title: Epithelial and stromal metabolite changes in the transition from cervical intraepithelial neoplasia to cervical cancer: an in vivo 1H magnetic resonance spectroscopic imaging study with ex vivo correlation.
abstract: To investigate epithelial and stromal metabolite changes in cervical intraepithelial neoplasia (CIN) and cervical cancer in vivo and correlate findings with MR spectroscopy of tissue samples. Forty-seven women (19 with CIN, 28 with cervical cancer) underwent endovaginal MR at 1.5 T with T2-W and localised 2D MR spectroscopic imaging (PRESS, TR = 1,500 ms, TE = 135 ms). tCho, 2 ppm and -CH(2) lipid peaks were measured in epithelial (>50% epithelium, no tumour), stromal (>50% stroma, no tumour) and tumour (>30% tumour) voxels. Unsuppressed water signal from the same voxel provided a concentration reference. (1)H HR-MAS MR spectra were acquired from tissue in 37 patients (11.74 T, pulse-acquire and cpmg sequences, with water pre-saturation). Analysable data from 17 CIN and 25 cancer patients showed significant increases in tCho (p = 0.03) and 2 ppm (p = 0.007) in tumour compared with epithelial voxels from CIN patients, but not with epithelial voxels from cancer patients. No significant differences were seen in stroma from cancer compared with CIN patients. Differences in -CH(2) lipids were not significant between groups. There was no significant correlation between in vivo and ex vivo tCho or -CH(2) lipids. Estimated in vivo concentrations of tCho and 2 ppm resonances increase in tumour and adjacent epithelium in progression from CIN to cervical cancer.
authors.affiliation: Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
authors.forename: Sonali S
authors.initials: SS
authors.lastname: De Silva
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Payne
authors.forename: Veronica A
authors.initials: VA
authors.lastname: Morgan
authors.forename: Thomas E J
authors.initials: TE
authors.lastname: Ind
authors.forename: John H
authors.initials: JH
authors.lastname: Shepherd
authors.forename: Desmond P J
authors.initials: DP
authors.lastname: Barton
authors.forename: Nandita M
authors.initials: NM
authors.lastname: deSouza
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D002471:Cell Transformation, Neoplastic / Q000378:metabolism* / Q000473:pathology; D004847:Epithelial Cells / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D017154:Stromal Cells / Q000378:metabolism* / Q000473:pathology; D014018:Tissue Distribution; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D011522:Protons