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Iqbal Z, Albuquerque K, Chan KL. Magnetic Resonance Spectroscopy for Cervical Cancer: Review and Potential Prognostic Applications. Cancers (Basel) 2024; 16:2141. [PMID: 38893260 PMCID: PMC11171343 DOI: 10.3390/cancers16112141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
This review article investigates the utilization of MRS in the setting of cervical cancer. A variety of different techniques have been used in this space including single-voxel techniques such as point-resolved spectroscopy (PRESS) and stimulated echo acquisition mode spectroscopy (STEAM). Furthermore, the experimental parameters for these acquisitions including field strength, repetition times (TR), and echo times (TE) vary greatly. This study critically examines eleven MRS studies that focus on cervical cancer. Out of the eleven studies, ten studies utilized PRESS acquisition, while the remaining study used STEAM acquisition. These studies generally showed that the choline signal is altered in cervical cancer (4/11 studies), the lipid signal is generally increased in cervical cancer or the lipid distribution is changed (5/11 studies), and that diffusion-weighted imaging (DWI) can quantitatively detect lower apparent diffusion coefficient (ADC) values in cervical cancer (2/11 studies). Two studies also investigated the role of MRS for monitoring treatment response and demonstrated mixed results regarding choline signal, and one of these studies showed increased lipid signal for non-responders. There are several new MRS technologies that have yet to be implemented for cervical cancer including advanced spectroscopic imaging and artificial intelligence, and those technologies are also discussed in the article.
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Affiliation(s)
- Zohaib Iqbal
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75235, USA;
| | - Kevin Albuquerque
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75235, USA;
| | - Kimberly L. Chan
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75235, USA;
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De Castro F, Vergaro V, Benedetti M, Baldassarre F, Del Coco L, Dell'Anna MM, Mastrorilli P, Fanizzi FP, Ciccarella G. Visible Light-Activated Water-Soluble Platicur Nanocolloids: Photocytotoxicity and Metabolomics Studies in Cancer Cells. ACS APPLIED BIO MATERIALS 2020; 3:6836-6851. [PMID: 35019346 DOI: 10.1021/acsabm.0c00766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Nanoparticle-based drug delivery systems for cancer therapy offer a great promising opportunity as they specifically target cancer cells, also increasing the bioavailability of anticancer drugs characterized by low water solubility. Platicur, [Pt(cur) (NH3)2](NO3), is a cis-diamine-platinum(II) complex linked to curcumin. In this work, an ultrasonication method, coupled with layer by layer technology, allows us to obtain highly aqueous stable Platicur nanocolloids of about 100 nm. The visible light-activated Platicur nanocolloids showed an increased drug release and antitumor activity on HeLa cells, with respect to Platicur nanocolloids in darkness. This occurrence could give very interesting insight into selective activation of the nanodelivered Pt(II) complex and possible side-effect lowering. For the first time, the metabolic effects of Platicur nanocolloid photoactivation, in the HeLa cell line, have been investigated using an NMR-based metabolomics approach coupled with statistical multivariate data analysis. The reported results highlight specific metabolic differences between photoactivated and non-photoactivated Platicur NC-treated HeLa cancer cells.
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Affiliation(s)
- Federica De Castro
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy
| | - Viviana Vergaro
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy.,Institute of Nanotechnology, CNR NANOTEC, Consiglio Nazionale delle Ricerche, via Monteroni, 73100 Lecce, Italy
| | - Michele Benedetti
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy
| | - Francesca Baldassarre
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy.,Institute of Nanotechnology, CNR NANOTEC, Consiglio Nazionale delle Ricerche, via Monteroni, 73100 Lecce, Italy
| | - Laura Del Coco
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy
| | | | | | - Francesco Paolo Fanizzi
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy
| | - Giuseppe Ciccarella
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, via Monteroni, 73100 Lecce, Italy.,Institute of Nanotechnology, CNR NANOTEC, Consiglio Nazionale delle Ricerche, via Monteroni, 73100 Lecce, Italy
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Dietz C, Ehret F, Palmas F, Vandergrift LA, Jiang Y, Schmitt V, Dufner V, Habbel P, Nowak J, Cheng LL. Applications of high-resolution magic angle spinning MRS in biomedical studies II-Human diseases. NMR IN BIOMEDICINE 2017; 30:10.1002/nbm.3784. [PMID: 28915318 PMCID: PMC5690552 DOI: 10.1002/nbm.3784] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/21/2017] [Accepted: 07/10/2017] [Indexed: 05/06/2023]
Abstract
High-resolution magic angle spinning (HRMAS) MRS is a powerful method for gaining insight into the physiological and pathological processes of cellular metabolism. Given its ability to obtain high-resolution spectra of non-liquid biological samples, while preserving tissue architecture for subsequent histopathological analysis, the technique has become invaluable for biochemical and biomedical studies. Using HRMAS MRS, alterations in measured metabolites, metabolic ratios, and metabolomic profiles present the possibility to improve identification and prognostication of various diseases and decipher the metabolomic impact of drug therapies. In this review, we evaluate HRMAS MRS results on human tissue specimens from malignancies and non-localized diseases reported in the literature since the inception of the technique in 1996. We present the diverse applications of the technique in understanding pathological processes of different anatomical origins, correlations with in vivo imaging, effectiveness of therapies, and progress in the HRMAS methodology.
