Diagnostic Accuracy  of Magnetic Resonance Spectroscopy  and Diffusion-Weighted Mri in Differentiating Between Pyogenic Brain Abscesses  and Necrotic Brain Tumors

Objective: To determine the diagnostic accuracy of magnetic resonance spectroscopy plus diffusion-weighted Magnetic Resonance Imaging in differentiating pyogenic brain abscess and necrotic brain tumors, taking histopathology as the gold standard. Study Design: Validation study. Place and Duration of Study: Department of Radiology, District Headquarters Hospital, Sargodha Pakistan, Jun 2019 to May 2022. Methodology: A total of 160 patients presenting with symptoms suggestive of brain abscess or tumor, ranging from 20 to 70 years of age, irrespective of gender, were included. All patients were subjected to Magnetic Resonance Imaging including magnetic resonance spectroscopy and diffusion-weighted image. Patients were referred for biopsy to the department of neurosurgery of tertiary care hospitals. Histopathological diagnosis was taken as the gold standard for the determination of diagnostic accuracy. Results: The values for magnetic resonance spectroscopy plus diffusion-weighted Magnetic Resonance Imaging differentiating pyogenic brain abscess and necrotic brain tumor, taking histopathology as the gold standard were as follows: sensitivity 93(75%); specificity (95.31%); positive predictive value 96(77%); negative predictive value 91(04%); and diagnostic accuracy 94(38%). Conclusion: Diffusion-weighted images plus MRS are non–invasive tools with high-level diagnostic value. The combination of these modalities should be employed for accurate diagnosis, precise management, and prompt follow-up of the patients under suspicion of tumor or brain abscess.