الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
Aim of the work: The aim of the study is to show the role and diagnostic value of magnetic resonance spectroscopy (1 HMRS) in differentiating progression from pseudoprogression in malignant glioma patients treated with radiotherapy. Patients and method: this study was carried out in the Radiology Departments of Ain Shams University Hospitals. All the patient were referred from the clinical oncology Department, Ain shams University hospitals. A total of 20 patients presented with pathologically proven high grade glioma. They were 12 (60%) females and 8 (40%) males. Their age ranged from 26 to 78 years old. Results: There was slight agreement between intralesional Ch/NAA and Clinical Assessment (kappa=0.143) as 42.9% of clinically deteriorated cases showed deterioration by Ch/NAA, and 71.4% of clinically non deteriorated cases showed no deterioration by Ch/NAA. The ratio showed accuracy 57.1%, Sensitivity 42.9%, Specificity 71.4%, Positive predictive value (PPV) 60% and Negative predictive value (NPV) 55.5%. Conclusion: Conventional contrast enhanced MRI is an effective and accurate tool in assessment of treatment response to RTH +/- CTH of high grade glioma patients, unlike intralesional Choline/NAA ratio that show low accuracy. MR Spectroscopy imaging could play potential role in response monitor, yet a multiparametric imaging approach may aid PsP/PD distinction, combining DWI, perfusion with spectroscopy data can improve the diagnostic accuracy and may further improve sensitivity and specificity of standard imaging in diagnosing recurrence of brain tumors.