Assignment of glial brain tumors in humans byin vivo 1H-magnetic resonance spectroscopy and multidimensional metabolic classification

This study presents a simple approach for the noninvasive assignment of glial brain tumors according to malignancy by single-voxel proteon magnetic resonance spectroscopy at short echo times (TE≦50 milliseconds). Based on peak area ratios, a five-dimensional data set was obtained for each investigated subject. This vector was then projected along metabolic coordinates in a two-dimensional metabolic space. These coordinates had been determined in a previous study (Hagberg G et al., 1995,Magn Reson Med 34: 242–252). Tumor assignment was done without any knowledge of histology by comparing the location of the new cases to the features of the previous study. All 11 investigated glioblastomas multiforme, as well as 4 of 5 astrocytomas grade II, could easily be assigned to the groups of high- and low-grade tumors, respectively. Classification was more difficult in the case of a cystic astrocytoma grade II and one astrocytoma grade III. Two spectra measured in normal-appearing matter of glioblastoma patients were not classified as healthy. Using single-voxel proton magnetic resonance spectroscopy at short echo times with the knowledge of a base study, a straightforward, fast, and noninvasive differential diagnosis of glial brain tumors is possible. Supported by the Swiss National Science Foundation Research Grants No. 31-32533.91 (to J.S.) and 32.39773.93 (to W.S.).W.R. and E.W.R. have been supported by the Krebsliga beider Basel. A preliminary account of this work was given at the Third Annual Scientific Meeting of the International Society for Magnetic Resonance in Medicine, Nice, France, August 1995, abstract 1719.