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Diagnostic impact of proton MR-spectroscopy versus image-guided stereotactic biopsy

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Summary

Background. The aim of this study was to compare the diagnostic accuracy of 1H MR-spectroscopy versus image-guided stereotactic biopsy.

Method. A cohort of 83 consecutive patients with a broad spectrum of brain lesions were examined. Prior to stereotactic biopsy, the patients were subjected to 1H MR-spectroscopy examination. Diagnostic accuracy of 1H MR-spectroscopy and image guided stereotactic biopsy was determined for the largest diagnostic subgroups. Each diagnostic procedure was tested for concordance in every subgroup.

Findings. The subgroups of patients comprised: low grade glioma, high grade glioma (grades III and IV), lymphoma and metastasis. For the sensitivity of 1H MR-spectroscopy ranged from 87.7 in high grade glioma to 92.3% in metastasis and for specificity from 93.3% for high grade glioma to 100% in low grade glioma. The highest positive predictive value of 100% was reached in the subgroup of low grade glioma. The highest negative predictive value was reached in lymphoma and metastasis, 100%. The kappa values were highly significant for all comparisons (p<0.001). The co-efficient ranged from 0.68 to 0.84. It was lowest in assessing high grade glioma and highest in lymphoma.

Conclusion. Compared with each other 1H MR-spectroscopy and image-guided stereotactic biopsy showed a moderate to good, statistically highly significant concordance. In patients in whom operation is at an increased risk e.g., due to severe medical illness, 1H MR-spectroscopy as a noninvasive procedure may be sufficient to assess the diagnosis.

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Authors and Affiliations

  1. Department of Neurosurgery, Institute of Neuroradiology, and Department of Neuropathology (Edinger Institute), Johann Wolfgang Goethe-University, Frankfurt am Main, Germany

    M. Setzer, S. Herminghaus, G. Marquardt, D. S. Tews, U. Pilatus, V. Seifert, F. Zanella & H. Lanfermann

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  1. M. Setzer
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  2. S. Herminghaus
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  3. G. Marquardt
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  7. F. Zanella
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  8. H. Lanfermann
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Setzer, M., Herminghaus, S., Marquardt, G. et al. Diagnostic impact of proton MR-spectroscopy versus image-guided stereotactic biopsy. Acta Neurochir (Wien) 149, 379–386 (2007). https://doi.org/10.1007/s00701-007-1126-0

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  • DOI: https://doi.org/10.1007/s00701-007-1126-0

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