Malignant focal brain lesions. Value of MRS tumour biomarkers in preoperative prediction of grades of malignancy

Purpose: Our aim is to describe the spectrum of proton-MR spectroscopy in malignant focal brain lesions and to detect grade of malignancy using MRS tumor biomarkers. Materials and methods: 87 patients (63 males and 24 females) with focal brain lesion(s) are included in this study. All had a brain tumor recently diagnosed by MRI and had received no previous treatment. They were referred to MRS examination before surgical biopsy and/or resection or radiotherapy. Results: In malignant brain tumors, average Cho/NAA ratio was 3.3 ± 0.22, Cho/Cr ratio was 2.95 ± 0.21, MI/NAA ratio was 1.5 ± 0.12, MI/Cr was 0.53 ± 0.11 with lower MI levels and higher choline levels in more malignant tumours, lipid/lactate peak was detected in brain metastasis and high grade malignant brain tumors. Conclusion: Higher Cho/NAA, Cho/Cr and MI/NAA ratios with lower MI/Cr, and high lipid/lactate peak, were most likely to be in high grade malignant brain tumors