Differentiation between neoplastic and nonneoplastic brain masses using intermediate echo time MR Spectroscopy

Abstract
Aim: The aim of this study was to evaluate the role of intermediate echo time (TE) Proton Magnetic Resonance Spectroscopy (1 H-MRS) in the differential diagnosis of neoplastic and nonneoplastic cerebral mass lesions. Materials and Methods: The research was done at Cukurova University in a 1.5 Tesla whole-body MR system. In point-resolved-single volume-spectroscopy (PRESS) localization method, Probe-P pulse sequence was studied with intermediate TE (TE=144). Of 55 cases whose diagnosis was confirmed with the histopathologically or clinical and radiological follow-up, MR Spectroscopy findings were discussed. Results: Twenty cases’ definite diagnosis were neoplastic and thirty-five cases’ were nonneoplastic lesions. For tumor detection in cerebral mass lesions, intermediate TE MRS was determined 100% sensitive and 91.7% specific. The positive predictive value was 86.4% and the negative one was 100%. In this study, in the neoplastic-nonneoplastic lesion differential diagnosis, NAA/Cho, NAA/Cr, Cho/Cr, and Cho/NAA ratios were evaluated and the most useful of them were found to be Cho/NAA ratio. Conclusion: It is concluded that intermediate TE MR Spectroscopy is a reliable imaging technique for the neoplastic-nonneoplastic differential diagnosis of the cerebral mass lesions.