Proton magnetic resonance spectroscopy and apparent diffusion coefficient in evaluation of solid brain lesions

Advanced magnetic resonance techniques can provide insight in physiological changes within pathological canges and contribute to better distinquishing between different tumor types and their discrimination from non-neoplastic lesions. The aim of this study was to evaluate the role of proton magnetic resonance spectroscopy (1H-MRS) and apparent diffusion coefficients (ADC) in distinguishing intracranial glial tumors from tumor like nonneoplastic lesions, as well as for differentiating high- from low-grade gliomas.

This retrospective study included 47 patients with solid brain lesions (25 nonneoplastic, 14 low-grade and 8 anaplastic glial tumors). In all patients 1H-MRS (at a TE of 135 ms and 30 ms) and diffusion-weighted imaging (DWI) were performed. The choline to creatine (Cho/Cr), choline to N-acetyl aspartate (Cho/NAA), N-acetyl aspartate to creatine (NAA/Cr) and myoinositol to creatine (mIn/Cr) ratios and the apparent diffusion coefficient (ADC) were determined.

The Cho/Cr ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.008) and in glial tumors grade III than in non-neoplastic lesions (p = 0.001). The Cho/NAA ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.037). AADC/ADC between glial tumors grade II and glial tumors grade III showed a statistical significance (p = 0.023).

Our study showed that 1H-MRS and apparent diffusion coefficients can help in evaluation and differentiation of solid brain lesions.