The contribution of the 1H-MRS lipid signal to cervical cancer prognosis: a preliminary study

Abstract

Background The aim of this study was to investigate the role of the lipid peak derived from 1H magnetic resonance (MR) spectroscopy in assessing cervical cancer prognosis, particularly in assessing response to neoadjuvant chemotherapy (NACT) of locally advanced cervical cancer (LACC). Methods We enrolled 17 patients with histologically proven cervical cancer who underwent 3-T MR imaging at baseline. In addition to conventional imaging sequences for pelvic assessment, the protocol included a single-voxel point-resolved spectroscopy (PRESS) sequence, with repetition time of 1,500 ms and echo times of 28 and 144 ms. Spectra were analysed using the LCModel fitting routine, thus extracting multiple metabolites, including lipids (Lip) and total choline (tCho). Patients with LACC were treated with NACT and reassessed by MRI at term. Based on tumour volume reduction, patients were classified as good responder (GR; tumour volume reduction > 50%) and poor responder or nonresponder (PR-or-NR; tumour volume reduction ≤ 50%). Results Of 17 patients, 11 were LACC. Of these 11, only 6 had both completed NACT and had good-quality 1H-MR spectra; 3 GR and 3 PR-or-NR. A significant difference in lipid values was observed in the two groups of patients, particularly with higher Lip values and higher Lip/tCho ratio in PR-NR patients (p =0.040). A significant difference was also observed in choline distribution (tCho), with higher values in GR patients (p = 0.040). Conclusions Assessment of lipid peak at 1H-MR spectroscopy could be an additional quantitative parameter in predicting the response to NACT in patients with LACC.

Clinical utility of MR spectroscopy for gynecological pelvic abscesses using next‑generation sequencing technology for the detection of causative bacteria

“…As for other diseases in terms of the use of MRS for pelvic lesions, there are reports in the field of malignancies. There were reports that in ovarian tumors, high peaks of choline and lactate (more than twice the noise) were findings suggestive of malignancy ( 16 ), and that in locally advanced cervical cancer, high peak of lipid was predictive marker of a poor response to neo-adjuvant chemotherapy ( 17 ). The indication for pelvic lesions seems feasible, and future studies are expected on abscesses as well.…”

Magnetic Resonance Spectroscopy for Cervical Cancer: Review and Potential Prognostic Applications

“…Another work focusing on therapy response was by Dolciami et al [ 24 ], where they studied the role of MR spectroscopy as a prognostic test for assessing the response of cervical cancer to neoadjuvant chemotherapy. Seventeen patients were included in their study and these patients were scanned utilizing a 3 T scanner.…”

“…Most of these have been in the brain and have included the study of neurodegenerative diseases [ 13 , 14 ], psychiatric disorders [ 15 , 16 ], and brain tumors [ 10 , 17 , 18 ]. However, MRS is increasingly being used to study diseases and disorders affecting a range of other bodily organs including spinal cord injury [ 19 ], myocardial infarction [ 20 ], peripheral arterial disease [ 21 ], prostate cancer [ 22 , 23 ], and cervical cancer [ 24 , 25 ]. MRS has also been applied to study a range of metabolic disorders including diabetes [ 26 ] and liver disease [ 27 ].…”