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Martinez Luque E, Liu Z, Sung D, Goldberg RM, Agarwal R, Bhattacharya A, Ahmed NS, Allen JW, Fleischer CC. An Update on MR Spectroscopy in Cancer Management: Advances in Instrumentation, Acquisition, and Analysis. Radiol Imaging Cancer 2024; 6:e230101. [PMID: 38578207 PMCID: PMC11148681 DOI: 10.1148/rycan.230101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 04/06/2024]
Abstract
MR spectroscopy (MRS) is a noninvasive imaging method enabling chemical and molecular profiling of tissues in a localized, multiplexed, and nonionizing manner. As metabolic reprogramming is a hallmark of cancer, MRS provides valuable metabolic and molecular information for cancer diagnosis, prognosis, treatment monitoring, and patient management. This review provides an update on the use of MRS for clinical cancer management. The first section includes an overview of the principles of MRS, current methods, and conventional metabolites of interest. The remainder of the review is focused on three key areas: advances in instrumentation, specifically ultrahigh-field-strength MRI scanners and hybrid systems; emerging methods for acquisition, including deuterium imaging, hyperpolarized carbon 13 MRI and MRS, chemical exchange saturation transfer, diffusion-weighted MRS, MR fingerprinting, and fast acquisition; and analysis aided by artificial intelligence. The review concludes with future recommendations to facilitate routine use of MRS in cancer management. Keywords: MR Spectroscopy, Spectroscopic Imaging, Molecular Imaging in Oncology, Metabolic Reprogramming, Clinical Cancer Management © RSNA, 2024.
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Affiliation(s)
- Eva Martinez Luque
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Zexuan Liu
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Dongsuk Sung
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Rachel M. Goldberg
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Rishab Agarwal
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Aditya Bhattacharya
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Nadine S. Ahmed
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Jason W. Allen
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
| | - Candace C. Fleischer
- From the Departments of Radiology and Imaging Sciences (E.M.L., Z.L.,
D.S., J.W.A., C.C.F.) and Neurology (J.W.A.), Emory University School of
Medicine, Atlanta, Ga; Department of Biomedical Engineering (E.M.L., Z.L., D.S.,
J.W.A., C.C.F.), Georgia Institute of Technology and Emory University, Atlanta,
Ga; College of Arts and Sciences, Emory University, Atlanta, Ga (R.M.G.); and
College of Business (R.A.) and College of Sciences (A.B., N.S.A.), Georgia
Institute of Technology, Atlanta, Georgia
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Stamatelatou A, Bertinetto CG, Jansen JJ, Postma G, Selnaes KM, Bathen TF, Heerschap A, Scheenen TWJ. A multivariate curve resolution analysis of multicenter proton spectroscopic imaging of the prostate for cancer localization and assessment of aggressiveness. NMR IN BIOMEDICINE 2024; 37:e5062. [PMID: 37920145 DOI: 10.1002/nbm.5062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023]
Abstract
In this study, we investigated the potential of the multivariate curve resolution alternating least squares (MCR-ALS) algorithm for analyzing three-dimensional (3D) 1 H-MRSI data of the prostate in prostate cancer (PCa) patients. MCR-ALS generates relative intensities of components representing spectral profiles derived from a large training set of patients, providing an interpretable model. Our objectives were to classify magnetic resonance (MR) spectra, differentiating tumor lesions from benign tissue, and to assess PCa aggressiveness. We included multicenter 3D 1 H-MRSI data from 106 PCa patients across eight centers. The patient cohort was divided into a training set (N = 63) and an independent test set (N = 43). Singular value decomposition determined that MR spectra were optimally represented by five components. The profiles of these components were extracted from the training set by MCR-ALS and assigned to specific tissue types. Using these components, MCR-ALS was applied to the test set for a quantitative analysis to discriminate tumor lesions from benign tissue and to assess tumor aggressiveness. Relative intensity maps of the components were reconstructed and compared with histopathology reports. The quantitative analysis demonstrated a significant separation between tumor and benign voxels (t-test, p < 0.001). This result was achieved including voxels with low-quality MR spectra. A receiver operating characteristic analysis of the relative intensity of the tumor component revealed that low- and high-risk tumor lesions could be distinguished with an area under the curve of 0.88. Maps of this component properly identified the extent of tumor lesions. Our study demonstrated that MCR-ALS analysis of 1 H-MRSI of the prostate can reliably identify tumor lesions and assess their aggressiveness. It handled multicenter data with minimal preprocessing and without using prior knowledge or quality control. These findings indicate that MCR-ALS can serve as an automated tool to assess the presence, extent, and aggressiveness of tumor lesions in the prostate, enhancing diagnostic capabilities and treatment planning of PCa patients.
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Affiliation(s)
- Angeliki Stamatelatou
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Jeroen J Jansen
- Department of Analytical Chemistry & Chemometrics, Radboud University, Nijmegen, The Netherlands
| | - Geert Postma
- Department of Analytical Chemistry & Chemometrics, Radboud University, Nijmegen, The Netherlands
| | - Kirsten Margrete Selnaes
- Department of Circulation and Medical Imaging, Norwegian University of Technology and Science, Trondheim, Norway
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Technology and Science, Trondheim, Norway
- Department of radiology and nuclear medicine, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - Arend Heerschap
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom W J Scheenen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
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Sheikhi N, Bahraminejad M, Saeedi M, Mirfazli SS. A review: FDA-approved fluorine-containing small molecules from 2015 to 2022. Eur J Med Chem 2023; 260:115758. [PMID: 37657268 DOI: 10.1016/j.ejmech.2023.115758] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023]
Abstract
Fluorine-containing small molecules have occupied a special position in drug discovery research. The successful clinical use of fluorinated corticosteroids in the 1950s and fluoroquinolones in the 1980s led to an ever-increasing number of approved fluorinated compounds over the last 50 years. They have shown various biological properties such as antitumor, antimicrobial, and anti-inflammatory activities. Fluoro-pharmaceuticals have been considered a strong and practical tool in the rational drug design approach due to their benefits from potency and ADME (absorption, distribution, metabolism, and excretion) points of view. Herein, approved fluorinated drugs from 2015 to 2022 were reviewed.
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Affiliation(s)
- Negar Sheikhi
- Department of Medicinal Chemistry, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Bahraminejad
- Department of Medicinal Chemistry, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Saeedi
- Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Persian Medicine and Pharmacy Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyedeh Sara Mirfazli
- Department of Medicinal Chemistry, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran.
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Seierstad T, Hole KH, Tulipan AJ, Strømme H, Lilleby W, Revheim ME, Hernes E. 18F-Fluciclovine PET for Assessment of Prostate Cancer with Histopathology as Reference Standard: A Systematic Review. PET Clin 2021; 16:167-176. [PMID: 33648662 DOI: 10.1016/j.cpet.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The PET tracer 18F-fluciclovine (Axumin) was recently approved in the United States and Europe for men with suspected prostate cancer recurrence following prior treatment. This article summarizes studies where systematic sector-based histopathology was used as reference standard to assess the diagnostic accuracy of the tracer 18F-fluciclovine PET in patients with prostate cancer.
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Affiliation(s)
- Therese Seierstad
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway.
| | - Knut Håkon Hole
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Andreas Julius Tulipan
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Sognsvannsveien 20, 0372 Oslo, Norway
| | - Wolfgang Lilleby
- Department of Oncology, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424 Oslo, Norway
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway
| | - Eivor Hernes
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
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