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Studies on clinical significance of metabolic or functional tumor imaging by clinical MR machine

临床MR机代谢或功能性肿瘤显像的临床意义研究

基本信息

批准号：
07457197
负责人：
ISHII Yasushi
金额：
$ 3.07万
依托单位：
Fukui Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1996
项目状态：
已结题

项目摘要

In addition to orient a tumor itself, specific characterization such as tumor grading and its viability on therapeutic intervention should be necessary to complete imaging diagnosis. PET is appeared to suit for this and with its ability of metabolic imaging, but it is not widely available. At present, we have attempted to use clinical MR machine as an alternative for PET as metabolic or functional imaging of brain tumor on radiation therapy and its clinical significance has been evaluated. Present studies consist of two parts : (1) metabolic imaging by in vivo ^1H MR spectroscopy (MRS), and (2) functional imaging by dynamic suceptiblity contrast MR imaging (DISC MRI).(1) Metabolic imaging by in vivo ^1H MR spectroscopy. To determine whether assessment of ^1H MRS is useful for predicting the outcome of radiotherapy on brain tumor, ^1H MRS studies were performed in eight patients with primary or metastatic brain tumor before and during radiotherapy. Among various spectroscopic metabolite peaks, lactate peak, that is represented by anaerobic glycolysis, substantially decreased in the radio sensitive cases as early as 20Gy, whereas the lactate peak did not decrease even at the end of therapy in radioresistant cases. It is concluded that assessment of the lactate peak on MRS adjunctivecly contribute to the early prediction of radiotherapeutic effect on brain tumors.(2) Functional imaging by dynamic susceptibility contrast MR imaging (DISC MRI). DISC MRI was performed on eleven patients with brain tumors before and after radiotherapy to determine whether this method is clinically useful for monitoring radiotherapeutic effect on brain tumors. The calculated integrating images, that represent regional cerebral blood volume (rCBV), were also produced for evaluation of the tumor vascular beds. Changes of the tumor vascular bed, angiogenesis, on radiotherapy were also appeared to be a good indicator of therapeutic effect as well as ^1H-MRS.

除了定位肿瘤本身，特定的表征，如肿瘤分级和治疗干预的可行性，应该是必要的，以完成成像诊断。PET似乎适合于此，并具有代谢成像的能力，但它并不广泛使用。目前，我们尝试用临床MR机代替PET作为脑肿瘤放射治疗的代谢或功能成像，并对其临床意义进行了评价。目前的研究包括两个部分：（1）利用活体^1H磁共振波谱（MRS）进行代谢成像;（2）利用动态增强磁共振成像（DISC MRI）进行功能成像。(1)体内^1H核磁共振波谱代谢成像。为探讨^1HMRS对脑肿瘤放疗疗效的预测价值，对8例脑肿瘤原发灶或转移灶患者在放疗前及放疗中进行了^1HMRS检查。在各种光谱代谢物峰中，以无氧糖酵解为代表的乳酸峰在放射敏感病例中早在20 Gy就显著降低，而在放射抵抗病例中，乳酸峰甚至在治疗结束时也没有降低。结论：MRS乳酸峰的检测有助于脑肿瘤放射治疗效果的早期预测。(2)通过动态磁敏感对比MR成像（DISC MRI）进行功能成像。本文对11例脑肿瘤患者在放疗前后进行了DISC MRI检查，以确定该方法是否可用于监测脑肿瘤的放疗效果。计算的积分图像，代表区域脑血容量（rCBV），也产生了肿瘤血管床的评价。放射治疗时肿瘤血管床的变化，血管生成，也似乎是治疗效果的良好指标，以及^1H-MRS。