Technology Assessment

Magnetic Resonance Spectroscopy For Brain Tumors

2003

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Issue

Magnetic Resonance Spectroscopy (MRS) measures in vivo concentrations of specific metabolites within a pre-determined volume of brain tissue. Using this information, MRS could potentially assist in the diagnosis of space occupying lesions in the brain.

The use of MRS is currently subject to a national noncoverage determination (Coverage Issues Manual Section 50-13).

On August 8, 2002 the American College of Radiology formally requested a National Coverage Determination (NCD) be made for MRS for the following indications:

1. Cerebral tumor versus abscess or other infectious or inflammatory process, and

2. Cerebral tumor versus radiation necrosis.

Technology Assessment

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Other Material

Questions

For patients presenting with signs or symptoms of a space-occupying brain lesion:

  1. For what metabolic profiles does the yield of MRS provide equivalent, complementary, or more accurate diagnostic information for (i) initial diagnosis, (ii) recurrence, or (iii) assessing therapy than
    • Brain biopsy
    • Conventional anatomic imaging studies
    • MRS + conventional anatomic imaging studies vs. brain biopsy

  2. Does the use of MRS lead to an improved net health outcome by
    • Avoiding unnecessary biopsy
    • Obtaining appropriate biopsy, from appropriate location
    • Directing biopsy to an appropriate location
    • Receiving appropriate treatment
    • Avoiding an inappropriate treatment

  3. Are voxel positions and operator error important factors in obtaining diagnostic images? If so, how do they impact MRS accuracy?

Questions

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