Magnetic resonance spectroscopy (MRS), unlike conventional magnetic resonance
imaging (MRI), provides information on the brain’s chemical environment (rather than
neuroanatomical structure) and the data are most commonly presented as line spectra.
This capacity for determining brain metabolite concentrations provides the basis for
clinical investigation of, and differentiation between, neurological and neurosurgical
Combined methods have led to further refinements
with, for example, high visuospatial resolution afforded by MRI combined with
metabolic information from the lesion site (measured with 18F-fluorodeoxyglucose
positron emission tomography; FDG-PET) to indicate location and malignancy of
gliomas, which in turn informs radiosurgical targeting. Kapsalaki et al. (Chapter 7)
consider MRS spectroscopic profiles for differentiation among ring enhancing lesions
including high grade gliomas, abscesses and post-radiation necrosis.