Unique magnetic resonance spectroscopy profile of intracranial meningiomas compared to gliomas: a systematic review

Background and purpose The goal of this study was to systematically review the metabolic profile of meningiomas using magnetic resonance spectroscopy in comparison to gliomas, as measured by mean metabolite ratios. Methods Following the PRISMA guidelines, a systematic literature review was performed using the PubMed, Ovid Embase, Web of Science, and the Cochrane databases from inception to May 2021. Studies were selected based on predetermined inclusion and exclusion criteria. Results Eight studies were ultimately selected with 207 patients included. Fifty-nine patients were diagnosed with meningioma (age = 48.4, 66.7% female) and 148 patients diagnosed with glioma (age = 56.4, 49.2% female). Three studies reported elevated Cho/Cr in meningiomas compared to gliomas (5.71 vs. 1.46, p < 0.05, 7.02 vs. 2.62, p < 0.05, and 4.64 vs. 2.52, p = 0.001). One study reported Ala/Cr to be significantly elevated in meningiomas compared to gliomas (1.30 vs. undetectable, p < 0.001). One study reported myo-Inositol/Cr to be significantly elevated in meningiomas in comparison to gliomas (1.44 vs. 1.08, p < 0.05). One study reported Glu/Cr to be significantly elevated in meningiomas in comparison to gliomas (3.47 vs. 0.89, p = 0.002). Two studies reported Cho/NAA to be significantly elevated in meningiomas in comparison to gliomas (4.46 vs. 2.6, p = 0.004, and 5.8 vs. 2.55, p < 0.05). Two studies reported NAA/Cr was significantly elevated in gliomas compared to meningiomas (undetectable vs. 1.54, p < 0.001 and undetectable vs. 0.58, p < 0.05). Conclusions Significant differences in metabolite ratios between tumor types were reported in Cho/Cr, Ala/Cr, Glu/Cr, Cho/NAA, myoI/Cr and NAA/Cr between meningiomas and gliomas.