Roles of multi-voxel proton magnetic resonance spectroscopy for identifying low- and high-grade gliomas

Objective To investigate the roles of multi-voxel proton magnetic resonance spectroscopy for identifying low- and high-grade gliomas. Methods From January 2015 to December 2015, 53 consecutive patients with brain glioma diagnosed pathologically at the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University were enrolled. There were 29 patients in the low-grade group and 24 in the high-grade group. SIEMENS Prisma 3 T magnetic resonance scanner performed conventional magnetic resonance scanning and 1H-MRS scanning before procedure. The choline (Cho)/N- acetyl aspartate (NAA) of the region of interest at same parts of the side of tumor and contralateral side (unaffected side) was obtained according to the 1H-MRS results. The ratios of mean values of Cho/NAA and the maximum values in both groups were compared. Receiver operating characteristic (ROC) curve was used to analyze the Cho/NAA value and assess the efficiency of glioma grade. Results Compared with contralateral same area of the same group, the mean value of Cho/NAA in the tumor parenchyma areas of the low- and high-grade groups increased significantly. There was significant difference (all P<0.001). Compared with the low-grade group, the maximum ratio, mean value, side of tumor and the ratio of contralateral Cho/NAA mean values of the tumor parenchyma Cho/NAA in the high-grade group were all increased. There were significant differences (all P<0.01). The ROC curve analysis showed that the Cho/NAA maximum ratio of tumor parenchyma, the mean value of Cho/NAA, the ratios of the mean values of the side of tumor and contralateral Cho/NAA for diagnosis of the area under the curve of the different grade gliomas were 0.7938 (the sensitivity and specificity were 54.6% and 92.9% respectively) and 0.7581 (the sensitivity and specificity were 59.1% and 78.6% respectively), and 0.7386 (the sensitivity and specificity were 45.5% and 92.9% respectively). Conclusion 1H-MRS detection of Cho/NAA has clinical application value for identifying the low-grade and high-grade gliomas. Key words: Glioma; Magnetic resonance imaging; Proton magnetic resonance spectroscopy; Multi-voxel