Diagnostic Efficacy of Magnetic Resonance Spectroscopy at Perilesional Edema of Neoplastic Brain Lesion for Detection of Glioma

Background: Magnetic Resonance Spectroscopy (MRS) offers metabolic information about lesions in the brain and could enhance the differentiation between tumor types, especially in the perilesional edema. Objective: The study aimed to assess the diagnostic usefulness of MRS in the differentiation of glioma and other neoplastic brain lesions in a Bangladeshi population. Methodology: The study was a cross-sectional analytical study that was carried out in Bangabandhu Sheikh Mujib Medical University, Dhaka, between April 2023 and March 2025. There were 35 adult patients of neoplastic lesions of the brain with perilesional edema who were subjected to conventional MRI, and, afterwards, to MRS. The ratios of the metabolites were compared with the histopathological results, which are regarded as the gold standard. SPSS version 26 was used to perform a statistical analysis and Fisher's exact test was used to evaluate associations. Results: Glioma was the most common among the respondents (80.0%), then meningiomas (11.4%), and lastly, metastases (8.6%). The elevated Cho/Cr ratio (>1.24) was found in 92.9% of the cases of glioma and 28.6% of other tumors (p = 0.001). The Cho/Cr ratio was sensitive (92.86) and specific (71.43), with a positive predictive value (92.86) and a negative predictive value (71.43) as well as an overall diagnostic accuracy (88.57) in distinguishing between gliomas and other neoplastic lesions. Conclusion: MRS, especially Cho/Cr ratio based on the perilesional edema, is a viable non-invasive method of distinguishing between glioma and other types of brain tumor. It is used to supplement standard MRI and improve the preoperative diagnostic accuracy to aid in making a better clinical decision. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):49-57