Abstract
The spectroscopic variant of magnetic resonance, magnetic resonance spectroscopy (MRS) allows the non-invasive detection and identification of a wide repertoire of molecules in solution which are present in cells and tissues in the millimolar range. Lactate, alanine, NMR-visible mobile lipids/Macromolecules, N-acetyl aspartate, glutamine, glutamate, creatine, choline, taurine, glucose, glycine and myo-inositol are the most common substances that can be detected in normal brain and in brain tumors. It is suggested that the voxel or volume of Interest (VOI) is placed after having performed the MRI exam, preferably with contrast administration and that the acquisition parameters used are widely accepted and used in the MR community. When reporting on a Single Voxel (SV) MRS study in the context of the clinical diagnosis or staging of brain tumors, it is advisable to carry out an structured description of the spectrum that, assigns the peaks to known metabolites and, describes the relationships between one another.The quantitative analysis can range from simple methods such as ratios between metabolites to semi-automated systems such using a decision-support system (DSS). Three situations can be indicated for SV MRS in suspected brain tumors: discrimination between tumor and pseudotumoral lesion, tumor grading, and follow-up of brain tumors after treatment.
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