# Diagnostic yield of the combined magnetic resonance imaging and magnetic resonance spectroscopy to predict malignant brain tumor
> Mulyadi R.

URL kanonis: https://discover.unhas.ac.id/publications/diagnostic-yield-of-the-combined-magnetic-resonance-imaging-and-magnetic-resonan
Jurnal / Konferensi: Bali Medical Journal
Tahun terbit: 2020
DOI: https://doi.org/10.15562/bmj.v9i1.1486
ISSN: 20891180
Citations: 3

## Authors
- Mulyadi R.

## Abstract
Introduction: Brain tumor is a neoplasm originating from various type of intracranial tissue. Histopathology is the gold standard to diagnose brain tumor. However, due to its invasive nature, the biopsy procedure poses a substantial risk. Therefore, advanced imaging, such as conventional Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS), has been widely developed to determine brain tumor type. Conventional MRI has been a routine examination for a suspected brain tumor in Indonesia, and with the utilization of MRS, could theoretically improve the diagnostic yield. This study aims to find diagnostic properties of conventional MRI, Choline/Creatine and Choline/NAA ratio extracted from MRS, and as a combined parameter to differentiate brain tumor type.Methods: This cross-sectional study involved 52 patients who underwent conventional MRI, MRS, and histopathology examination for a suspected brain tumor. The cut-off from Dean Criteria of conventional MRI, Choline/Creatine and Choline/NAA ratio to classify tumor type was determined from the ROC curve and then the diagnostic parameters were calculated from cross-tabulation. Also, a novel approach was made with logical-mathematical equation (disjunction/ ˅ / “or” and conjunction/ ˄ / “and”) to combined parameter obtained from MRI and MRS to predict histopathological brain tumor type.Results: Conventional MRI combined with MRS improve diagnostic yield compared to a single parameter with a sensitivity of 87.5%, a specificity of 88.6%, accuracy of 88.5%, PPV of 58.3%, NPV of 97.5%, LR+ of 7.68, dan LR- of 0.1.Conclusion: Combination of conventional MRI and MRS parameter could improve the diagnostic yield in differentiating the type of brain tumor.

## Keywords
- Magnetic resonance imaging
- Brain tumor
- Histopathology
- Choline
- Creatine
- Medicine
- In vivo magnetic resonance spectroscopy
- Gold standard (test)
- Biopsy
- Radiology
- Nuclear medicine
- Pathology
- Internal medicine

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Sumber: Discover Unhas — RIMS Universitas Hasanuddin.
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