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A clinical decision model which uses MR spectroscopy to help physicians differentiate between recurrent tumours and changes in the brain tissue due to radiation treatments, may help patients avoid invasive procedures and treatments, according to a study performed at the University of Michigan Health System in Ann Arbor, MI.

The study included 33 patients who had undergone radiation treatment for brain tumours and had MRI examinations that showed new lesions (either a recurrent tumour or radiation changes). Patients then underwent MR spectroscopy and ratios of three metabolites, choline (Cho), creatine (Cr) and n-acetylaspartate (NAA) were calculated. An ROC curve and prediction model was then created, which determined the post-test probability of a patient having a recurrent tumour. For the study, the final number of patients with recurrent tumours was 20 and those with post-radiation change were 13.

“MR spectroscopy looks inside each area of the brain and determines concentrations of metabolites that are there,” said Ethan Smith, MD, lead author of the study. “Choline, creatine and NAA are the three metabolites that are most commonly looked at. They are found inside the cells of the brain and the ratios between each change depending on if the cells are malignant or benign. With further work, this technique could save some patients from unnecessary brain biopsies,” said Dr. Smith.

This study appears in the February issue of the American Journal of Roentgenology.