Early in vivo detection of metabolic response: a pilot study of 1H MR spectroscopy in extracranial lymphoma and germ cell tumours.
Early in vivo detection of metabolic response: a pilot study of 1H MR spectroscopy in extracranial lymphoma and germ cell tumours.
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DOI：
10.1259/bjr.75.900.750959
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发表时间：
2002-12
期刊：
影响因子：
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通讯作者：
A. Schwarz;N. Maisey;D. Collins;D. Cunningham;R. Huddart;M. Leach
中科院分区：
文献类型：
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作者：
A. Schwarz;N. Maisey;D. Collins;D. Cunningham;R. Huddart;M. Leach
监测治疗效果在肿瘤学实践中至关重要。我们已经研究了使用质子（1）H磁共振波谱（MRS）的可行性，定位于恶性淋巴瘤和生殖细胞病变的颅外腔，在体内监测肿瘤代谢化疗治疗期间。(1)H在淋巴瘤或生殖细胞肿瘤患者治疗前和化疗的第一个周期期间进行单体素MRS（受激回波采集模式，重复时间/回波时间=2000/20 ms）。在治疗后57天（范围44-93天）的中位时间通过独立临床随访评估患者反应。扫描的所有12个非囊性病变均显示为含胆碱代谢物（tCho）的信号; 9个在治疗前和治疗后均进行了扫描。发现治疗后tCho：水比率的变化可预测随后的患者反应。在这9名患者中，有7名患者在首次治疗后扫描中tCho：水比率降低，随后所有患者均对治疗产生部分反应。在其余2例患者中，均在治疗期间发生进展，tCho：水比率未发生显著变化。归一化至治疗前值，非应答组值（1.07和0.97）与应答组明显不同，应答组的值范围为0.43至低于检测水平。据我们所知，这是第一次报告（1）H MR谱从这些肿瘤类型和网站。这些初步结果表明，代谢物信号可以使用（1）H MRS在这些肿瘤类型和位置检测，因为已经建立了在大脑，乳腺和前列腺。此外，在tCho区域观察到的谱的差异性变化表明：（1）H MRS可以提供对化疗的代谢反应的早期和敏感的指标。
Monitoring therapeutic efficacy is essential in oncological practice. We have investigated the feasibility of using proton (1)H MR spectroscopy (MRS), localized to malignant lymphoma and germ cell lesions outside the cranial cavity, to monitor tumour metabolism in vivo during chemotherapy treatment. (1)H single voxel MRS, (stimulated echo acquisition mode, repetition time/echo time=2000/20 ms) was performed prior to treatment in patients with lymphoma or germ cell tumours, and during the first cycle of chemotherapy. Patient response was assessed by independent clinical follow-up at a median of 57 days (range 44-93 days) post-treatment. All 12 non-cystic lesions scanned showed a signal assigned to choline-containing metabolites (tCho); 9 were scanned both pre- and post-treatment. Changes in the tCho:water ratio following treatment were found to predict subsequent patient response. In seven of these nine patients, the tCho:water ratio decreased in the first post-treatment scan, and all subsequently achieved a partial response to treatment. In the remaining two patients, both of whom progressed on treatment, the tCho:water ratio did not change significantly. Normalized to pre-treatment values, the non-responder group values (1.07 and 0.97) were clearly distinct from the responder group, whose values ranged from 0.43 to below detection level. To our knowledge, this is the first report of (1)H MR spectra from these tumour types and sites. These preliminary results indicate that metabolite signals can be detected using (1)H MRS in these tumour types and locations, as has already been established in the brain, breast and prostate. Moreover, the differential changes observed in the tCho region of the spectrum suggest that (1)H MRS could provide an early and sensitive indicator of metabolic response to chemotherapy.