Prediction of Glioma Grade by Radiological Analysis of its Metabolites.

BACKGROUND: This study targeted to evaluate the ability of magnetic resonance spectroscopy (MRS) as a noninvasive predictive tool for histo-pathological grade of cerebral gliomas. Results: Our study showed that 42/45 of the high grade glioma group (HGGG) had acquired markedly elevated Choline (Cho)/ Creatine (Cr) levels and 40/45 of them had acquired markedly elevated Choline (Cho)/ N acetyl aspartate (NAA) levels. On The other hand and across low grade gliom group (LGGG); 13/15 lesions had acquired mildly elevated Cho/Cr levels and 14/15 lesions had acquired mildly elevated Cho/NAA levels with proved positive significant statistical correlation between Cho/Cr and Cho/NAA within the two groups and the detected histopathological data. Markedly elevated Cho/Cr and Cho/NAA levels were significantly correlated with HGGG; namely (grades III and IV). Mildly elevated Cho/Cr and Cho/NAA levels were correlated with LGGG; namely (grades I and II) (p ≤ 0.05).Conclusion: MRS can be used a predictor of glioma grade. The estimated MRS cut off values to prognosticate high grade glioma is ≥ 4.2 for Cho/Cr and ≥ 4.5 for Cho/NAA based on Receiver operating characteristic (ROC) analysis.Key words: MRS - High grade cerebral gliomas - Low grade cerebral gliomas.