Clinical applicability of human in vivo localized phosphorus-31 magnetic resonance spectroscopy of bone and soft tissue tumors.
BACKGROUND
Magnetic resonance imaging (MRI) is of restricted value for the in vivo characterization of tumor types. The applicability of phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) in the diagnosis of bone and soft tissue tumors is unknown.


METHODS
A total of 191 consecutive patients (85 females and 106 males; mean age 41 years, range 1-80) with a well-defined bone or soft tissue tumor on MRI were analyzed for additional 31P spectroscopy. Histology and/or cytology was obtained from all tumors. Because of low sensitivity of the 31P nucleus and the contamination of surrounding tissue, only large, superficially located tumors accessible to the surface coil could be accepted for MRS.


RESULTS
Twenty-one patients (11%) could be included in the study. From this remaining group only 12 studies (57%) produced spectra with well resolved phosphorus peaks and an acceptable signal-to-noise ratio. However, these spectra did not allow differentiation between the benign and malignant nature of the lesions. The other 9 studies showed spectra with poor signal intensities and/or poorly defined peaks, making tumor differentiation impossible.


CONCLUSIONS
Only 6% of the bone and soft tissue tumors produced well defined spectra, which implies that localized 31P MRS cannot be considered as a routine technique in the diagnostic and treatment evaluation of bone and soft tissue tumors.
Department of Surgical Oncology, Groningen University Hospital, The Netherlands.
H J
HJ
Hoekstra
W J
WJ
Boeve
R L
RL
Kamman
E L
EL
Mooyaart
D000255:Adenosine Triphosphate / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010725:Phosphocreatine / Q000378:metabolism; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism; D010744:Phosphoric Monoester Hydrolases / Q000378:metabolism; D010759:Phosphorus Isotopes; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000378:metabolism
D010759:Phosphorus Isotopes; D010725:Phosphocreatine; D000255:Adenosine Triphosphate; D010744:Phosphoric Monoester Hydrolases; D010727:Phosphoric Diester Hydrolases