Hepatic cancers and their response to chemoembolization therapy. Quantitative image-guided 31P magnetic resonance spectroscopy.
OBJECTIVE
Hepatic embolization combined with intra-arterial administration of cytostatic drugs (chemoembolization) is frequently used to treat primary and metastatic cancers to the liver. Quantitative phosphorus-31 magnetic resonance spectroscopy (31P MRS) was used to assess the metabolic state of hepatic cancers and their metabolic response to chemoembolization.


METHODS
Fifteen localized 31P MRS studies were performed on five patients with liver tumors. Thirteen healthy volunteers served as controls. Metabolite ratios and molar metabolite concentrations were calculated.


RESULTS
Untreated hepatic tumors, relative to normal controls, showed elevated phosphomonoester/adenosine triphosphate (PME/ATP) ratios, reduced concentrations of ATP and inorganic phosphate (Pi), and normal phosphodiester (PDE) concentrations. As an acute response to chemoembolization, ATP, PME, and/or PDE concentrations diminished, whereas Pi concentrations increased or stayed relatively constant. Long-term follow-up after chemoembolization showed decreased PME/ATP and increased ATP concentrations in the absence of changes on standard magnetic resonance and computed tomographic images.


CONCLUSIONS
These preliminary spectroscopic data suggest that quantitative 31P MRS can be successfully used to monitor directly metabolic response to hepatic chemoembolization.
Meyerhoff
D J
DJ
Magnetic Resonance Unit, DVA Medical Center, San Francisco, CA 94121.
Karczmar
G S
GS
Valone
F
F
Venook
A
A
Matson
G B
GB
Weiner
M W
MW
D000230:Adenocarcinoma / Q000378:metabolism / Q000556:secondary / Q000628:therapy*; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008113:Liver Neoplasms / Q000378:metabolism / Q000556:secondary / Q000628:therapy*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged