Diagnostic Accuracy Of Mr Spectroscopy For The Detection Of Supratentorial Neoplastic Space-Occupying Lesions Of The Brain By Taking Histopathology As The Gold Standard At Tertiary Care Hospital, Karachi

Authors

  • Mehak
  • Naureen Farhan
  • Amber Shams
  • Bhavesh Sagar
  • Faryal Zafar

Abstract

Objective: To determine the diagnostic accuracy of MR spectroscopy for the detection of supratentorial neoplastic space-occupying lesions of the brain by taking histopathology as the gold standard at Tertiary Care Hospital, in Karachi.

Design: Cross-sectional study

Place and Duration of Study: This study was conducted from 11th May 2024 to 10th Nov 2024 at the Department of Radiology, Ziauddin Hospital

Methodology: The diagnosis of benign and malignant intracranial lesions based solely on imaging methods remains a challenging problem. Patients aged 20 to 70 years underwent MR spectroscopy for the detection of supratentorial neoplastic space-occupying lesions of the brain. A histopathological assessment of biopsy specimens was performed to establish the final diagnosis. Diagnostic performance measures, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of MR spectroscopy, were calculated using histopathology as the gold standard.

Results:  The average age of the patients was 40.68±12.05 years (Range: 21-69). There were more males (61.24%) than females (38.76%). The prevalence of neoplastic space-occupying lesions was 75.97% [95% CI: 68.6%–83.3%]. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of MR spectroscopy for detecting supratentorial neoplastic space-occupying lesions of the brain were 80.61% [95% CI: 71.69–87.22], 87.10% [95% CI: 71.15–94.87], 95.18% [95% CI: 88.25–98.11], 58.70% [95% CI: 44.34–71.71], and 82.17% [95% CI: 74.67–87.82], respectively


Conclusion:  Magnetic Resonance Spectroscopy (MRS) offers a reliable non-invasive method for distinguishing brain lesions, reducing the need for biopsies and improving patient outcomes..

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References

[1] Alshammari QT, Salih M, Gameraddin M, Yousef M, Abdelmalik B, Loaz O. Accuracy of Magnetic Resonance Spectroscopy in Discrimination of Neoplastic and Non-Neoplastic Brain Lesions. Curr Med Imaging. 2021;17(7):904-10.

[2] Seano G, Nia HT, Emblem KE, Datta M, Ren J, Krishnan S et al. Solid stress in brain tumours causes neuronal loss and neurological dysfunction and can be reversed by lithium. Nat. Biomed. Eng. 2019;3(3):230–45.

[3] Nikmaneshi MR, Firoozabadi B, Mozafari A, Munn LL. A multi-scale model for determining the effects of pathophysiology and metabolic disorders on tumor growth. Sci. Rep. 2020;10(1):3025.

[4] Nandu H, Wen PY, Huang RY. Imaging in neuro-oncology. Ther. Adv. Neurol. Disorder. 2018;11:1756286418759865.

[5] Falk Delgado A, Van Westen D, Nilsson M, Knutsson L, Sundgren PC, Larsson EM et al. Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview. Insights Imaging. 2019;10(1):84.

[6] Mandal PK. Magnetic Resonance Spectroscopy (MRS) and its application in Alzheimer’s disease. Concepts Magn Reson Part A. 2007;30A:40–64.

[7] Abdel-Monem ND, Manal EB, Manal H, Noha S. Magnetic resonance spectroscopy and diffusion imaging in the evaluation of neoplastic brain lesions. The Egyptian Journal of Radiology and Nuclear Medicine. 2014;45:485- 93.

[8] Bertholdo D, Watcharakorn A, Castillo M. Brain proton magnetic resonance spectroscopy: introduction and overview. Neuroimaging Clin N Am. 2013;23:359-80.

[9] Kostas N., Fountas; Proton Magnetic Resonance Spectroscopic Imaging Can Predict Length of Survival in Patients with Supratentorial Gliomas. Neurosurgery. 2004;55:257-58.

[10] Abbas A, Javeed F, Rehman L, Afzal A, Rizvi Rk. Magnetic Resonance Spectroscopic and Histopathological Findings in the Supratentorial Brain Space Occupying Lesions. Pak J Neurol Surgery. 2020 Sep 25;24(3):210-5.

[11]

[12] Shokry A. MRS of brain tumors: Diagrammatic representations and diagnostic approach. The Egyptian Journal of Radiology and Nuclear Medicine. 2012; 43(4):603-12.

[13] Ahmed NGM, Aamin A, Khalifa S, Elhassan SM, Albashir M, Ahmed M, et al. Characterization of brain lesions using magnetic resonance spectroscopy. 2021.

[14] Musawar S, Ayyaz AS, Manzoor A, Manzoor I. Diagnostic accuracy of magnetic resonance spectroscopy (MRS) for diagnosis of focal brain lesions taking histopathology as gold standard. Professional Med J 2022; 29(11):1740-1744.

[15] Surur A, Cabral JF, Marangoni A, Marchegiani S, Palacios C, Herrera E, et al. Contributions of magnetic resonance spectroscopy in brain lesions. RAR. 2010; 74(3):239-49.

[16] Qadir R, Rehman L, Bokhari I, Shah RA, Qasim A, Arooqi YA, Hasan M. Role ofmagnetic resonance spectroscopy in supratentorial brain lesions. Pakistan Journal ofMedical & Health Sciences. 2023 Mar 10;17(02):176-.

[17] Rajasree D, Kumar TL, Vijayalakshmi K. Role of magnetic resonance spectroscopy in the evaluation of ring-enhancing lesions of the brain. Journal of Clinical & Diagnostic Research. 2020; 14(10)

[18] Alam MS, Ahsan H, Sajjad Z, Beg M, Bhatti U, Enam A, et al. Magnetic resonance spectroscopy of enhancing cerebral lesions: Analysis of 78 histopathology proven cases. JPMA The Journal of the Pakistan Medical Association. 2014; 64(10):1141.

[19] Nisar SA, Rauf MA, Sarfraz LU. Diagnostic Accuracy (sensitivity and specificity) ofMagnetic Resonance Spectroscopy as an imaging tool in the differentiation of benignvs malignant intracranial space occupying lesions. PJMHS. 2020;14(3):528.

[20] Mullins ME. MR spectroscopy: truly molecular imaging; past, present and future. Neuroimaging Clinics. 2006; 16(4):605-18.

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Published

2025-06-10

How to Cite

1.
Mehak M, Farhan N, Shams A, Sagar B, Zafar F. Diagnostic Accuracy Of Mr Spectroscopy For The Detection Of Supratentorial Neoplastic Space-Occupying Lesions Of The Brain By Taking Histopathology As The Gold Standard At Tertiary Care Hospital, Karachi. J Neonatal Surg [Internet]. 2025 Jun. 10 [cited 2026 Apr. 14];14(32S):10255-61. Available from: https://jneonatalsurg.com/index.php/jns/article/view/9858

Issue

Vol. 14 No. 32S (2025): Journal of Neonatal Surgery

Section

Original Article

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