|Ref. no.||Sample size||Inclusions||SVS/MVS,|
|Choline quantification method||Results||Comparison with the present study|
|Aggarwal S et al. 2014 (3)||30||Bone and soft tissue lesions,|
mainly soft tissue masses
|Cho/SNR > 2 in at least two TEs||Sensitivity 60%|
Concluded that MRS is a promising adjunct tool.
|Wang et al. 2004 (5)||36||Both bone (15) and soft tissue (21) masses||SVS|
choline peak on spectra at least two TEs
|Choline found in 18/19 malignant tumors.|
|Very similar results|
|Zhang et al. 2013 (6)||83||Only bone tumors||SVS|
Cho:lipid ratio ≥ 0.2 was positive result
|Concluded that MRS can help in differentiating benign and malignant bone tumors.|
|Zi-Hua QI et al. 2009 (7)||56||Both bone and soft tissue tumors||SVS|
|Cho/Cr ratios were significantly higher in malignant lesions.|
|Sensitivity, specificity similar.|
PPV, NPV probably different because of the semi-quantitative method.
|Fayad LM, Wang X et al. 2010 (9)||34||Bone and soft tissue lesions.||SVS|
Cho concentrations calculated
|Choline present in all 3 pre-treatment malignant lesions.|
Choline concentration was different in benign and malignant.
|42||Patients undergoing MRI for musculoskeletal tumors||MVS|
|Quantitative||Cho/Cr ratios were significantly higher in malignant lesions.||Statistical significance seen between Cho/Cr ratio and histological grade of the tumor.|
|Fayad LM, Blumke DA et al. 2006 (13)||13||Resected specimens of bone sarcomas||MVS|
|All bone sarcomas showed choline peak which was much higher than normal marrow.||Similar results, Concluded that choline can be used as a marker for malignancy in bone tumors.|
|Fayad LM, Barker PB 2006 (14)||23 lesions in 18 patients||Bone (6 patients) and soft tissue lesions (12 patients)||SVS (20) + MVS(3)|
|Choline peak present in all pretreatment malignant cases.|
Mean Cho/SNR ratios in malignant and benign lesions was different
|Lee CW et al. 2009|
|27||Both bone and soft tissue tumors.|
19 malignant and 8 benign lesions.
Cho concentration calculated.
Concluded that low-grade malignancies have a may false-negative result on MRS
|S. Doganay et al. 2011 (16)||30||Bone or soft tissue tumors.||SVS|
Cho peak on spectra from at least two TEs
|Concluded that MRS may be a useful tool.|
|Teixeria PAG et al.|
|76 lesions in 74 patients||Both bone and soft tissue tumors.|
28 bone tumors, 15 malignant.
|Qualitative||Did not recommend MRS for characterization.|
For bone tumors.
Selection bias possible