Prospective diagnostic performance evaluation of single-voxel 1H MRS for typing and grading of brain tumours
Julià Sapé, Ma. Margarita (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)
Coronel Linárez, Indira Evelia (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)
Majos, Carles (Institut de Diagnòstic per la Imatge (IDI))
Candiota Silveira, Ana Paula (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)
Serrallonga, Marta (Institut de Diagnòstic per la Imatge (IDI))
Cos, Mònica (Institut de Diagnòstic per la Imatge (IDI))
Aguilera, Carles (Institut de Diagnòstic per la Imatge (IDI))
Acebes Martín, Juan José (Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina)
GRIFFITHS, JOHN R (Cancer Research UK Cambridge Research Institute)
Arús i Caraltó, Carles (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)

Data:	2012
Resum:	The purpose of this study was to evaluate whether single-voxel 1H MRS could add useful information to conventional MRI in the preoperative characterisation of the type and grade of brain tumours. MRI and MRS examinations from a prospective cohort of 40 consecutive patients were analysed double blind by radiologists and spectroscopists before the histological diagnosis was known. The spectroscopists had only the MR spectra, whereas the radiologists had both the MR images and basic clinical details (age, sex and presenting symptoms). Then, the radiologists and spectroscopists exchanged their predictions and re-evaluated their initial opinions, taking into account the new evidence. Spectroscopists used four different systems of analysis for 1H MRS data, and the efficacy of each of these methods was also evaluated. Information extracted from 1H MRS significantly improved the radiologists' MRI-based characterisation of grade IV tumours (glioblastomas, metastases, medulloblastomas and lymphomas) in the cohort [area under the curve (AUC) in the MRI re-evaluation 0. 93 versus AUC in the MRI evaluation 0. 85], and also of the less malignant glial tumours (AUC in the MRI re-evaluation 0. 93 versus AUC in the MRI evaluation 0. 81). One of the MRS analysis systems used, the INTERPRET (International Network for Pattern Recognition of Tumours Using Magnetic Resonance) decision support system, outperformed the others, as well as being better than the MRI evaluation for the characterisation of grade III astrocytomas. Thus, preoperative MRS data improve the radiologists' performance in diagnosing grade IV tumours and, for those of grade II-III, MRS data help them to recognise the glial lineage. Even in cases in which their diagnoses were not improved, the provision of MRS data to the radiologists had no negative influence on their predictions.
Ajuts:	Ministerio de Ciencia e Innovación SAF2008-03323
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Diagnostic Techniques and Procedures ; Diagnosis, Computer-Assisted ; ROC curve ; Brain Neoplasms ; Magnetic Resonance Spectroscopy ; Magnetic Resonance Imaging
Publicat a:	NMR in biomedicine, Vol. 25, Num. 4 (April 2012) , p. 661-673, ISSN 1099-1492

DOI: 10.1002/nbm.1782
PMID: 21954036

Postprint 42 p, 1.2 MB

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