Proton magnetic resonance spectroscopy (H1-MRS) has been increasingly receiving more attention from radiologists, neurosurgeons, radiation and medical oncologists in the “in situ” clinical evaluation of human tumors. The utilization of H1-MRS, especially in human brain tumors, coupled to both routine magnetic resonance imaging (MRI) and functional MRI techniques provides greater information concerning tumor grading and extension and characterization of the normal surrounding tissue than what is possible with any other imaging technique alone. In this paper, we will review the current status of proton MR spectroscopy with emphasis on its clinical utility to diagnose tumors, its utility in planning surgical and radiation therapy interventions, and in its use in monitoring tumor treatment.
References
1.
CastilloM., and KwockL.Clinical applications of proton magnetic reso nance spectroscopy in the evaluation of common intracranial tumors. Topics Mag. Res. Imaging10, 104–113 (1999).
2.
TaylorJ. S., LangstonJ. W., ReddickW. E., KingsleyP. B.Clinical value of proton magnetic resonance spectroscopy for differentiating recur rent or residual brain tumor from delayed cerebral necrosis. Int. J. Radiation Oncology Biol. Phys.36, 1251–1261 (1996).
3.
CastilloM. (ed.), Proton MR Spectroscopy of the Brain, Neuroimaging Clinics of North America, Vol. 18 (4), W. B. Saunders Co., Philadelphia, pp. 713–926.(1998).
4.
BurtscherI. M., and HoltasS.Proton MR spectroscopy in clinical routine. J. Magn. Reson. Imaging13, 560–567, (2001).
5.
VigneronD. B., NelsonS. J., and KurhanewiczJ., Proton chemical shift imaging of cancer, In Magnetic Resonance Imaging of the Body, Chapter 12, 3rd edition, HigginsC. B., HricakH., and HelmsC. A. (eds.), Lippincott-Raven Press, New York, pp. 205–220. (1997).
6.
KvistadK. A., BakkenI. J., GribbestadI. S., Characterization of neo plastic and normal human breast tissues with in vivo H-1 MR spectroscopy. J. Magn. Reson. Imaging10, 159–164 (1999).
7.
AllenJ. R., ProstR. W., GriffithO. W., in vivo proton (H-1) magnet ic resonance spectroscopy of cervical carcinoma. Am. J. Clin. Oncol.24, 522–529 (2001).
8.
KwockL., Localized MR spectroscopy: Basic Principles. Neuroimaging Clinics of North America8, 713–732 (1998).
9.
GreutterR., WeisdorfS. A., RajanayaganV.Resolution improve ments in “in vivo” NMR spectra with increased magnetic field strength. J. Magn. Reson.135, 260–264 (1998).
10.
FulhamM. J., BizziA., DietzM. J.. Mapping of brain tumor metabolites with proton MR spectroscopic imaging: Clinical relevance. Radiology185, 675–686 (1992).
11.
ZeiselS. H.Choline, A nutrient that is involved in the regulation of cell proliferation, cell death and cell transformation. Adv. Exp. Med. Biol.399, 131–141 (1996).
12.
MillerB. L., ChangL., BoothR.in vivo H-1 MRS choline: Correlation with In Vitro chemistry/histology. Life Sciences58, 1929–1935 (1996).
13.
ShimizuH., KumabeT., ShiraneR., and YoshimotoT.Correlation between choline level measured by proton MR spectroscopy and Ki-67 labeling index in gliomas. Am. J. Neuroradiol.21, 659–665 (2000).
14.
SmithJ. K., KwockL., and CastilloM.Effects of contrast material on single — volume proton MR spectroscopy. Am. J. Neuroradiol.21, 1084–1089, (2000).
15.
SomorjaiR. L., NikulinA. E., PizziN.Computerized concensus diagnosis: A classification strategy for the robust analysis of MR spectra. I. Application to H-1 spectra of thyroid neoplasms. Magn. Reson. Med.33, 257–263 (1995).
16.
PreulM. C., CaramanosZ., CollinsD. L.Linear discriminant analy sis based on proton MR spectroscopic imaging of human brain tumors improves pre-operative diagnosis. Nature Med.2, 323–325 (1996).
17.
WallaceJ. C., RaaphorstG. P., SomorjaiR. L.Classification of H-1 MR spectra of biopsies from untreated and recurrent ovarian cancer using linear discriminant analysis. Magn. Reson. Med.38, 569–576 (1997).
