title: Serial measurement of hepatic lipids during chemotherapy in patients with colorectal cancer: a 1 H MRS study.
abstract: Hepatic steatosis is a hallmark of chemotherapy-induced liver injury. We made serial (1) H MRS measurements of hepatic lipids in patients over the time course of a 24-week chemotherapeutic regimen to determine whether (1) H MRS could be used to monitor the progression of chemotherapy-induced steatosis. Thirty-four patients with stage III or IV colorectal cancer receiving 5-fluorouracil, folinic acid and oxaliplatin (n=21) or hepatic arterial infusion of floxuridine with systemic irinotecan (n=13) were studied prospectively. (1) H MRS studies were performed at baseline and after 6 and 24 weeks of treatment. A (1) H MR spectrum was acquired from the liver during a breath hold and the ratio of fat to fat+water (FFW) was calculated to give a measure of hepatic triglycerides (HTGCs). The methodology was histologically validated in 18 patients and the reproducibility was assessed in 16 normal volunteers. Twenty-seven patients completed baseline, 6-week and 24-week (1) H MRS examinations and one was censored. Thirteen of 26 patients (50%) showed an increase in FFW after completion of treatment. Six patients (23%) developed hepatic steatosis and two patients converted from steatosis to nonsteatotic liver. Patients whose 6-week hepatic lipid levels had increased significantly relative to baseline also had a high probability of lipid elevation relative to baseline at the completion of treatment. Serial (1) H MRS is effective for the monitoring of HTGC changes during chemotherapy and for the detection of chemotherapy-associated steatosis. Six of 26 patients developed steatosis during chemotherapy. Lipid changes were observable at 6 weeks.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: Jing
authors.initials: J
authors.lastname: Qi
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.forename: Leonard
authors.initials: L
authors.lastname: Saltz
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Kemeny
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.forename: Jinru
authors.initials: J
authors.lastname: Shia
authors.forename: Amita
authors.initials: A
authors.lastname: Shukla-Dave
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.forename: William M
authors.initials: WM
authors.lastname: Jarnagin
authors.forename: Richard K G
authors.initials: RK
authors.lastname: Do
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: Jason A
authors.initials: JA
authors.lastname: Koutcher
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Zakian
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D005234:Fatty Liver / Q000139:chemically induced* / Q000378:metabolism*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D011522:Protons