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Affiliation(s)
- Christopher Dietz
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Faculty of Medicine, Julius Maximilian University of Würzburg, 97080 Würzburg, Germany
| | - Felix Ehret
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Faculty of Medicine, Julius Maximilian University of Würzburg, 97080 Würzburg, Germany
| | - Francesco Palmas
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Department of Chemical and Geological Sciences, University of Cagliari, Cagliari, Sardinia, 09042 Italy
| | - Lindsey A. Vandergrift
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
| | - Yanni Jiang
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029 China
| | - Vanessa Schmitt
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Faculty of Medicine, Julius Maximilian University of Würzburg, 97080 Würzburg, Germany
| | - Vera Dufner
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
- Department of Hematology and Oncology, Charité Medical University of Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Piet Habbel
- Department of Hematology and Oncology, Charité Medical University of Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Johannes Nowak
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, 97080 Würzburg, Germany
| | - Leo L. Cheng
- Departments of Radiology and Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard-MIT Health Sciences & Technology, Charlestown, Massachusetts 02129, USA
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Lin G, Lai CH, Tsai SY, Lin YC, Huang YT, Wu RC, Yang LY, Lu HY, Chao A, Wang CC, Ng KK, Ng SH, Chou HH, Yen TC, Hung JH. 1H MR spectroscopy in cervical carcinoma using external phase array body coil at 3.0 Tesla: Prediction of poor prognostic human papillomavirus genotypes. J Magn Reson Imaging 2016; 45:899-907. [DOI: 10.1002/jmri.25386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/28/2016] [Indexed: 12/23/2022] Open
Affiliation(s)
- Gigin Lin
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital at Linkou; Guishan Taoyuan Taiwan
| | - Chyong-Huey Lai
- Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics; National Chengchi University; Wenshan District Taipei Taiwan
| | - Yu-Chun Lin
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Yu-Ting Huang
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Ren-Chin Wu
- Department of Pathology; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Lan-Yan Yang
- Clinical Trial Center; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Hsin-Ying Lu
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
- Clinical Phenome Center, Chang Gung Memorial Hospital at Linkou; Guishan Taoyuan Taiwan
| | - Angel Chao
- Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Chiun-Chieh Wang
- Department of Radiation Oncology; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Koon-Kwan Ng
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention; Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology and Gynecologic Cancer Research Center; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Center for Advanced Molecular Imaging and Translation (CAMIT); Chang Gung Memorial Hospital at Linkou; Guishan Taoyuan Taiwan
| | - Ji-Hong Hung
- Department of Radiation Oncology; Chang Gung Memorial Hospital at Linkou and Chang Gung University; Guishan Taoyuan Taiwan
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Milak MS, Proper CJ, Mulhern ST, Parter AL, Kegeles LS, Ogden RT, Mao X, Rodriguez CI, Oquendo MA, Suckow RF, Cooper TB, Keilp JC, Shungu DC, Mann JJ. A pilot in vivo proton magnetic resonance spectroscopy study of amino acid neurotransmitter response to ketamine treatment of major depressive disorder. Mol Psychiatry 2016; 21:320-7. [PMID: 26283639 PMCID: PMC4758914 DOI: 10.1038/mp.2015.83] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 01/29/2015] [Accepted: 03/09/2015] [Indexed: 12/11/2022]
Abstract
The N-methyl-D-aspartate receptor antagonist ketamine can improve major depressive disorder (MDD) within hours. To evaluate the putative role of glutamatergic and GABAergic systems in ketamine's antidepressant action, medial prefrontal cortical (mPFC) levels of glutamate+glutamine (Glx) and γ-aminobutyric acid (GABA) were measured before, during, and after ketamine administration using proton magnetic resonance spectroscopy. Ketamine (0.5 mg kg(-1) intravenously) was administered to 11 depressed patients with MDD. Glx and GABA mPFC responses were measured as ratios relative to unsuppressed voxel tissue water (W) successfully in 8/11 patients. Ten of 11 patients remitted (50% reduction in 24-item Hamilton Depression Rating Scale and total score ⩽10) within 230 min of commencing ketamine. mPFC Glx/W and GABA/W peaked at 37.8%±7.5% and 38.0%±9.1% above baseline in ~26 min. Mean areas under the curve for Glx/W (P=0.025) and GABA/W (P=0.005) increased and correlated (r=0.796; P=0.018). Clinical improvement correlated with 90-min norketamine concentration (df=6, r=-0.78, P=0.023), but no other measures.
