FOCAL BRAIN-LESIONS - EFFECT OF SINGLE-VOXEL PROTON MR SPECTROSCOPIC FINDINGS ON TREATMENT DECISIONS

PURPOSE: To determine the influence of single-voxel proton magnetic re sonance (MR) spectroscopic findings on the treatment of patients suspe cted of having a brain tumor. MATERIALS AND METHODS: Medical records w ere reviewed in 78 patients who underwent MR spectroscopy for evaluati on of a focal brain mass suspected of being neoplastic. MR spectroscop ic findings were positive for neoplasm in 49 patients and negative in 29. Treatment with or without performance of biopsy was noted. In pati ents with positive findings who underwent irradiation or chemotherapy without biopsy and in patients with negative finding who were treated medically or followed up for interval changes, MR spectroscopy was cla ssified as having an potential positive influence on treatment. In pat ients with positive findings with subsequently proved nonneoplastic le sions and in patients with negative findings with subsequently proved tumors, MR spectroscopy was classified as having a potential negative influence. RESULTS: MR spectroscopy in eight (16%) patients with posit ive findings and in 15 (52%) patients with negative findings had a pot ential positive influence on treatment. In two (3%) patients, MR spect roscopy had a potential negative influence. CONCLUSION: MR spectroscop y may play a beneficial role in the management of suspected brain tumo rs. Prospective studies are needed to test the effect of MR spectrosco py on clinical practice and to measure costs and benefits.