Bone and soft-tissue lesions: diagnosis with combined H-1 MR imaging and P-31 MR spectroscopy.

Abstract

The feasibility of combined magnetic resonance (MR) imaging and surface coil phosphorus-31 MR spectroscopy at 1.5 T was examined in a clinical study of 34 patients before biopsy of bone or soft-tissue lesions of the extremity and trunk. The results confirmed the inability of MR imaging alone to distinguish most benign lesions from malignant ones. Malignant lesions were distinguished from benign lesions on the basis of significantly higher mean peak ratios of phosphomonoester (PME) to beta-nucleoside triphosphate (NTP) and of phosphodiester to NTP, a significantly lower mean peak area ratio of phosphocreatine to NTP, and a higher mean pH. The diagnostic performance of the PME/NTP peak area ratio is characterized by a sensitivity (true-positive fraction) of 1.00 and a specificity (true-negative fraction) of 0.93. This study provided preliminary evidence that P-31 MR spectroscopy may be used to improve diagnostic specificity in bone and soft-tissue lesions.

Energy Status And Metabolism in Intracranial Space Occupying Lesions: A Prospective 31p Spectroscopic Study

“…Also tumours demonstrate a wide range of pH within them. Thus, pH may not be useful in determining the types of tumours [6,24]. Our study showed pH of all pathologies tending towards the acidic range, the values were not statistically significant to differentiate the grade or types of tumours and non-neoplastic lesions.…”

“…P MRS is an established technique for evaluating tumours of extremity, head, neck and liver [5][6][7][8][9]. It allows non invasive characterization of phosphate containing compounds within tumour cells and determination of energy status and pH [9][10][11].…”

“…High PME was observed in abscess compared to low grade glioma, probably due to presence of inflammatory cells and cellular turnover. A relationship between the elevated phospholipid precursors of Phosphocholine, phosphoethanolamine and cell proliferation in cancers has been suggested to signify an increased membrane turnover or increased phospholipase activity [6,12]. PDE contains mobile phospholipid compounds such as glycerol-3-phosphoethanolamine and glycerol-3-phosphocholine which contributes to cell wall structure and increased resonance indicates the presence of breakdown products of membrane metabolism [15,17].…”

Correlation of lipid content and composition with liposarcoma histology and grade

“…The ability of NMR spectroscopy to detect metabolite profiles indicative of tumor differentiation is important because in many tumor types, particularly liposarcoma, the histologic type is one of the most important factors in predicting risk for relapse and overall survival. To date, studies of human soft-tissue sarcomas have largely been confined to 31p_ NMR in vivo studies (15)(16)(17)(18)(19)(20). a3C-NMR spectroscopy offers more detailed biochemical information relating to lipid content and composition than does 31P-NMR.…”

Tumour Oxygenation Assessed by Polarographic Needle Electrodes and Bioenergetic Status Measured by31P Magnetic Resonance Spectroscopy in Human Soft Tissue Tumours

“…With this new system it was possible to sample multiple values of the tissue partial oxygen pressure (PO,). Also 31P-MRS was tested in human neoplasms (10,11) using magnets with a field strength of typically 1.5 T. The attraction was that phosphorus spectroscopy was non-invasive, not painful and could be performed repeatedly, which gave a unique opportunity to monitor the responsiveness to a specific treatment. Moreover, it was documented to provide specific information about the in vivo metabolic status of mouse tumour models using high field scanners of about 4.7 T (12).…”