The Role of Three-Dimensional Magnetic Resonance Spectroscopy in Diagnosing and Grading of Gliomas

In patients with suspected cerebral glioma, non-invasive preoperative evaluation of brain tumor grading is important for planning treatment and prognostication. Conventional MRI is an established and useful tool in brain tumor grading, but MRI-based tumor grading may lead to low-grade or high-grade misclassification in some cases. Three-dimensional magnetic resonance spectroscopy (MRS) has been proposed as an alternative modality for grading cerebral glioma. It is a noninvasive functional imaging method based on metabolite detection by measurement of a spectrum for specific isotopes in tissues, providing additional information to anatomical imaging. MRS can identify several metabolites, but currently only a few of them have a role in diagnosis of gliomas. Among them are N-acetylaspartate, choline, creatine, lactate and lipids. [1-5]. Multivoxel magnetic resonance spectroscopy is becoming available for clinical applications and can distinguish normal tissue morphology from abnormal based on their metabolic composition. The aim of our study was to determine the role of multivoxel MRS in diagnosing and treatment planning of gliomas. According to our data obtained the MRS seem to provide unique information that when combined with high-quality anatomical MR images has implications for defining tumor type and grade, directing biopsy or surgical resection, planning focal radiation and understanding the mechanisms of success and failure of new treatments [6-10].