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Role of MR spectroscopy in musculoskeletal imaging.

Deshmukh S, Subhawong T, Carrino JA, Fayad L - Indian J Radiol Imaging (2014)

Bottom Line: By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response.Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged.The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA.

ABSTRACT
Magnetic resonance spectroscopy (MRS) is an imaging approach that allows for the noninvasive molecular characterization of a region of interest. By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response. Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged. The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.

No MeSH data available.


Related in: MedlinePlus

A 36 year old man who presented with a spontaneous soft tissue mass in the thigh. Although a hematoma was suspected, the lack of history of trauma raised the possibility of a tumor. Axial fat-suppressed T2W image (A) shows the hyperintense mass. Proton MRS (B) no evidence of a discrete choline peak, suggesting benign etiology. The patient underwent a biopsy which showed no evidence of malignant cells, and then a follow-up which showed resolution of the hematoma
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Figure 5: A 36 year old man who presented with a spontaneous soft tissue mass in the thigh. Although a hematoma was suspected, the lack of history of trauma raised the possibility of a tumor. Axial fat-suppressed T2W image (A) shows the hyperintense mass. Proton MRS (B) no evidence of a discrete choline peak, suggesting benign etiology. The patient underwent a biopsy which showed no evidence of malignant cells, and then a follow-up which showed resolution of the hematoma

Mentions: Current literature investigating the use of choline as a marker for malignancy by musculoskeletal MRS has been largely qualitative.[2] A recent comprehensive pooled analysis of previously published literature on qualitative MRS assessment of de novo musculoskeletal lesions demonstrated a sensitivity of 88% and a specificity of 68% for the presence of detectable choline as a predictor of malignancy. The positive predictive value (PPV) and negative predictive value for malignancy in the presence of a discrete total choline peak were 73% and 86%, respectively. Interestingly, of the 20 benign entities with detectable choline peaks, 15 were either giant cell tumors or peripheral nerve sheath tumors which are lesions that may have aggressive biological behavior [Figure 4].[5] Using a quantitative approach, however, MRS measurements of choline concentration raised the negative predictive value for excluding malignancy to 100%(PPV remained at 73%) when a threshold of 0.3 IU was used. Therefore, at this time, proton MRS is most useful for its high negative predictive value in ruling out malignancy in a musculoskeletal lesion [Figure 5].


Role of MR spectroscopy in musculoskeletal imaging.

Deshmukh S, Subhawong T, Carrino JA, Fayad L - Indian J Radiol Imaging (2014)

A 36 year old man who presented with a spontaneous soft tissue mass in the thigh. Although a hematoma was suspected, the lack of history of trauma raised the possibility of a tumor. Axial fat-suppressed T2W image (A) shows the hyperintense mass. Proton MRS (B) no evidence of a discrete choline peak, suggesting benign etiology. The patient underwent a biopsy which showed no evidence of malignant cells, and then a follow-up which showed resolution of the hematoma
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126135&req=5

Figure 5: A 36 year old man who presented with a spontaneous soft tissue mass in the thigh. Although a hematoma was suspected, the lack of history of trauma raised the possibility of a tumor. Axial fat-suppressed T2W image (A) shows the hyperintense mass. Proton MRS (B) no evidence of a discrete choline peak, suggesting benign etiology. The patient underwent a biopsy which showed no evidence of malignant cells, and then a follow-up which showed resolution of the hematoma
Mentions: Current literature investigating the use of choline as a marker for malignancy by musculoskeletal MRS has been largely qualitative.[2] A recent comprehensive pooled analysis of previously published literature on qualitative MRS assessment of de novo musculoskeletal lesions demonstrated a sensitivity of 88% and a specificity of 68% for the presence of detectable choline as a predictor of malignancy. The positive predictive value (PPV) and negative predictive value for malignancy in the presence of a discrete total choline peak were 73% and 86%, respectively. Interestingly, of the 20 benign entities with detectable choline peaks, 15 were either giant cell tumors or peripheral nerve sheath tumors which are lesions that may have aggressive biological behavior [Figure 4].[5] Using a quantitative approach, however, MRS measurements of choline concentration raised the negative predictive value for excluding malignancy to 100%(PPV remained at 73%) when a threshold of 0.3 IU was used. Therefore, at this time, proton MRS is most useful for its high negative predictive value in ruling out malignancy in a musculoskeletal lesion [Figure 5].

Bottom Line: By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response.Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged.The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, Maryland, USA.

ABSTRACT
Magnetic resonance spectroscopy (MRS) is an imaging approach that allows for the noninvasive molecular characterization of a region of interest. By detecting signals of water, lipids, and other metabolites, MRS can provide metabolic information for lesion characterization and assessment of treatment response. Although MRS has been routinely used in the brain, clinical applications within the musculoskeletal system have only more recently emerged. The aim of this article is to review the technical considerations for performing MRS in the musculoskeletal system, focusing on proton MRS, and to discuss its potential roles in musculoskeletal tumor imaging and the assessment of muscle physiology and disease.

No MeSH data available.


Related in: MedlinePlus