18.
LeanC. L., NewlandR. C., EndeD. A.Assessment of human col orectal biopsies by H-1 MRS: Correlation with Histopathology. Magn. Reson. Med.30, 525–533 (1993).
19.
SijensP. E., van DijkP., OudkerkM.Correlation between choline level and Gd-DPTA enhancement in patients with brain metastases of mammary carcinoma. Magn. Reson. Med.32, 549–555 (1994).
20.
MackinnonW. B., BarryP. A., MalychaP. L.Fine-needle biopsy specimens of benign breast lesions distinquished from invasive cancer ex Vivo with proton MR spectroscopy. Radiology204, 661–666 (1997).
21.
MukherjiS. K., SchiroS., CastilloM.Proton MR spectroscopy of squamous cell carcinoma of the extracranial head and neck: In vitro and in vivo studies. Am. J. Neuroradiol.18, 1057–1072 (1997).
22.
HendrikusG., KrouwerJ., KimT. A.Single-voxel proton MR spec troscopy of non-neoplastic brain lesions suggestive of a neoplasm. Am. J. Neuroradiol.19, 1695–1703 (1998).
23.
BitschA., BruhnH., VougioukasV.Inflammatory CNS Demyelination: Histopatholigic correlation with in vivo quantitative proton MR spectroscopy. Am. J. Neuroradiol.20, 1619–1627 (1999).
24.
MartinA. J., LiuH., HallW. A., and TruwitC. L.Preliminary assessement of turbo spectroscopic imaging for targeting in brain biopsy. Am. J. Neuroradiol.22, 959–968 (2001).
25.
CastilloM., ScatliffJ. H., BouldinT. W., and SuzukiK.Radiologic-pathologic correlation: Intracranial astrocytoma. Am. J. Neuroradiol.13, 1609–1616 (1992).
26.
CastilloM., KwockL., ScatliffJ., and MukherjiS. K.Proton MR spec troscopy in neoplastic and non-neoplastic brain disorders. MRI Clinics of North America6, 1–19 (1998).
27.
TienR. D., LaiP. H., SmithJ. S., and LazeyrasF.Single voxel proton brain spectroscopy exam (PROBE/SV) in patients with primary brain tumors. AJR167, 201–209 (1996).
28.
CastilloM., SmithJ. K., and KwockL.Correlation of myo-inositol lev els and grading of cerebral astrocytomas. Am. J. Neuroradiol.21, 1645–1649 (2000).
29.
DowlingC., BollenA. W., NoworolskiS. M.Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. Am. J. Neuroradiol.22, 604–612 (2001).
30.
LiuH., HallW. A., MartinA. J., and TruwitC. L.An efficient chemical shift imaging scheme for magnetic resonance-guided neurosurgery. J. Magn. Reson. Imaging14, 1–7 (2001).
31.
KondziolkaD., FlickingerJ. C., BissonetteD. J.Survival benefits of sterotactical radiosurgery for patients with malignant glial neoplasms. Neurosurgery41, 776–785 (1997).
32.
WatanabeM., TanakaR., and TakedaN.Magnetic resonance imaging and histopathology of cerebral gliomas. Neuroradiology34, 463–469 (1992).
33.
GravesE. E., NelsonS. J., VigneronD. B.Apreliminary study of the prognostic value of proton MR spectroscopic imaging in gamma knife radio surgery of recurrent malignant gliomas. Neurosurgery46, 319–328 (2000).
34.
RubinD. B. and GriemM. L., The histopathology of irradiated endothelium, In: The radiation biology of the vascular endothelium, RubinD. B. (ed.), CRC Press, Boca Raton, FL, pp. 13–38. (1998).
35.
GravesE. E., NelsonS. J., VigneronD. B.Serial proton MR spec troscopic imaging of recurrent malignant gliomas after gamma knife radio surgeryAm. J. Neuroradiol.22, 613–624 (2001).
36.
KueselA. C., SutherlandG. R., HallidayW., and SmithI. C. P.H-1 MRS of high grade astrocytomas: Mobile lipid accumulation in necrotic tissue. NMR Biomed.7, 149–155 (1994).
37.
