1H-MRS of intracranial meningiomas: What it can add to known clinical and MRI predictors of the histopathological and biological characteristics of the tumor?

Mikhail F. Chernov, Hidetoshi Kasuya, Kotaro Nakaya, Koichi Kato, Yuko Ono, Shigetoshi Yoshida, Yoshihiro Muragaki, Takashi Suzuki, Hiroshi Iseki, Osami Kubo, Tomokatsu Hori, Yoshikazu Okada, Kintomo Takakura

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)


Objective: The main goal of the present study was evaluation of proton magnetic resonance spectroscopy (1H-MRS) in diagnosis of histopathologically aggressive intracranial meningiomas. Methods: Single-voxel 1H-MRS of 100 intracranial meningiomas was performed before their surgical resection. Investigated metabolites included mobile lipids, lactate, alanine, N-acetylaspartate (NAA), and choline-containing compounds (Cho). According to criteria of World Health Organization (WHO) 82 meningiomas were assigned histopathological grade I, 11 grade II, and 7 grade III. The MIB-1 index varied from 0% to 27.3% (median, 1.6%). In 43 cases tight adhesion of the tumor to the pia mater or brain tissue was macroscopically identified at surgery. The consistency of 49 meningiomas was characterized as soft, 26 as hard, and 25 as mixed. Results: No one metabolic parameter had statistically significant association with histopathological grade and subtype, invasive growth, and consistency of meningioma. Univariate statistical analysis revealed greater 1H-MRS-detected Cho content (P = 0.0444) and lower normalized NAA/Cho ratio (P = 0.0203) in tumors with MIB-1 index 5% and more. However, both parameters lost their statistical significance during evaluation in the multivariate model along with other clinical and radiological variables. It was revealed that non-benign histopathology of meningioma (WHO grade II/III) is mainly predicted by irregular shape (P = 0.0076) and large size (P = 0.0316), increased proliferative activity by irregular shape (P = 0.0056), and macroscopically invasive growth by prominent peritumoral edema (P = 0.0021). Conclusion: While 1H-MRS may be potentially used for the identification of meningiomas with high proliferative activity, it, seemingly, could not add substantial diagnostic information to other radiological predictors of malignancy in these tumors.

Original languageEnglish
Pages (from-to)202-212
Number of pages11
JournalClinical Neurology and Neurosurgery
Issue number3
Publication statusPublished - 2011 Apr
Externally publishedYes


  • Consistency
  • Histopathological grade
  • Histopathological subtype
  • Invasiveness
  • MIB-1 index
  • Meningioma
  • Proton magnetic resonance spectroscopy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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