios were estimated. The data collected were used to differentiate neoplastic from non-neoplastic lesions, and low-grade from high-grade lesions. Results: The mean age of the patients was 37.92 ± 16.86 years, and 54.35% of patients were males. The neoplastic brain lesions had a significantly raised mean Cho/NAA ratio and Cho/Cr ratio than non-neoplastic lesions ( P < .0001). The high-grade lesions had a higher mean Cho/NAA ratio (5.25 ± 1.54) than low-grade lesions (4.81 ± 1.54), but this difference was not significant ( P = .472). The high-grade lesions had a higher mean Cho/Cr ratio (5.43 ± 0.87) than the low-grade lesions (3.64 ± 1.08; P < .0001). Conclusion: MRS can easily distinguish between neoplastic and non-neoplastic brain lesions, thereby reducing the need for an invasive brain biopsy.
Chaple et al. (Tue,) studied this question.