Greg Fellows1, Alan James Wright2, Naomi Sibtain3, Philip Rich4, Kirstie S. Opstad2, Dominick J.O McIntyre5, Brian Anthony Bell1, John Griffiths5, Franklyn Arron Howe6
1Academic Neurosurgery Unit, St. George's University of London, London, UK; 2Basic Medical Sciences, St. George's University of London, London, UK; 3Neuroradiology, Kings College Hospital NHS Trust, London, UK; 4Neuroradiology, St. George's Hospital NHS Trust, London, UK; 5CRUK Cambridge Research Institute, Cambridge, UK; 6Cardiac and Vascular Sciences, St. George's University of London, London, UK
Oncological practice requires histopathological confirmation of glioblastoma multiforme (GBM) prior to radiotherapy. If lesion location or patient health precludes surgical debulking prior to treatment, then 1H MRS could provide a clinically useful alternative diagnosis to biopsy. 89 patients with 1H-MRS, CT and MRI were evaluated neuroradiologically and spectroscopically. Of patients selected on clinical and neuroradiological grounds for diagnostic biopsy alone, there was 100% concordance between a spectroscopy and histopathological diagnosis of GBM. We propose a 1H MRS protocol for accurate diagnosis of a subset of GBM patients for which a surgical procedure and treatment delay could be avoided.