NegendankW., and SauteR.R.Intratumoral lipids in H-1 MRS in vivo in brain tumors: experience of the Siemens cooperative clinical trial. Anticancer Res.16, 1533–1538 (1996).
38.
TomoiM., KimuraH., YoshidaM.Alterations of lactate (+lipid) concentration in brain tumors with in vivo hydrogen magnetic resonance spectroscopy during radiotherapy. Invest. Radiol.32, 288–296 (1997).
39.
BizziA., MovsasB., TedeschiG.Response of non-Hodgkin lym phoma to radiation therapy: Early and long-term assessment with H-1 MR spectroscopic imaging. Radiology194, 271–276 (1995).
40.
TzikaA. A., ZurakowskiD., PoussaintT. Y.Proton magnetic spec troscopic imaging of the child's brain: The response of tumors to treatment. Neuroradiol.43, 169–177 (2001).
41.
KwockL., CastilloM., and SmithJ. K.Comparison of proton MR spec tral patterns of glioblastoma multiforme (GBM) versus metastatic brain tumors, resented at the 37th Meeting of The American Society of Neuroradiology1999, San Diego, CA, p. 58 (Book of Abstracts).
42.
IshimaruH., MorikawaM., IwanagaS.Differentiation between high-grade glioma and metastatic brain tumor using single-voxel proton MR spectroscopyEur. Radiol.11, 1784–1791 (2001).
43.
ErnstR. R., BodenhausenG., and WokaunA.Principles of NMR, in one and two dimensions, Oxford, Oxford Publications, 1987.
44.
TraficanteD. D.The nature of the second dimension in 2D NMR. Concepts in Magnetic Resonance1, 7–13 (1989).
45.
DeromeA. E.Homonuclear Shift Correlation, in: Modern NMR Techniques for Chemistry Research, Pergamon Press, Oxford, pp. 183–244 (1987).
46.
LeanC. L., MackinnonW. B., and MountfordC. E.Fucose in H-1 COSY spectra of plasma membrane fragments shed from human malignant col erectal cells. Magn. Reson. Med.20, 306–311 (1991).
47.
IsselbacherK. J.Increased uptake of amino acids and 2-deoxy-D-glucose by virus-transformed cells in culture. Proc. Natl. Acad. Sci. USA69, 585–589 (1972).
48.
RussellP., LeanC. L., DelbridgeL., MayG. L.Proton magnetic resonance and human thyroid neoplasia I: Discrimination between benign and malignant neoplasms. Am. J. Medicine96, 383–388 (1994).
49.
MountfordC. E., LeanC. L., MacKinnonW. B., and RussellP.The use of proton MR in cancer pathology, In: Annual Reports on NMR Spectroscopy (WebbG. A., ed.), 27, 173–216 (1993).
50.
ThomasM. A., BineshN., YueK., and DeBruhlN.Volume-localized two-dimensional correlated magnetic resonance spectroscopy of human breast cancer. J. Magn. Reson. Medicine14, 181–186 (2001).
51.
SwansonM. G., VigneronD. B., TranT-K. C.. Single-voxel over sampled J-resolved spectroscopy of in vivo human prostate tissue. Magn. Reson. Medicine45, 973–980 (2001).
52.
ThomasM. A., RynerL. N., MehtaM. P.Localized 2D J-resolved H-1 MR spectroscopy of human brain tumors in vivo. J. Magn. Reson. Imaging6, 453–459 (1996).
53.
RossB. D., Ben-YosephO., and ChenevertT. L.in vivo magnetic reso nance imaging and spectroscopy: Application to brain tumors. Advances in Neurochemistry8, 145–177 (1997).
54.
HuggJ. W., MatsonG. B., TweigD. B.Phosphorus-31 MR spectroscopic imaging (MRSI) of normal and pathological human brains. Magn. Reson. Imaging10, 227–243 (1992).
55.
NgT. C., GrundfestS., VijayakumarS.. Therapeutic response of breast carcinoma montitored by P-31 MRS in Situ. Magn. Reson. Medicine10, 125–134 (1989).
56.
McSheehyP. M. J. and GriffithsJ. R.F-19 MRS of fluoropyrimidine chemotherapy. A review. NMR Biomed.2, 133–140 (1989).
57.
LondonR. E.C-13 Labeling in studies of metabolic regulation. Prog. NMR Spectroscopy20, 331–383 (1988).
