Comparison of MR spectroscopy and MR perfusion in benign and malignant infiltrative brain tumors

Purpose: To compare the choline/creatine (Cho/Cr), N-acetylaspartase/creatine (NAA/Cr) ratios, and turner perfusion between benign and malignant infiltrative brain tumors. Methods and Materials: Magnetic resonance spectroscopy (MRS) and magnetic resonance (MR) perfusion of 9 patients with histological diagnosis of benign (2 astrocytomas, 1 oligodendroglioma) and malignant (3 anaplastic astrocytomas, 1 malignant astrocytoma, 1 malignant mixed oligoastrocytoma, 1 glioblastoma multiforme infiltrative brain tumors were retrospectively reviewed. Four areas of interest were analyzed including normal brain (area 1), normal brain adjacent to the lesions (area 2), non-enhancing hypersignal T-2 area (area 3) and solid enhancing area (area 4). Results: The perfusion ratios of malignant and benign tumors were 100% and 100% for area 1, 119.7 +/- 46.53% and 90.67 +/- 18.01% for area 2, 128.33 +/- 70.16% and 70.67 +/- 70.69% for area 3, and 308 194.81% and 235 +/- 37.32% for area 4. Cho/Cr ratios were 1.23 +/- 0.29 and 0.90 +/- 0. 13 for area 1, 1.26 +/- 0.22 and 1.45 +/- 0.78 for area 2, 1.89 +/- 0.61 and 1.93 +/- 0.31 for area 3, and 4.26 +/- 2.10 and 2.97 +/- 1.66 for area 4. NAA/Cr ratios were 1.69 +/- 0.36 and 1.56 +/- 0.19 for area 1, 1.61 +/- 0.24 and 1.83 +/- 0.60 for area 2, 1.3 +/- 0.39 and 1.35 +/- 0.28 for area 3, and 1.0 +/- 0.31 and 0.88 +/- 0.51 for area 4. Conclusions: Increased Cho/Cr ratio and decreased NAA/creatine ratio indicates the presence of tumor. The perfusion value in the tumor area is higher than that of normal white matter. Differentiating benign from malignant Gliomas by using in vivo proton MRS and perfusion MRI is challenging. Copyright (C) 2004 S. Karger AG, Basel.