Role of magnetic resonance spectroscopy and diffusion weighted imaging in characterization of brain tumors and its clinical implication - Our experience

Swapnil Puranik; Monika Bapat Puranik; Karuna Agawane; Dimple Shah

Volume : VIII, Issue : I, January - 2019

Role of magnetic resonance spectroscopy and diffusion weighted imaging in characterization of brain tumors and its clinical implication - Our experience

Swapnil Puranik, Monika Bapat Puranik, Karuna Agawane, Dimple Shah

Abstract :

Purpose: To evaluate the imaging characteristics and differential diagnosis of Brain Tumours on multi–voxel proton Magnetic Resonance Spectroscopy (MRS) and Diffusion Weighted Imaging (DWI) with its clinical implications.

Material/Methods: The study comprised of 60 patients with a clinical diagnosis of ain tumour irrespective of age and sex. Detailed MR imaging, diffusion weighted imaging (DWI) and in vivo proton MR spectroscopy (H1– MRS) were performed using a 1.5 Tesla whole–body scanner (Siemens magnetom maestro class) available in the department using the MR and MRS pulse sequences and the standard head coil.

Results: In our study 20 cases of astrocytomas, 14 cases of meningiomas, 6 cases of vestibular schwannoma, 4 cases each of ependymoma and germinoma, 2 cases each of central neurocytoma, choroid plexus papilloma, craniopharyngioma, lymphoma, medulloblastoma, metastasis. On MRS, all gliomas showed increased choline with reduced N–acetylaspartate. All the cases of meningioma showed increase of choline peak with two cases (14%) showing lipid/lactate peaks. Alanine peak at 1.4–1.5 ppm was detected in 10/14 cases (71%). On MRS, metastases showed elevated choline peak with reduced NAA and creatine levels. Lipid and lactate peaks were also noted. On DWI two cases of astrocytoma (WHO Grade IV tumors) and medulloblastoma, 2 cases of germinoma and lymphoma showed restricted diffusion.

Conclusion: Magnetic Resonance Spectroscopy (MRS) and Diffusion weighted imaging (DWI) help in further characterization of the tumour as assessed by MR imaging and lead to more specificity in the final diagnosis of nature and differentiation of the type and grade of the tumour.