TY - JOUR
AU1 - Hollingworth, W.
AU2 - Medina, L.S.
AU3 - Lenkinski, R.E.
AU4 - Shibata, D.K.
AU5 - Bernal, B.
AU6 - Zurakowski, D.
AU7 - Comstock, B.
AU8 - Jarvik, J.G.
AB - BACKGROUND AND PURPOSE: Proton MR spectroscopy ( 1 H-MR spectroscopy) is a potentially useful adjunct to anatomic MR imaging in the characterization of brain tumors. We performed an updated systematic review of the evidence. METHODS: We employed a standardized search strategy to find studies published during 2002–2004. We reviewed studies measuring diagnostic accuracy and diagnostic, therapeutic, or health impact of 1 H-MR spectroscopy. We abstracted information on study design, 1 H-MR spectroscopy technique, and methodologic quality. We categorized studies into 5 subgroups: (1) metastasis versus high-grade tumor; (2) high-versus low-grade tumor; (3) recurrent tumor versus radiation necrosis; (4) tumor extent; and (5) tumor versus non-neoplastic lesion. RESULTS: We identified 26 studies evaluating diagnostic performance, diagnostic impact, or therapeutic impact. No articles evaluated patient health or cost-effectiveness. Methodologic quality was mixed; most used histopathology as the reference standard but did not specify blinded interpretation of histopathology. One large study demonstrated a statistically significant increase in diagnostic accuracy for indeterminate brain lesions from 55%, based on MR imaging, to 71% after analysis of 1 H-MR spectroscopy. Several studies have found that 1 H-MR spectroscopy is highly accurate for distinguishing high- and low-grade gliomas, though the incremental benefit of 1 H-MR spectroscopy in this setting is less clear. Interpretation for the other clinical subgroups is limited by the small number of studies. CONCLUSION: The current evidence on the accuracy of 1 H-MR spectroscopy in the characterization of brain tumors is promising. However, additional high-quality studies are needed to convince policy makers. We present guidelines to help focus future research in this area.
TI - A Systematic Literature Review of Magnetic Resonance Spectroscopy for the Characterization of Brain Tumors
JF - American Journal of Neuroradiology
DA - 2006-08-01
UR - https://www.deepdyve.com/lp/american-journal-of-neuroradiology/a-systematic-literature-review-of-magnetic-resonance-spectroscopy-for-7WPygtV3fx
VL - 27
IS - 7
DP - DeepDyve
ER -