Macquarie Medical Imaging and Macquarie University Hospital have expanded the use of Magnetic Resonance Spectroscopy in Australia – and set the future of neuroimaging.

Led by Professor John Magnussen, the MRI program at Macquarie Medical Imaging (MMI) has embarked on a ground-breaking new study in neuroimaging of crucial importance for patients with brain tumours and other neurological diseases.

MMI, located within Macquarie University Hospital, is the first site in the Southern Hemisphere to conduct a novel study using Magnetic Resonance Spectroscopy (MRS), technology that measures brain chemistry rather than anatomy.

In the new era of genomic analysis, MRS reads the chemical composition of a region of tissue, which could be used as biomarkers – now considered superior diagnostic, prognostic and therapeutic indicators in the analysis of brain tumours.

“MRS provides information on the metabolic profile of different pathologies, rather than the shape of the brain,” explains Dr Antonio Di Ieva, Associate Professor of Neuroanatomy and Neurosurgery at Macquarie University Hospital, who worked closely with Professor Magnussen and Professor Changho Choi (from the University of Texas Southwestern Medical Centre, Dallas) to bring advanced MRS to Australia.

“Specific MRS biomarkers, their quantity and patterns of distribution of the metabolites can help in the differential diagnosis of types and sub-types of brain tumours versus tumour mimics – often seen in infective or inflammatory diseases.”

The current MMI study is investigating the ability of MRS to quantify the oncometabolite 2-hydroxyglutarate (2HG) ¬– a product of a genetic mutation (IDH) – to improve diagnostic and prognostic outcomes for brain tumour patients.

“With this technique, we are now able to identify a relevant genetic mutation in brain cancer even before the operation,” said Professor Di Ieva, who introduced the term ‘spectrobiopsy’ – along with other ground-breaking innovations in neurosurgery and neuroimaging.

The study is also applying advanced computational analysis to radiological images to address the growing challenge of interpreting the exponential sums of data produced by MRS and other parametric diagnostic tools that are now the norm in neuroradiology and neuropathology.

“This large and complex data is difficult to interpret – even for experienced sub-specialists – let alone be easily translated into general use,” explains Professor Di Ieva.

“Computation modelling, artificial intelligence-based and machine learning tools for big data analysis will become the diagnostic routine of brain tumours and other pathologies over the next few decades. At Macquarie University we are at the frontline of such advancements, for the benefit of patients.”


GPs can refer patients suspected of having neurological disease or patients with brain tumour to MMI for advanced imaging and to the MUH neurosurgeons for advanced multidisciplinary management.

All MMI neuro-radiologists have sub-specialist fellowship training and significant experience delivering high-calibre expertise in their area.

Patients can be assessed for suitability for the 2HG study, or treated through other pathways.

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