 My topic is role of MS spectroscopy in the evaluation of intraactual brain tumors. Interactual brain masses are a significant health problem and present several imaging challenges. These lesions include primary neoplasms, high end low grade, secondary metastatic neoplasms, lymphoma, tumor factor 3-myelinatal lesions, abscesses and thin capillitis. We are witnessing a shift in imaging from merely providing anatomical information towards providing information about tumor physiology. MR imaging in particular has emerged as the imaging reality most frequently used to evaluate intravenial tumors. And it continues to have an ever expanding multi-faceted role. The role of MR imaging in the workup of intraactual tumors can be broadly divided into tumor diagnosis and classification, treatment planning and post-treatment surveillance. In addition to conventional MR imaging techniques, a variety of advanced techniques have found their place in clinical practice. These techniques offer more than just an atopic information provided by conventional MR imaging sequences by generating physiological data and information on chemical composition. A few of the advanced techniques include perfusion imaging, diffusion weighted imaging, MR spectroscopy and bold imaging. The aims and objective work to determine the biochemical markers of intraactual brain tumors using MR spectroscopy to evaluate the role of MR spectroscopy in diagnosing and breeding of intraactual brain tumors with histopathological coordination and to evaluate the role of MR spectroscopy in determining the infiltrated nature of the intraactual brain tumors. But beyond that, patients with clinically suspected brain tumors referred to the Department of Federal Diagnosis and CAHMS was included in the study. It was a hospital-based descriptor study. Equipment and technique used were MRI scans were performed using GE Sigma HD XT 1.5 Desa MRI scanner machine. The sequences taken were conventional spin echo sequences, Actual T1, T2, Flare, Coronal T2, Sagittal T1, Post Contrast T1 Action, Coronal and Sagittal, TWI, SC Press 144, SC Press 31, Signal Box spectroscopy, 2D Press 144, Multivox spectroscopy performed at DE of 144 milliseconds and 31 milliseconds and TR of 2000 milliseconds. In signal voxel studies, the voxel is placed on the lesion so that it covers the maximum area of the solutimeral area. In Multivox spectroscopy, the voxel was extended to cover the perillational area in selected cases of high-grade tumors, avoiding areas of cysts or necrosis and with minimal contamination from the surrounding non-tumor tissue. Volume of interest ranged between 1.5 x 1.5 x 1.5 cm and 2 x 2 x 2 cm cube. Sectroscopy was avoided in small lesions close to bones and sinuses. All patients with known history of intraactual brain tumors all patients who were incidentally diagnosed with intraactual brain tumors by CT and clinically detected cases. Exclusion criteria, cases with benign lesions after histopathological transformation, patients having history of claustrophobia, history of metallic implant insertion, cardiac pacemakers and foreign bodies and clinically unstable patients. This is an analysis we've done using Microsoft Excel leadership. An analysis was done using EP, Info7 software, descriptive statistics, frequencies and proportions were calculated and tabulated. An open EP software was used to calculate sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy to test the validity of spectroscopy with respect to histopathological examination. The short exact list was the test of significance for teticorical data. The value of less than 0.5 was considered as statistically significant. This is a table 1 which shows distribution of sample according to age. As we can see here, approximately 16% for majority of the patients lie between 14 to 15 years age group. This is table 2 which shows distribution of sample according to gender. 70% of the population was male while the remaining was female. Distribution based on the location. Approximately 70% of the population had supra-tentorial humus. 20% had infratentorial humus and 6% had both supra and infra. This is a table 2 in distribution of sample based on T1 weighted imaging characteristics. Approximately 40% of the lesions were hyper intense, 36% were tetra intense and 20% were iso intense. The statistics based on T2 weighted imaging showed approximately 60% of lesions being tetra intense, 30% as T2 hyper intense, and 6% as T1 iso intense. This is a table which showed proportion of brain tumours which showed blooming on tetra weighted imaging or GRE. Approximately 53% of lesions showed blooming while 46% did not show blooming. And out of them as well, approximately 92% were bleeds and the remaining 7% were calcifications. This is a table which shows distribution of the sample size based on edema. Approximately 80% of lesions had bleeds edema while 20% did not. With the previous distribution of brain tumours based on contrast enhancement, 60% of lesions showed intense contrast enhancement while 16% showed moderate and 20% showed mild enhancement. This is a table showing the distribution of solid and cystic component of brain tumours. 