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Affiliation(s)
- Matthew S. Milak
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - Caitlin J. Proper
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
| | - Stephanie T. Mulhern
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
| | - Amy L. Parter
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
| | - Lawrence S. Kegeles
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - R. Todd Ogden
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- Department of Biostatistics, Columbia University, Mailman School of Public Health
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - Xiangling Mao
- Department of Radiology, Weill Medical College of Cornell University
| | - Carolyn I. Rodriguez
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - Maria A. Oquendo
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - Raymond F. Suckow
- New York State Psychiatric Institute, Weill Medical College of Cornell University
- Analytical Psychopharmacology Laboratory, the Nathan S. Kline Institute for Psychiatric Research
| | - Thomas B. Cooper
- New York State Psychiatric Institute, Weill Medical College of Cornell University
- Analytical Psychopharmacology Laboratory, the Nathan S. Kline Institute for Psychiatric Research
| | - John C. Keilp
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
| | - Dikoma C. Shungu
- New York State Psychiatric Institute, Weill Medical College of Cornell University
- Department of Radiology, Weill Medical College of Cornell University
| | - J. John Mann
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University, College of Physicians and Surgeons
- Department of Radiology, Columbia University, College of Physicians and Surgeons
- New York State Psychiatric Institute, Weill Medical College of Cornell University
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Payne GS, deSouza NM, Messiou C, Leach MO. Single-shot single-voxel lactate measurements using FOCI-LASER and a multiple-quantum filter. NMR IN BIOMEDICINE 2015; 28:496-504. [PMID: 25802214 PMCID: PMC4737099 DOI: 10.1002/nbm.3276] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 05/15/2023]
Abstract
Measurement of tissue lactate using (1) H MRS is often confounded by overlap with intense lipid signals at 1.3 ppm. Single-voxel localization using PRESS is also compromised by the large chemical shift displacement between voxels for the 4.1 ppm (-CH) resonance and the 1.3 ppm -CH3 resonance, leading to subvoxels with signals of opposite phase and hence partial signal cancellation. To reduce the chemical shift displacement to negligible proportions, a modified semi-LASER sequence was written ("FOCI-LASER", abbreviated as fLASER) using FOCI pulses to permit high RF bandwidth even with the limited RF amplitude characteristic of clinical MRI scanners. A further modification, MQF-fLASER, includes a selective multiple-quantum filter to detect lactate and reject lipid signals. The sequences were implemented on a Philips 3 T Achieva TX system. In a solution of brain metabolites fLASER lactate signals were 2.7 times those of PRESS. MQF-fLASER lactate was 47% of fLASER (the theoretical maximum is 50%) but still larger than PRESS lactate. In oil, the main 1.3 ppm lipid peak was suppressed to less than 1%. Enhanced suppression was possible using increased gradient durations. The minimum detectable lactate concentration was approximately 0.5 mM. Coherence selection gradients needed to be at the magic angle to avoid large water signals derived from intermolecular multiple-quantum coherences. In pilot patient measurements, lactate peaks were often observed in brain tumours, but not in cervix tumours; lipids were effectively suppressed. In summary, compared with PRESS, the fLASER sequence yields greatly superior sensitivity for direct detection of lactate (and equivalent sensitivity for other metabolites), while the single-voxel single-shot MQF-fLASER sequence surpasses PRESS for lactate detection while eliminating substantial signals from lipids. This sequence will increase the potential for in vivo lactate measurement as a biomarker in targeted anti-cancer treatments as well as in measurements of tissue hypoxia.
