Noninvasive evaluation of malignancy of brain tumors with proton MR spectroscopy

Hiroaki Shimizu, Toshihiro Kumabe, Teiji Tominaga, Takamasa Kayama, Kazushi Hara, Yasuki Ono, Koetsu Sato, Nobuyuki Arai, Satoru Fujiwara, Takashi Yoshimoto

Research output: Contribution to journalArticlepeer-review

130 Citations (Scopus)


PURPOSE: To test clinical proton MR spectroscopy as a noninvasive method for predicting tumor malignancy. METHODS: Water-suppressed single-voxel point resolved spectroscopy in the frontal white matter of 17 healthy volunteers and 25 patients with brain tumors yielded spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cre), and lactate. These peak intensities were semiquantitated as a ratio to that of the external reference. The validity of the semiguantitation was first evaluated through phantom and volunteer experiments. RESULTS: The variation in measurements of the designated region in the volunteers was less than 10%. Normal ranges of NAA/reference, Cho/reference, and Cre/reference were 3.59 ± 0.68, 1.96 ± 0.66, and 1.53 ± 0.64 (mean ± SD), respectively. In 17 gliomas, the Cho/reference value in high-grade gliomas was significantly higher than in low-grade gliomas. Levels of NAA/reference were also significantly different in low-grade and high-grade malignancy. In eight meningiomas (four newly diagnosed and four recurrent), the level of Cho/reference was significantly higher in recurrent meningiomas than in normal white matter or in newly diagnosed meningiomas. CONCLUSIONS: Higher grades of brain tumors in this study were associated with higher Cho/reference and lower NAA/reference values. These results suggest that clinical proton MR spectroscopy may help predict tumor malignancy.

Original languageEnglish
Pages (from-to)737-747
Number of pages11
JournalAmerican Journal of Neuroradiology
Issue number4
Publication statusPublished - 1996 Apr


  • Brain neoplasms, magnetic resonance
  • Magnetic resonance, spectroscopy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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