Gliomas grading prediction using multicenter 3T Magnetic Resonance Spectroscopy
6 affiliations
- 1School of Computer and Information Engineering, Fujian Engineering Research Center for Medical Data Mining and Application, Xiamen University of Technology, Xiamen, 361024 China
- 2Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, School of Electronic Science and Engineering, Xiamen University, Xiamen, 361005 China
- 3Department of Applied Marine Physics and Engineering, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen, 361005 China
- 4Department of Radiology, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, 361000 China
- 5Department of Nuclear Magnetic Resonance, The Second Hospital & Clinical Medical School, Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou University, Lanzhou, 730030 China
- 6Department of Radiology, Zhongshan Hospital (Xiamen), Xiamen Municipal Clinical Research Center for Medical Imaging, Fujian Province Key Clinical Specialty for Medical Imaging, Xiamen Key Laboratory of Clinical Transformation of Imaging Big Data and Artificial Intelligence, Fudan University, Xiamen, 361015 China
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.
Clinical trial number: Not applicable.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12880-026-02640-5.
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BibTeX
@article{guo2026gliomas,
title = {{Gliomas grading prediction using multicenter 3T Magnetic Resonance Spectroscopy}},
author = {Di Guo and Kaiwei Xie and Jiacheng Lin and Jianshu Chen and Jialue Zhang and Meijin Lin and Xiaobo Qu and Wanjun Hu and Jianhua Wang and Dongyun Liang},
journal = {BMC Medical Imaging},
year = {2026},
month = jul,
doi = {10.1186/s12880-026-02640-5},
url = {https://doi.org/10.1186/s12880-026-02640-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Gliomas grading prediction using multicenter 3T Magnetic Resonance Spectroscopy
AU - Di Guo
AU - Kaiwei Xie
AU - Jiacheng Lin
AU - Jianshu Chen
AU - Jialue Zhang
AU - Meijin Lin
AU - Xiaobo Qu
AU - Wanjun Hu
AU - Jianhua Wang
AU - Dongyun Liang
PY - 2026
DA - 2026/07/31
JO - BMC Medical Imaging
DO - 10.1186/s12880-026-02640-5
UR - https://doi.org/10.1186/s12880-026-02640-5
AB - 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. Clinical trial number: Not applicable. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12880-026-02640-5.
SN - 1471-2342
ER -