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Affiliation(s)
- Geoffrey S Payne
- Cancer Research UK Cancer Imaging Centre, Royal Marsden Hospital and Institute of Cancer Research, Sutton, Surrey, UK
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Blankenberg FG, Strauss HW. Recent Advances in the Molecular Imaging of Programmed Cell Death: Part II—Non–Probe-Based MRI, Ultrasound, and Optical Clinical Imaging Techniques. J Nucl Med 2012; 54:1-4. [DOI: 10.2967/jnumed.112.111740] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Pacholczyk B, Fabiańska A, Kusińska R, Potemski P, Kordek R, Jankowski S. Analysis of cancer tissues by means of spectroscopic methods. Contemp Oncol (Pozn) 2012; 16:290-4. [PMID: 23788897 PMCID: PMC3687423 DOI: 10.5114/wo.2012.30056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 11/15/2011] [Accepted: 01/18/2012] [Indexed: 12/31/2022] Open
Abstract
The personalized approach in cancer treatment stimulates the search for new analytical techniques, including spectroscopic methods such as Raman spectroscopy, mass spectrometry MALDI (matrix-assisted laser desorption/ionization) imaging and high-resolution magic angle spinning nuclear magnetic resonance (HR MAS NMR). The purpose of these studies is determination of metabolic profiles of cancer tissues, and their application in diagnostics and therapy of cancers. The review is mainly focused on application of HR MAS NMR technique. Qualitative and quantitative analysis of metabolites by means of this method is described for breast cancer tissues. In the near future HR MAS NMR in vitro studies of metabolic profiles combined with in vivo studies using MRI scanners may be applied as a new diagnostic tool.
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Affiliation(s)
- Barbara Pacholczyk
- Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Poland
| | - Anna Fabiańska
- Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Poland
| | - Renata Kusińska
- Department of Pathology, Chair of Oncology, Medical University of Lodz, Poland
| | - Piotr Potemski
- Department of Chemotherapy, Chair of Oncology, Medical University of Lodz, Poland
| | - Radzisław Kordek
- Department of Pathology, Chair of Oncology, Medical University of Lodz, Poland
| | - Stefan Jankowski
- Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Poland
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Change in T2-fat saturation MRI correlates with outcome in cervical cancer patients. Int J Radiat Oncol Biol Phys 2011; 81:e707-12. [PMID: 21641733 DOI: 10.1016/j.ijrobp.2010.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 09/23/2010] [Accepted: 10/02/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare pretreatment and midtreatment tumor intensity as measured by T2 fat-saturation (T2-FS) MRI and its association with treatment response in cervical cancer patients. METHODS AND MATERIALS Weekly MRI scans were performed for brachytherapy planning on 23 consecutive patients with clinical Stage IB1 to IIIB cervical cancer treated with definitive chemoradiotherapy. These scans were performed on a 1.5-T clinical scanner using a specialized pelvic coil. Mean signal intensity from T2-FS imaging was calculated for each tumor voxel. Average tumor intensity and tumor volume were recorded pre- and midtreatment (at Weeks 0 and 4). All patients subsequently underwent routine follow-up, including periodic clinical examinations and fluorodeoxyglucose-positron emission tomography imaging. RESULTS Mean follow-up for surviving patients was 14.5 months. Mean tumor volume at presentation was 49.6 cc, and mean midtreatment tumor volume was 16.0 cc. There was no correlation between initial tumor volume and pretreatment signal intensity (r=0.44), nor was there a correlation between pre- or midtreatment tumor volume with disease-free survival (p=0.18, p=0.08 respectively.) However, having at least a 30% drop in signal intensity from pretreatment to midtreatment was correlated with having disease resolution on posttreatment fluorodeoxyglucose-positron emission tomography imaging (p=0.05) and with disease-free survival (p=0.03.) Estimated disease-free survival at 22 months was 100% for patients with at least a 30% drop in tumor signal intensity compared with 33% for patients above this selected threshold (p=0.004). CONCLUSIONS Longitudinal changes in T2-FS tumor intensity during chemoradiation correlated with disease-free survival in cervical cancer patients. Persistently high midtreatment tumor intensities correlated with a high risk of treatment failure, whereas large decreases in tumor intensity correlated with a favorable outcome.
