[Spectroscopic imaging of the human liver using 3D CSI: optimization and application in patients with metastatic uvea melanoma].
OBJECTIVE
(31)P MR spectroscopy (MRS) allows the noninvasive assessment of metabolic alterations in tumors. Due to physical as well as technical limitations, mostly large and single voxels are used. We used a spatially resolved (31)P MRS technique to characterize metabolic abnormalities inside and adjacent to liver metastases of patients with uvea melanoma.


METHODS
Optimization of 3D chemical shift imaging (3D CSI) was performed in healthy volunteers (n = 19; voxel size 25 ml). Patients (n = 8) with liver metastases were then examined. Cross sectional imaging was available for all patients.


RESULTS
Compared to healthy volunteers, the PME/PDE ratios of patients with liver metastasis were significantly higher (0.56 +/- 0.30 vs. 0.39 +/- 0.21; p < 0.05). A trend towards increased PME/beta ATP ratios (2.07 +/- 1.83 vs. 1.02 +/- 0.45; p = 0.12) and decreased Pi/PME ratios (0.57 +/- 0.29 vs. 1.06 +/- 0.58; p = 0.06) was also observed. Patients with metastases > or = 5 cm showed significantly higher PME/PDE ratios (0.68 +/- 0.17 vs. 0.45 +/- 0.03; p < 0.05). Liver parenchyma adjacent to metastases did not show any significant changes compared to non-diseased tissue.


CONCLUSIONS
3D CSI allows the simultaneous analysis of metabolic alterations in diseased as well as in healthy human liver. Metastases show significant metabolic alterations. Thus, (31)P MRS opens new possibilities for therapeutic monitoring.
Beer
M
M
Institut für Röntgendiagnostik, Universitätsklinikum Würzburg. beer@roentgen.uniwuerzburg.de
Winkelmann
V
V
Becker
J C
JC
Terheyden
P
P
Stenzel
M
M
Bröcker
E-B
EB
Hahn
D
D
Köstler
H
H
D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000503:physiopathology*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000503:physiopathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000503:physiopathology / Q000556:secondary*; D008875:Middle Aged; D015588:Observer Variation; D010725:Phosphocreatine / Q000378:metabolism; D010743:Phospholipids / Q000378:metabolism; D012016:Reference Values; D012680:Sensitivity and Specificity; D055815:Young Adult
D010743:Phospholipids; D010725:Phosphocreatine; D000255:Adenosine Triphosphate