BACKGROUND: Juvenile brain tumors may have a variety of tumor pathologies and comparable imaging appearances and noninvasive diagnosis can be difficult. When paired with conventional magnetic resonance imaging's high spatial resolution anatomical images (MRI), magnetic resonance spectroscopy (MRS) gives metabolic information from the surrounding tissue and the lesion itself. Making the distinction between malignant and non-cancerous tumor, as well as between low-grade and high-grade neoplasms, is crucial for selecting the best course of treatment. In this study, we useMRS to measure certain metabolic ratios and examine the metabolic profiles of various lesions in order to make a more precise diagnosis. METHOD: 30 individuals were prospectively included in this study, ranging in age from 1 to 16 years old and with a mean age (SD) of 11.56 2.48 years (14 males and 16 female). They went to the pediatric cancer clinic between May 2020 and May 2022 with brain mass lesions that had been detected by computed tomography(CT). The patient's guardians provided written informed consentin conformity with the National Ethics Committee. All patients had complete clinical assessments, routine MRS, and MRI exams utilizing a 1.5T scanner outfitted with the typical head coil. Due to anomalies that were too near to the complete medical or nasal cavity, several instances were excluded from the investigation, which resulted in a poor diagnostic spectrum. RESULTS: 28 of the 30 individuals who had MRI and MRS scans exhibited intracranial mass lesions, according to the data. The remaining two people were found to have multiple sclerosis in one case and acute disseminated encephalomyelitis (ADEM) in the other after radiological and clinical follow-ups. After receiving an orthogonal biopsy, 26 of the 28 patients with mass lesions were histologically shownto be malignant. Two cases of brainstem gliomas underwent clinical and radiological monitoring but did not undergo surgery or a biopsy. CONCLUSIONS: For the non-invasive diagnosis of adolescent brain tumors, the use of important metabolic enzymes with high specificity and sensitivity to differentiate between malignant from benign tumor lesions and minimal from growing neoplasms is helpful. MRS may address sampling issues with inaccessible and different lesions as well as an unneeded sample of adenoma by evaluating tumor spatial extent and projecting tumor activity

tumor, brain, MRS, pediatrics