60% of the tumours were solid cystic while the remaining 36% were simply solid. The distribution based on characteristic of tumour margins we found 50% of the tumours to be well-defined while 46% were well-defined. This is a table showing distribution of sample based on the spectroscopic findings. The metabolites, 30% of the cases showed increased cooling. 30% of them showed reduced NaN-3-9 ratio. Approximately 60%, sorry, 100% showed reduced NaN-3-9 ratio. 60% showed increased lipid and lactate. 90% showed reduced or absent myoenocetone. 100% showed increased choline-3-9 ratio. And 100% showed increased choline-9 ratio. This is the same description in the form of this biograph. This is a table which shows distribution of cases according to pathology. We found 50% of the cases to be hydrate leona while the remaining were distributed on slow-grade olemorphid glioma, gliometrophysiorepride epinemoma and other less common ones. This is a table showing distribution of cases based on MRI diagnosis and correlation with histopathology. So almost all of the MRI diagnosis correlated well with histopathology. So 85% of them correlated with histopathology. And the same table showing 50% of the data of various values with the histopathological diagnosis. So this curtain, MRX is a means of non-invasive physiological imaging of the brain which measures absolute and relative levels of various brain tissue metabolites. MRX presents the individual information as metabolic peak amplitude versus frequency where frequency can be expressed as absolute values of births or better what we use is relative units of BPM. Its relative amount and chemical structure is the amplitude and frequency of a particular metabolic peak. And this phenomenon of chemical shift forms the basis of MRX. These are the base normal metabolites which can be read on our MR spectrum graph which is shown here. It is usually read from right to left. The first peak which we get to see is lipid peak followed by the lactate peak. Then we have the NA peak followed by creatinine peak and then the chlorine peak and finally the myopinositone peak. We are talking about all of them briefly. For me, it is the most specific marker of viable neurons. We get to see the peak at two parts per million. The ability to quantify neuronal loss or damage in vivo is one of the most important potential applications of MRX. And NA can be reduced in multiple conditions like regenerative disorders and MS and stroke. We are going to see the peak at 3.9 BPM but the main peak is at 3 BPM. It is used in internal standard to which the resonance intensities of other metabolites are normalized and focal decrease of creatinine can be seen in actual destructive pathologies like malignant tumors. Coaline or DNA peak, it is a peak which consists of several soluble components of clain myelin and fluid cell membranes. And as most coaline-containing brain constituents are not normally soluble, pathological alternations and membrane turnover in conditions like tumors and MS result in massive increasing MRS visible coaline. Followed by the myonositone peak which is mostly a diagnostic modifier and it is an astrocyte marker and osmolite which contributes specificity in dementia diagnosis. Glutamine and glutamine peak commonly called GLX it is a mixture of closely related amino acids. It is an intangible product of the CREP cycle and it is a vital marker in imaging with stroke, lymphoma, hypoxia and many metabolites. Lipid and lactate peaks, lipid peak is at 9.9 to 1.4 BPM while lactate is in at 1.3 BPM. Lipid peak can be seen in tuberculosis and brain tumors wherein lipid indicates necrosis and lactate peak is generally peak. It is a product of anaerobic like polycystin and it is seen in conditions like mitochondrial membranes, but in tumors it can be a marker of tumor of decimus. So MRS and intraactual brain tumors there are two classes of spatial localization techniques for MR spectroscopy which includes single voxel techniques that is breast and steam and multi voxel technique also called MRSI or chemical shift imaging CSI. These proteins can record spectra from multiple regions and thereby map out the spatial distribution of metabolites within the brain. While both of them have their