title: Magnetic Resonance Spectroscopy and Single-Photon Emission Computed Tomography in the Evaluation of Cerebral Tumors: A Case Report.
abstract: In their daily clinical practice, physicians have to confront diagnostic dilemmas which cannot be resolved by the application of only one imaging technique. In this case report, we present a 66-year-old woman who was admitted to our institution for the surgical resection of a recently diagnosed brain tumor. The patient had a history of epileptic seizures and was hospitalized in the past for anti-phospholipid syndrome related to a non-Hodgkin lymphoma in remission. Magnetic resonance imaging (MRI) examination revealed an enhancing right parasagittal lesion with significant edema suggestive of a high grade glioma. Advanced MRI techniques including proton magnetic resonance spectroscopy (1H-MRS) showed findings compatible of glioma. An additional examination was performed as part of a protocol that we are routinely performing in our institution for all brain tumors including not only the gold standard advanced MRI techniques but also single-photon emission computed tomography (SPECT) with technetium-99m (Tc99m). Brain SPECT indicated the presence of a meningioma which was verified by the histopathology of the resected specimen. In conclusion, a multimodality approach for the pre-surgical assessment of brain tumors has significant advantages not only for the diagnosis but also for the evaluation of intracranial tumors histology.
authors.affiliation: Department of Neurosurgery, University Hospital of Larissa, Greece; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, Buffalo, NY, USA.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Siasios
authors.affiliation: Department of Nuclear Medicine, University Hospital of Larissa, Greece.
authors.forename: Varvara
authors.initials: V
authors.lastname: Valotassiou
authors.affiliation: Department of Diagnostic Radiology, University Hospital of Larissa, Greece.
authors.forename: Eftychia
authors.initials: E
authors.lastname: Kapsalaki
authors.affiliation: Department of Medical Physics, University Hospital of Larissa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Tsougos
authors.affiliation: Department of Nuclear Medicine, University Hospital of Larissa, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Georgoulias
authors.affiliation: Department of Neurosurgery, University Hospital of Larissa, Greece.
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Fotiadou
authors.affiliation: Department of Pathology, University Hospital of Larissa, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Ioannou
authors.affiliation: Department of Pathology, University Hospital of Larissa, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Koukoulis
authors.affiliation: Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, Buffalo, NY, USA.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Dimopoulos
authors.affiliation: Department of Neurosurgery, University Hospital of Larissa, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Fountas
keywords: 1H-MRS; Brain SPECT; Brain tumors; MRI advanced techniques; Pre-surgical evaluation; Tumor grading