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Yakoub D, Keun HC, Goldin R, Hanna GB. Metabolic profiling detects field effects in nondysplastic tissue from esophageal cancer patients. Cancer Res 2010; 70:9129-36. [PMID: 20884633 DOI: 10.1158/0008-5472.can-10-1566] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The variable rate of missed cancer in endoscopic biopsies and lack of other biomarkers reduce the effectiveness of surveillance programs in esophageal cancer. Based on the "field cancerization" hypothesis that tumors arise within a transformed field with an altered biochemical phenotype, we sought to test if metabolic profiling could differentiate between histologically normal tissue from individuals with and without esophageal cancer. Thirty-five patients with esophageal adenocarcinoma and 52 age-matched controls participated in the study. Using 1H magic angle spinning-nuclear magnetic resonance spectroscopy of intact tissue, we generated metabolic profiles of tumor tissue, proximal histologically normal mucosa from cancer patients (PHINOM), and proximal histologically normal mucosa from a control group. Using multivariate regression and receiver-operator characteristic analysis, we identified a panel of metabolites discriminating malignant and histologically normal tissues from cancer patients and from that of controls. Whereas 26% and 12% of the spectral profile regions were uniquely discriminating tumor or control tissue, respectively, 5% of the profile exhibited a significant progressive change in signal intensity from controls to PHINOM to tumor. Regions identified were assigned to phosphocholine (PC), glutamate (Glu), myo-inositol, adenosine-containing compounds, uridine-containing compounds, and inosine. In particular, the PC/Glu ratio in histologically normal tissue signified the presence of esophageal cancer (n=123; area under the curve, 0.84; P<0.001). In conclusion, our findings support the hypothesis of the presence of metabonomic field effects in esophageal cancer, even in non-Barrett's segments. This indicates that metabolic profiling of tissue can potentially play a role in the surveillance of cancer by reporting on the phenotypic consequences of field cancerization.
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Affiliation(s)
- Danny Yakoub
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London, United Kingdom
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Payne GS, Schmidt M, Morgan VA, Giles S, Bridges J, Ind T, DeSouza NM. Evaluation of magnetic resonance diffusion and spectroscopy measurements as predictive biomarkers in stage 1 cervical cancer. Gynecol Oncol 2009; 116:246-52. [PMID: 19875159 DOI: 10.1016/j.ygyno.2009.09.044] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 09/28/2009] [Accepted: 09/30/2009] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To establish whether ADC and total choline were significantly different between cervical tumors with different histological characteristics (type, degree of differentiation, presence or absence of lymphovascular invasion, lymph-node involvement) in order to establish their role as predictive biomarkers. METHODS 62 patients with stage 1 cervical cancer were scanned at 1.5 T. T2-weighted imaging (TR/TE=4500/80 ms), to identify tumor and normal cervix, was followed by diffusion-weighted imaging (TR/TE=2500/69 ms; 5 b-values 0, 100, 300, 500 and 800 s/mm(2)) and MR spectroscopic imaging (15 mm slice, 7.5 mm in-plane resolution, TR=888 ms). Regions of interest in normal cervix and tumor were drawn on apparent diffusion coefficient (ADC) maps by an expert observer with reference to the T2-weighted images. ADCs were calculated using a monoexponential fit of data from all b-values. MR spectra in voxels designated as tumor (>30% tumor) or non-tumor were quantified using LCModel and referenced to tissue water. RESULTS There was a statistically significant difference between the ADC of tumor regions (1117+/-183x10(-6) mm(2)/s) and of selected normal regions (1724+/-198x10(-6) mm(2)/s; p<0.001), and between tumors that were well/moderately differentiated (1196+/-181x10(-6) mm(2)/s) compared with those that were poorly differentiated (1038+/-153x10(-6) mm(2)/s; p=0.016). There was no significant difference between the ADCs of the tumors when separated by other characteristics (tumor type, lymphovascular invasion, lymph-node metastases), or between measured total choline in any of the groups. CONCLUSION ADCs are lower in cancer compared to normal cervical tissue, with degree of tumor differentiation contributing to this difference.
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Affiliation(s)
- Geoffrey S Payne
- CRUK/EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, MRI Unit, Downs Road, Sutton, Surrey, SM2 5PT, UK.
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