{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:25:09Z","timestamp":1789439109747,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012409","name":"Faculty of Health Sciences, University of Ottawa","doi-asserted-by":"publisher","award":["Joan Sealy Trust Fund (no award number)"],"award-info":[{"award-number":["Joan Sealy Trust Fund (no award number)"]}],"id":[{"id":"10.13039\/100012409","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009326","name":"Cancer Research Society","doi-asserted-by":"publisher","award":["Operating Grant ID #843139"],"award-info":[{"award-number":["Operating Grant ID #843139"]}],"id":[{"id":"10.13039\/100009326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Edited MRS technique such as MEshcher\u2010GArwood Point RESolved Spectroscopy (MEGA\u2010PRESS) can determine isocitrate dehydrogenase mutation (IDH) mutation status in patients with gliomas but its accuracy in assessing glioma grade has not yet been formally evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the diagnostic accuracy of metabolites such as lactate obtained from the PRESS and MEGA\u2010PRESS sequences in the preoperative grading of glioma. To assess the prognostic value of those metabolite ratios in the overall survival of patients with gliomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Sixty\u2010nine subjects with gliomas (16 grade 2, 21 grade 3, and 32 grade 4). Mean age was 50.5\u2009\u00b1\u200916.7\u2009years; 38 were male and 31 were female.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2009T\/MEGA\u2010PRESS, PRESS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Single voxel PRESS and MEGA\u2010PRESS spectra were obtained from tumors in patients undergoing preoperative MRI. Several tumor metabolites were measured from the PRESS, MEGA\u2010PRESS edit\u2010off, and difference spectra using LCModel (Linear Combination of Model Spectra) software. Diagnosis and glioma grading was done using the World Health Organization (WHO) 2016 classification. Overall survival was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Diagnostic accuracy was measured using receiver\u2010operating characteristic (ROC) curve. Univariate and multivariate Cox proportional hazards modeling was used for the assessment of prognostic factors for time to death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the differentiation between low\u2010 vs. high\u2010grade gliomas, tCr\/tCho ratios obtained from PRESS and MEGA\u2010PRESS sequences had similar accuracies (area under the ROC curves [AUCs]\u2009=\u20090.71) while Lac\/NAA from PRESS had a lower accuracy (AUC\u2009=\u20090.65). The presence of a detectable 2\u2010hydroxyglutarate peak on the difference spectrum was a favorable prognostic factor in univariate analysis (hazard ratio\u2009=\u20090.25, 95% confidence interval: 0.08\u20130.83). No other metabolite was found to be a significant prognostic factor in univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Edited MRS can be used to detect metabolites which can help in the preoperative grading of gliomas and in determination of the overall survival.\u2009A separate PRESS acquisition is needed for lactate quantification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Gliomas are brain tumors that vary in severity.  This study explored the use of two advanced MR spectroscopy techniques (PRESS and MEGA\u2010PRESS) in detecting tumor metabolites. The authors found that both techniques' choline\/creatine ratio showed moderate accuracy in identifying high\u2010grade gliomas. Lactate was better revealed with the PRESS technique and was associated with high\u2010grade gliomas. They confirmed that the MEGA\u2010PRESS technique allowed additional detection of 2\u2010hydroxyglutarate in IDH\u2010mutant gliomas, which was linked to better survival. These findings emphasize that advanced MR spectroscopy can extract metabolic information time\u2010efficiently, which can be used to improve the preoperative diagnosis of patients with gliomas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29690","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T13:44:21Z","timestamp":1741700661000},"page":"2480-2488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Accuracy of <scp><sup>1<\/sup>H<\/scp>\u2010<scp>MRS<\/scp> Using <scp>PRESS<\/scp> and <scp>MEGA<\/scp>\u2010<scp>PRESS<\/scp> Techniques in the Preoperative Grading of Patients With Gliomas"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5983-6003","authenticated-orcid":false,"given":"Maria L.","family":"Brun\u2010Vergara","sequence":"first","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics The Ottawa Hospital|University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Melkus","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics The Ottawa Hospital|University of Ottawa  Ottawa Ontario Canada"},{"name":"Division of Physics Carleton University  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2975-2260","authenticated-orcid":false,"given":"Santanu","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics The Ottawa Hospital|University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9990-2420","authenticated-orcid":false,"given":"Nader","family":"Zakhari","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics The Ottawa Hospital|University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4104-7115","authenticated-orcid":false,"given":"Carlos","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radiation Oncology and Medical Physics The Ottawa Hospital|University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"AlKherayf","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery The Ottawa Hospital|University of Ottawa  Ottawa Ontario 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