Abstract
Serial image guided 31P magnetic resonance spectroscopy (MRS) studies were performed in eight patients with non-Hodgkin's lymphoma to determine the changes in phosphorus metabolites that occur in vivo in response to chemotherapy. Pre-treatment spectral characteristics were different in high and low grade lymphoma. A larger inorganic phosphate (Pi) peak was seen in high grade NHL relative to phosphomonoesters (PME) or beta adenosine triphosphate (beta ATP), producing significant differences in the PME/Pi and Pi/beta ATP metabolite ratios, and probably reflecting a larger hypoxic cell fraction within the high grade lymphomas. Consistent metabolite changes were seen with treatment, and before reductions in tumour bulk had occurred. Alterations in tumour energetics with changes in Pi and beta ATP, and increases in phospholipid turnover reflected as an increase in the phosphodiester (PDE) resonance were detected. Changes were seen between days 10 and 27 in low grade lymphoma treated with oral alkylating therapy and between days 1 and 5 in lymphoma treated with intensive combination chemotherapy. Increases in the PDE/beta ATP metabolite ratio may be an early indicator of response to chemotherapy in human tumours. These studies illustrate the feasibility and clinical potential of image guided 31P MRS as a means of assessing response to therapy.
Highlights
We have used an image guided slice selective magnetic resonance spectroscopy (MRS) localisation technique to obtain well resolved 31p spectra serially from eight patients with non-Hodgkin's lymphoma (NHL)
We have used an image guided slice selective MRS localisation technique to obtain well resolved 31p spectra serially from eight patients with non-Hodgkin's lymphoma (NHL). The aim of this preliminary study being three-fold; to identify the pre-treatment phosphorus characteristics of low and high grade NHL; to establish by serial studies in the early period after the commencement of chemotherapy the 31p MRS characteristics that are associated with, or possibly predictive of a response to therapy; and to identify the time period in which these changes occur in relation to chemotherapy
MRS examinations were performed before starting chemotherapy and serially at various times after commencing treatment
Summary
We have used an image guided slice selective MRS localisation technique to obtain well resolved 31p spectra serially from eight patients with non-Hodgkin's lymphoma (NHL). The aim of this preliminary study being three-fold; to identify the pre-treatment phosphorus characteristics of low and high grade NHL; to establish by serial studies in the early period after the commencement of chemotherapy the 31p MRS characteristics that are associated with, or possibly predictive of a response to therapy; and to identify the time period in which these changes occur in relation to chemotherapy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
