Assessment of Residual Tumor After Resection of Glioma: A Magnetic Resonance Spectroscopic Study

Background: Detection of actual residual tumor extent after resection of gliomas is important for further treatment implications. Conventional MRI features such as T1 weighted contrast enhancement or T2 weighted hyperintensity are not strong indicators of the tumor. Therefore, it is needed to use advanced metabolic imaging such as magnetic resonance spectroscopy (MRS). Objectives: This work reports the contrast between MRS defining metabolic alteration and imaging features of residual tumor after glioma resection. Methods: Eighteen patients with glioma after tumor resection were included in the study. Routine MRI sequences and multi-voxel MRS were obtained. Metabolic regions of interest (ROI) were defined for Cho/NAA and Cho/Cr in di erent thresholds. Imaging ROI for residual tumor (ROI-t) was defined on conventional MR images. Area of each ROI, the distance between ROI centers, and dice coeÿcient for the evaluation of similarity between imaging and metabolic ROIs were calculated. Results: Maximum similarity and minimum distance of ROI centers were determined between ROI of Cho/NAA > 1.7 and ROI-t. For Cho/Cr, the maximum similarity was determined in > 1.5. Conclusions: Findings of the present study propose that MRS could be a proper detector for residual tumor after surgical treatment of glioma.