DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE SPECTROSCOPY IN DETECTING FOCAL BRAIN LESION KEEPING HISTOPATHOLOGY AS GOLD STANDARD

. GULLALY; B KHAN

doi:10.54112/pjicm.v5i02.179

Authors

. GULLALY Department of Neurosurgery, Ayub Teaching Hospital, Abbotabad, Pakistan
B KHAN Department of Neurosurgery, Ayub Teaching Hospital, Abbotabad, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.179

Keywords:

Magnetic Resonance Spectroscopy, Focal Brain Lesions, Neoplastic, Non-Neoplastic, Diagnostic Accuracy, Histopathology

Abstract

Background: Magnetic resonance spectroscopy (MRS) is a valuable non-invasive imaging modality that provides metabolic information useful in differentiating neoplastic from non-neoplastic focal brain lesions. Accurate preoperative characterization of these lesions is essential for clinical management and treatment planning. Objective: To determine the diagnostic accuracy of magnetic resonance spectroscopy (MRS) in distinguishing neoplastic from non-neoplastic focal brain lesions, using histopathology as the gold standard. Study Design: Cross-sectional validation study. Setting: The Department of Neurosurgery at Ayub Teaching Hospital, Abbottabad, Pakistan. Duration of Study: From 08-01-2025 to 08-05-2025. Methods: A total of 63 patients aged 5–70 years with radiologically suspected focal brain lesions were included. All participants underwent MRS using a single-voxel technique to measure key metabolites—choline (Cho), N-acetylaspartate (NAA), and creatine (Cr). The Cho/NAA and Cho/Cr ratios were evaluated for lesion characterization. Histopathological findings from biopsy specimens served as the reference standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using a 2×2 contingency table. Data were analyzed using SPSS version 25. Results: The mean age of patients was 39.10 ± 20.60 years, with 32 (50.8%) males and 31 (49.2%) females. MRS demonstrated a sensitivity of 89.19%, specificity of 92.31%, PPV of 94.29%, NPV of 85.71%, and an overall diagnostic accuracy of 90.48% in differentiating neoplastic from non-neoplastic lesions. Conclusion: Magnetic resonance spectroscopy is a highly sensitive and specific non-invasive diagnostic tool for differentiating neoplastic from non-neoplastic focal brain lesions. Its integration with conventional MRI enhances diagnostic confidence and assists in appropriate therapeutic decision-making.

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