PREDICTING HUMAN TUMOR RESPONSE BY 31P MRS

描述：此应用程序来自密歇根州底特律的CCCMH。31-P 人体肿瘤的磁共振波谱(MRS)研究 具有与正常人群不同的代谢特征 纸巾。这些指标包括磷单酯(PME)的高程、 磷酸二酯(PDE)、细胞pH和暗淡的磷酸肌酸 (聚合酶链反应)。这些特征已被证明提供了有用的 放射治疗敏感性的预后指标和预测因子 联合热疗治疗软组织肉瘤。这一背景 指示现在应该检查临床 MRS在癌症患者管理中的应用。这项研究建议 在本申请中是一项大量的合作前瞻性试验 患有癌症类型的患者特别适合解决这一问题 问题。此建议书是来自8个项目的8个交互式R01应用之一 机构合作研究了1400多名非 霍奇金淋巴瘤，局部晚期原发性乳腺癌，软组织 组织肉瘤和头颈部癌。细心关注 将支付给患者选择、方案管理、技术 质量控制和分组统计分析。最先进的 技术已经或将在所有机构建立，以 包括：访问宽带所需的双调谐1H 31-P表面线圈 这些癌症的不同解剖位置；31-质子去偶联 用于区分磷脂代谢物的个别成分；图像 导引三维化学位移成像精确定位~(31)P 肿瘤的磁共振波谱；代谢物的绝对定量；以及 光谱的模式识别。申请者将测试 体内~(31)P磁共振波谱可预测敏感性的假设 或通过将最初的反应与治疗相关 基线谱中的代谢特征和发生的变化 在治疗开始后的早期频谱中。这个 申请者还将测试31-P MRS包含的假设 通过关联患者的无病生存期获得预后信息 应答者，以及在可能的情况下，对代谢特征的总体存活率 在基线和后续光谱中。这项研究将确立 其他癌症和临床的MRS合作试验标准 设置，并将为MRS的临床试验铺平道路 被用来干预治疗方案的选择 个别癌症患者。

DESCRIPTION: This application from CCCMH, Detroit, Michigan. The 31-P Magnetic Resonance Spectroscopy (MRS) of human cancers in vivo typically have metabolic characteristics which differ from those of normal tissues. These include elevations of phosphomonoesters (PME), phosphodiesters (PDE), and cellular pH, and dimished phosphocreatine (PCr). These characteristics have been shown to provide useful prognostic indices and predictors of sensitivity to radiotherapy combined with hyperthermia in soft tissue sarcomas. This background indicates that it would now be appropriate to examine the clinical utility of MRS in the management of cancer patients. The study proposed in this application is a cooperative prospective trial in a large number of patients with types of cancers especially well suited to address this issue. This proposal is one of 8 Interactive R01 applications from 8 institutions collaborating to study over 1400 patients with non- Hodgkin's lymphomas, locally advanced primary breast cancers, soft tissue sarcomas, and carcinomas of the head and neck. Careful attention will be paid to patient selection, protocol management, technical quality control and group statistical analysis. State-of-the-art techniques have been or will be established at all institutions, to include: dual tuned 1H 31-P surface coils needed to access the wide variety of anatomic locations of these cancers; proton decoupling of 31- P to distinguish individual components of phospholipid metabolites; image guided 3 dimensional chemical shift imaging to accurately localize 31-P MR spectra to tumor masses; absolute quantitation of metabolites; and pattern recognition of spectra. The applicants will test the hypothesis that the in vivo 31-P Mr spectrum can predict the sensitivity or resistance to treatment by correlating the initial response to metabolic features in the baseline spectrum and to changes that occur in the spectrum early after the initiation of treatment. The applicants will also test the hypothesis that 31-P MRS contains prognostic information by correlating disease-free survival in responders, and where feasible overall survival, to metabolic features in the baseline and followup spectra. This study will establish standards for cooperative MRS trials in other cancers and clinical settings, and will pave the way for clinical trials in which MRS could be used to intervene in the selection of treatment regimens in individual cancer patients.