{"title":"Gliomas grading prediction using multicenter 3T Magnetic Resonance Spectroscopy.","authors":"Di Guo, Kaiwei Xie, Jiacheng Lin, Jianshu Chen, Jialue Zhang, Meijin Lin, Xiaobo Qu, Wanjun Hu, Jianhua Wang, Dongyun Liang","doi":"10.1186/s12880-026-02640-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Magnetic Resonance Spectroscopy (MRS) is a non-invasive imaging technique that detects various metabolites in brain tissues, making it essential for the grading of brain gliomas. MRS measures key metabolites such as N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr), whose ratio changes provide valuable information for glioma grading, guiding diagnosis, treatment, and prognosis. Current studies are largely single-center, with grading criteria differing across hospitals. This work aims to identify reliable and consistent metabolite ratios for glioma grading by jointly analyzing multicenter 3T single-voxel MRS of brain gliomas. The grading accuracy of these metabolite ratios is evaluated to establish a more standardized diagnostic basis.</p><p><strong>Materials and methods: </strong>We retrospectively included the MRS data from 60 glioma patients from 3 hospitals. MRS results included 4 metabolite ratios: NAA/Cr, Cho/NAA, Cho/Cr, and NAA/(Cho + Cr). The Shapiro-Wilk test was employed to ascertain the normality of the data, and the differences were calculated using either an independent t-test or a Mann-Whitney U-test. The classification performance was evaluated using ROC curve and accuracy analysis.</p><p><strong>Results: </strong>Across multicenter data, statistically significant differences were found in Cho/NAA and Cho/Cr ratios between low- and high-grade gliomas (P < 0.05). ROC analysis showed AUCs of 0.73 for Cho/NAA and 0.74 for Cho/Cr, indicating good classification performance. Validation results showed 75% accuracy, supporting their potential for clinical glioma grading. The optimal cut-off value trained from any two hospitals is validated at a third hospital, and the accuracies of Cho/Cr are 77.78%, 100%, and 65%, respectively.</p><p><strong>Conclusion: </strong>Multicenter data analysis confirmed the good classification accuracy of Cho/NAA and Cho/Cr in glioma grading, providing a reliable basis for clinical treatment and prognosis planning. This aligns with findings from other studies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"26 1","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13715249/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Medical Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12880-026-02640-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Magnetic Resonance Spectroscopy (MRS) is a non-invasive imaging technique that detects various metabolites in brain tissues, making it essential for the grading of brain gliomas. MRS measures key metabolites such as N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr), whose ratio changes provide valuable information for glioma grading, guiding diagnosis, treatment, and prognosis. Current studies are largely single-center, with grading criteria differing across hospitals. This work aims to identify reliable and consistent metabolite ratios for glioma grading by jointly analyzing multicenter 3T single-voxel MRS of brain gliomas. The grading accuracy of these metabolite ratios is evaluated to establish a more standardized diagnostic basis.
Materials and methods: We retrospectively included the MRS data from 60 glioma patients from 3 hospitals. MRS results included 4 metabolite ratios: NAA/Cr, Cho/NAA, Cho/Cr, and NAA/(Cho + Cr). The Shapiro-Wilk test was employed to ascertain the normality of the data, and the differences were calculated using either an independent t-test or a Mann-Whitney U-test. The classification performance was evaluated using ROC curve and accuracy analysis.
Results: Across multicenter data, statistically significant differences were found in Cho/NAA and Cho/Cr ratios between low- and high-grade gliomas (P < 0.05). ROC analysis showed AUCs of 0.73 for Cho/NAA and 0.74 for Cho/Cr, indicating good classification performance. Validation results showed 75% accuracy, supporting their potential for clinical glioma grading. The optimal cut-off value trained from any two hospitals is validated at a third hospital, and the accuracies of Cho/Cr are 77.78%, 100%, and 65%, respectively.
Conclusion: Multicenter data analysis confirmed the good classification accuracy of Cho/NAA and Cho/Cr in glioma grading, providing a reliable basis for clinical treatment and prognosis planning. This aligns with findings from other studies.
期刊介绍：
BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.
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