own advantage a key consideration for brain tumors is the metabolic inhomogeneity and high resolution MRSI is therefore favored for evaluating brain tumor metabolism. Although MRI is a more sensitive modality of brain tumors its specificity is low and several different type of tumors may share the same MRI appearance. Therefore the typical spectra of a neoplasm depicts a substantial elevation of choline reduction of NA and minor changes in creatinine. A high choline to NA ratio is a strong indicator of a higher grade neoplasm. A ratio of more than 1.3 is reported to have a high accuracy for detection of neoplasm. Since tumors are completely heterogeneous with necrotic cores, proliferative rinse and invasion of surrounding brain tissue the spectrum can vary greatly depending on that region that is sampling. Therefore the region of interest chosen for analysis has a large influence on the results and therefore MRSI is generally considered preftory since it allows metabolic heterogeneity to be evaluated. The role of mRNAs in tumor versus non-neoplasmic patients is of immense importance. If a region can be confidently diagnosed as non-neoplasmic invasive brain biopsy procedures can be avoided. This differentiation is very difficult using conventional MRI techniques. The use of contrast agents is also not good enough to tell about the various to differentiate between non-neoplasmic and neoplasmic since it is based on the disruption of that brain barrier and not all tumors enhance. Generally spectra from brain abscess that is non-neoplasmic conditions are very different than those from high grade neoplasms. Brain abscesses will usually have low choline signals as well as decreased innate reactants and they also exhibit increased signals from amino acids which are usually not seen in neoplasms like alanine, acetate, acetoacetates, and succinate. Therefore distinction between abscess and neoplasm is made quite straightforward using MRSI. The role of MRSI in treatment planning is also very important since non-invasive diagnosis in glioma patients is important because it helps in prognosticating and providing a therapeutic plan. Total MRSI and other physiological imaging techniques assist the surgeon in obtaining representative samples from the tumor tissue for histology and surgical resection. This helps in planning targeted radiotherapy as well as to differentiate residual or reverent tumor from radiation necrosis on follow. Multi-modulating MRI imaging using that is MRSI potentially provides information which aids to stratify patients into high or neoplasmic groups for clinical trials. MRSI also has a role in identification of active tumor and tumor inpatient. The goal of neuro-oncology is complete removal of tumor. Therefore, knowing the exact tumor borders is very important which becomes very difficult in high-grade tumors by evaluating metabolic abnormalities. Road on MRSI can help in enhancing the diagnostic yield of stereotactic free-in biopsy. The role of MRSI and biopsy is basically to recognize the regions of high-metabolic activity that is regions with elevated colon levels and low NA levels which are indicative of tumor tissue representing a good target for biopsy. And regions with low levels may indicate radiation necrosis or gliosis or macropatriosis. This is the agilination of the target volume for radiation therapy as well. So, patients with high-grade gliomas can receive high dose to the areas of active tumor and regions which are suspicious for infiltration are treated with lower doses. So, in conclusion, accurate creating of gliomas on the basis of MRS alone can be very difficult. Combining MRS with conventional and other MRI advanced techniques leads to more precision in the grading. Some features of tumors on conventional MRI that is enhancement surrounding ND-marked hemorrhage suggest high-grade, but MRS is complementary and helpful for bleeding. High-grade gliomas demonstrate marked elevation of colon reduced NA and presence of blood data levels. Ionositol can be high in low-grade tumors and it decreases with increasing rates of tumors. From our study, we conclude that in vivo MRS spectroscopy can be used as a relibrant method for glioma grading. It is useful in discrimination between WS-2 and 3 and 4 astrocytomas, as well as other interaction between tumors like gliomotrocytobriac, ependymoma, metronoblastoma, oligodendroglioma, lymphoma, meds, and orythlicis papilloma. Our study also demonstrates that spectroscopic MR measurements in peritumoral region can be used to demonstrate differences in solitary meds and high-grade gliomas and also peritumoral infiltrative nature of certain interaction brain tumors. These are my lectures. Thank you.