Decoding Brain Metabolism: Diagnostic Accuracy of Magnetic Resonance Spectroscopy Versus Fluorodeoxyglucose Positron Emission Tomography in Neurological Disorders

Abstract

Objective:  To compare the diagnostic performance of Magnetic Resonance Spectroscopy (MRS) and Positron Emission Tomography (PET) in the evaluation of brain metabolic disorders, with a specific focus on diagnostic accuracy, lesion detection, and metabolite quantification.

Materials and Methods:  This prospective observational study was conducted at the Department of Radiology, Lady Reading Hospital, Peshawar, from January to July 2023. A total of 150 patients with clinical suspicion of brain metabolic dysfunction underwent MRS at LRH and PET at affiliated external centers. Imaging findings were independently interpreted by two radiologists. Diagnostic metrics were calculated, and statistical significance was determined using chi-square and independent t-tests.

Results:  Lesion detection rates were 78.0% for MRS and 88.0% for PET. PET demonstrated higher sensitivity (88%) compared to MRS (78%), while MRS had slightly higher specificity (85% vs. 82%). Combined modality uses in concordant cases yielded the highest diagnostic accuracy (AUC = 0.93). Statistical analysis confirmed significant differences (p < 0.05).

Conclusion:  MRS and PET offer complementary diagnostic capabilities. Their combined application enhances diagnostic accuracy and clinical confidence, especially in resource-limited or diagnostically challenging scenarios.