title: Magnetic Resonance Spectroscopy of cancer-practicalities of multi-centre trials and early results in non-Hodgkin's lymphoma.
abstract: This review describes problems and solutions encountered in large scale multicentre trials of Magnetic Resonance Methods for monitoring cancer. It is illustrated with reference to the Multi-Institutional Group on Magnetic Resonance Spectroscopy (MRS) Applications to Cancer which was set up to perform a trial of 31P MRS for monitoring non-invasively chemotherapy of solid tumours. 31P MR spectra of non-Hodgkin's lymphoma (NHL) pre- and posttreatment, across nine Institutions, were acquired on either General Electric (GE) or Siemens 1.5T Clinical MR instruments. Development of the trial protocol, design of the Radio Frequency (RF) coils and Quality Control procedures necessary to ensure that the datasets acquired at each centre were comparable, are described. The data revealed that phosphomonoesters (PME)/nucleotide triphosphates (NTP) ratio decreased significantly after treatment in the Complete (P<0.001) and Partial (P<0.05) Responders but not in the Non-Responders (P>0.1). In addition, the PME/NTP ratio in the pre-treatment spectra correlated with the subsequent outcome of treatment indicating that PME/NTP levels are significant predictors of long-term clinical response and time-to-treatment failure in NHL.
authors.affiliation: Cancer Research Campaign Biomedical Magnetic Resonance Research Group, Department of Biochemistry and Immunology, St. George's Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Griffiths
authors.forename: A R
authors.initials: AR
authors.lastname: Tate
authors.forename: F A
authors.initials: FA
authors.lastname: Howe
authors.forename: M
authors.initials: M
authors.lastname: Stubbs
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D004867:Equipment Design; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D015337:Multicenter Studies as Topic; D011786:Quality Control; D012680:Sensitivity and Specificity; D016019:Survival Analysis