ArticleThe neuroradiology journal2015
MR spectroscopy of intracranial tuberculomas: A singlet peak at 3.8 ppm as potential marker to differentiate them from malignant tumors.
Article in The neuroradiology journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Cerebral tuberculoma in pregnancy (Jan 1975-May 2025): a systematic review and descriptive analysis of 33 published cases.BMC infectious diseases · 2026Pooled it
- Navigating complex presentations of central nervous system tuberculosis: A two-case analysis.Radiology case reports · 2026Article
- When Appearances Deceive: A Case Report of Neurocysticercosis Masquerading As Tuberculoma.Cureus · 2026Article
- Thalamic Tuberculoma Presenting as Isolated Gait Disturbance Without Systemic or Meningeal Symptoms in a 2-Year-Old Child: A Case Report.International medical case reports journal · 2026Article
- Stroke Mimicry: Unmasking a Brainstem Tuberculoma in a Young Patient.Clinical case reports · 2025Article
- Radiomics features for the discrimination of tuberculomas from high grade gliomas and metastasis: a multimodal study.Neuroradiology · 2024Article
- Magnetic resonance imaging findings in central nervous system tuberculosis: A pictorial review.Heliyon · 2024Review
- Clinical and Radiological End Points to Stop Anti-Tubercular Treatment in Central Nervous System Tuberculoma and Predictors of Poor Outcome: A Retrospective Study.The American journal of tropical medicine and hygiene · 2023Article
- Tumour-like presentation of brainstem tuberculoma: a lesson learnt.BMJ case reports · 2022Article
- Tuberculosis conundrum - current and future scenarios: A proposed comprehensive approach combining laboratory, imaging, and computing advances.World journal of radiology · 2022Review
- Tuberculosis presenting with seizure and abdominal pain in a young female: A case report.Radiology case reports · 2022Article
- Neuro-ophthalmic manifestations of tuberculosis.Eye (London, England) · 2022Review
- Amide proton transfer imaging for differentiation of tuberculomas from high-grade gliomas: Preliminary experience.The neuroradiology journal · 2021Article
- Utility of 3T single-voxel proton MR spectroscopy for differentiating intracranial meningiomas from intracranial enhanced mass lesions.Acta radiologica open · 2021Article
- Case Report: Unusual High-Grade Diffuse Leptomeningeal Glioneuronal Tumor Mimicking Tuberculous Meningitis in a Child From an Endemic Region.Frontiers in pediatrics · 2021Article
- Multiparametric MRI: practical approach and pictorial review of a useful tool in the evaluation of brain tumours and tumour-like lesions.Insights into imaging · 2020Review
- Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist.The neuroradiology journal · 2019Article
- Lack of choline elevation on proton magnetic resonance spectroscopy in grade I-III gliomas.The neuroradiology journal · 2019Article
- Magnetic resonance imaging spectrum of intracranial tubercular lesions: one disease, many faces.Polish journal of radiology · 2018Review
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Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe diagnosis of intracranial tuberculomas is often challenging. Our purpose is to describe the most common metabolic patterns of tuberculomas by MR spectroscopy (MRS) with emphasis on potential specific markers.
methodsSingle-voxel MRS short echo time was performed in 13 cases of tuberculomas proven by histology and/or response to anti-mycobacterial therapy. For comparison MRS was also performed in 19 biopsy-proven malignant tumors (13 high-grade gliomas and six metastasis). Presence of metabolic peaks was assessed visually and categorical variables between groups were compared using chi-square. Metabolite ratios were compared using Mann-Whitney test and diagnostic accuracy of the metabolite ratios was compared using receiver-operating characteristic (ROC) curves analysis.
resultsSpectroscopic peaks representing lipids and glutamate/glutamine (Glx) as well as a peak at ∼3.8 ppm were well defined in 77% (10/13), 77% (10/13) and 69% (nine of 13) of tuberculomas, respectively. Lipid and Glx peaks were also present in most of the malignant lesions, 79% (15/19) and 74% (14/19) respectively. However, a peak at ∼3.8 ppm was present in only 10% (two of 19) of the tumor cases (p < 0.001). Higher Cho/Cr and mI/Cr ratios helped discriminate malignant lesions with an area under the ROC curve of 0.86 (SE: 0.078, p < 0.002, CI: 0.7-1) and 0.8 (SE: 0.1, p < 0.009, CI: 0.6-1), respectively. Threshold values between 1.7-1.9 for Cho/Cr and 0.8-0.9 for mI/Cr provided high specificity (91% for both metabolites) and adequate sensitivity (75% and 80%, respectively) for discrimination of malignant lesions.
conclusionA singlet peak at ∼3.8 ppm is present in the majority of tuberculomas and absent in most malignant tumors, potentially a marker to differentiate these lesions. The assignment of the peak is difficult from our analysis; however, guanidinoacetate (Gua) is a possibility. Higher Cho/Cr and mI/Cr ratios should favor malignant lesions over tuberculomas. The presence of lipids and Glx is non-specific.
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