PREDICTING HUMAN TUMOR RESPONSE BY 31P MRS

说明：此应用程序来自FCCC。31-磷（31-P） 核磁共振（NMR）波谱（MRS）共振 体内的癌症揭示了不同于 那些正常组织。 这些包括PME、PDE和 细胞pH和PCr减少。 已发表的研究表明，MRS- 导出的pH和MRI导出的T2弛豫时间预测软组织的响应 组织肉瘤的辐射和高温， 预测几种不同的人类癌症对化疗的反应， 辐射 申请人提出了一项前瞻性试验， 体内31-P MRS可预测敏感性或耐药性假说 治疗患有特别适合于 确定MRS在癌症管理中的临床效用， 特别是非霍奇金淋巴瘤和局部晚期原发性乳腺癌 癌的 这将通过将缓解率和无病生存率相关联来完成 基线光谱中的代谢特征以及 开始治疗后早期出现的光谱。 这 应用程序是8个交互式R 01应用程序的核心之一， 合作研究1500多名非霍奇金淋巴瘤患者的机构 淋巴瘤、局部晚期乳腺癌、肉瘤和乳腺癌 头部和颈部。将注意患者选择、方案 管理、技术质量控制和统计分析。 的 国家的最先进的技术使用将是统一的8 机构，将包括：（1）使用双调 质子/磷表面线圈，以询问各种肿瘤解剖结构 地点 (2)磷谱的质子解耦以区分 PME和PDE中磷脂代谢物的单个组分 地区 (3)图像引导的三维化学位移成像， 准确定位13 P NMR光谱到肿瘤块，和（4）摩尔 肿瘤中代谢物浓度的定量。 这 申请还建议建立合作MRS的标准 在其他疾病和临床环境中进行试验，并寻求为 临床试验的方式，其中MRS可用于干预 癌症患者个体化治疗方案的选择。

DESCRIPTION: This application is from the FCCC. The 31-phosphorus (31-P) nuclear magnetic resonance (NMR) spectroscopy (MRS) resonance of human cancers in vivo reveals metabolic characteristics which differ from those of normal tissues. These include elevations in PME, PDE, and of cellular pH, and dimininution of PCr. Published studies show that MRS- derived pH and MRI-derived T2 relaxation time predict response of soft tissue sarcomas to radiation and hyperthermia, and that changes in PME's predict response of several different human cancers to chemotherapy and radiation. The applicant proposes a prospective trial to test the hypotheses that in vivo 31-P MRS can predict sensitivity or resistance to treatment inpatients with types of cancers especially well suited to determine the clinical utility of MRS in cancer management, in particular non-Hodgkin's lymphomas and locally-advanced primary breast cancers. This will be done by correlating response rate and disease-free survival to metabolic features in the baseline spectrum and to changes in the spectrum occurring early following initiation of treatment. This application is the central one of 8 interactive R01 applications from institutions cooperating to study over 1500 patients with non-Hodgkin's lymphomas, locally-advanced breast cancers,sarcomas, and carcinomas of the head and neck. Attention will be paid to patient selection, protocol management, technical quality control and statistical analyses. The state-of-the-art techniques used will be uniform across the 8 institutions and will include: (1) The use of dual-tuned proton/phosphorus surface coils to interrogate various tumor anatomical locations. (2) Proton-decoupling of phosphorus spectra to distinguish individual components of phospholipid metabolites in the PME and PDE regions. (3) Image-guided 3-dimensional chemical shift imaging to accurately localize 13P NMR spectra to tumor masses, and (4) Molar quantitation of metabolite concentrations in the tumors. This application also proposes to establish standards for cooperative MRS trials in other diseases and clinical settings, and seeks to pave the way for clinical trials in which MRS could be used to intervene in the selection of treatment regimens in individual patients with cancer.