Advanced MRI in brain neoplasms

Use of MRI in brain imaging has progressed from anatomical to functional imaging. This approach is effective in assessment of treatment response, pseudo progression and pseudo response.


With MRS malignant tumors can be differentiated from benign tumors by:


High grade tumor will demonstrate:


Higher ratios

  • Cho/Cr (cut of > 2.0) - HMRI

  • Cho/NAA (cut of > 2.2

  • Ch0 + Cr / NAA

  • Cr / NAA

Lower ratios

  • Lipid / Lactate

  • Cr / Lactate


Metastasis can be differentiated from high-grade astrocytomas by their high lipid/cr ratios.