Focal brain lesions: Effect of single-voxel proton MR spectroscopic findings on treatment decisions

PURPOSE: To determine the influence of single-voxel proton magnetic resonance (MR) spectroscopic findings on the treatment of patients suspected of having a brain tumor. MATERIALS AND METHODS: Medical records were reviewed in 78 patients who underwent MR spectroscopy for evaluation of a focal brain mass suspected of being neoplastic. MR spectroscopic findings were positive for neoplasm in 49 patients and negative in 29. Treatment with or without performance of biopsy was noted. In patients 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 classified as having an potential positive influence on treatment. In patients with positive findings with subsequently proved nonneoplastic lesions 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 positive findings and in 15 (52%) patients with negative findings had a potential positive influence on treatment. In two (3%) patients, MR spectroscopy had a potential negative influence. CONCLUSION: MR spectroscopy may play a beneficial role in the management of suspected brain tumors. Prospective studies are needed to test the effect of MR spectroscopy on clinical practice and to measure costs and benefits.