Prospective diagnostic performance evaluation of single-voxel 1H MRS for typing and grading of brain tumours

Margarida Julià-Sapé, Indira Coronel, Carles Majós, Ana Paula Candiota, Marta Serrallonga, Mònica Cos, Carles Aguilera, Juan José Acebes, John R. Griffiths, Carles Arús*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

43 Citations (Scopus)


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. © 2011 John Wiley & Sons, Ltd.
Original languageEnglish
Pages (from-to)661-673
Number of pages13
JournalNMR in Biomedicine
Issue number4
Publication statusPublished - 1 Apr 2012


  • Brain neoplasms
  • Diagnosis, computer-assisted
  • Diagnostic techniques and procedures
  • MRI
  • MRS
  • Receiver operating characteristic curve


Dive into the research topics of 'Prospective diagnostic performance evaluation of single-voxel <sup>1</sup>H MRS for typing and grading of brain tumours'. Together they form a unique fingerprint.

Cite this