The role of MR spectroscopy in neurooncology.

Magnetic resonance spectroscopy (MRS) is a diagnostic tool that provides information related to brain's metabolic activity. Literature data suggest that elevation of the ratio between the choline and creatine (the Cho/Cr ratio), the reduction of the ratio between n-acetyl-aspartate acid and creatine (the NAA/Cr ratio), increase of the ratio between myo-inositol and creatine (the MI/Cr ratio), and the presence of lipids and lactate are useful diagnostic markers in grading tumors as well as in the prediction of tumor malignancy potential. Two additional important roles of MRS are differentiation between recurrent tumor and radiation necrosis and evaluation of peritumoral region.