Monitoring response to chemotherapy of intact human tumours by 31P nuclear magnetic resonance.
10 kidneys bearing adenocarcinoma (hypernephroma), 1 ureteric tumour, 2 Wilms' tumour from patients undergoing nephrectomy, and normal human and animal kidneys were preserved and later tested to see whether normothermic blood perfusion restored glomerular filtration, oxygen consumption, and energy metabolism, as monitored by 31P nuclear magnetic resonance (NMR). NMR spectra of normal human kidney and of renal tumours were characteristic of kidney in other species (rat, rabbit, and dog), with six principal resonances assigned to adenosine monophosphate, inorganic phosphate (Pi), glycerophosphoryl choline, gamma, alpha, and beta adenosine triphosphate and an intrarenal pH 7.0-7.2. 7 out of 9 hypernephromas and 1 of the 2 Wilms' tumours produced an additional resonance at +4.2 ppm. This peak was absent from all normal kidney spectra and may represent Pi in a specific and highly acidic environment (pH 6.1-6.5) found in actively metabolising human tumours. Furthermore, in 1 tumour (out of 5 tested) the +4.2 ppm peak rose rapidly after the addition of chemotherapeutic agents to the perfusing blood. This observation may indicate drug sensitivity of this one tumour. The results suggest that 31P NMR imaging may be used to monitor therapeutic response during regional perfusion of malignant tumours in man.
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage; D010478:Chemotherapy, Cancer, Regional Perfusion; D004285:Dogs; D004359:Drug Therapy, Combination; D004734:Energy Metabolism; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D010710:Phosphates / Q000378:metabolism; D010761:Phosphorus Radioisotopes; D012079:Renal Circulation
D000970:Antineoplastic Agents; D010710:Phosphates; D010761:Phosphorus Radioisotopes