title: Proton magnetic resonance spectroscopy: ex vivo study to investigate its prognostic role in colorectal cancer.
abstract: BACKGROUND
  Proton Magnetic Resonance Spectroscopy (1H MRS) is used for clinical diagnosis in some tumours. The aim of this study is to explore ex vivo the potential of 1H MRS in identifying malignancy through metabolic markers in the perspective of its application in all cases of difficult diagnosis and after neoadjuvant treatment.
  
  
  METHODS
  Spectroscopy was performed ex vivo on 29 colorectal specimens. All patients were staged with imaging, underwent radical surgery and then followed-up. Spectral quantification analysis of components expressed in colorectal tumours and in healthy mucosa were evaluated. The MRS-tumour marker (MRS-tm) was calculated for each case. The U-test was used to compare MRS-tm in tumours and in healthy mucosa. In order to select a cut-off for MRS-tm in the tumour and healthy mucosa and to distinguish patients who were disease-free or with recurrence-progression, we performed the ROC curve analysis.
  
  
  RESULTS
  In the 24 subjects without neoadjuvant treatment, it was found that MRS-tm is able to discriminate healthy and neoplastic tissue and can discriminate patients with risk of recurrence/progression
  
  
  CONCLUSIONS
  Our data seem to show that 1H MRS may be successfully applied in vivo non-invasively to differentiate tumours from healthy mucosa and could also distinguish patients with different prognoses.
authors.affiliation: Department of Surgery, Civile Maggiore Hospital, University of Verona, Verona, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Minicozzi
authors.forename: Elisa
authors.initials: E
authors.lastname: Mosconi
authors.forename: Claudio
authors.initials: C
authors.lastname: Cordiano
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Pasquina
authors.initials: P
authors.lastname: Marzola
authors.forename: Alice
authors.initials: A
authors.lastname: Ferretti
authors.forename: Anna Margherita
authors.initials: AM
authors.lastname: Maffione
authors.forename: Andrea
authors.initials: A
authors.lastname: Sboarina
authors.forename: Maria
authors.initials: M
authors.lastname: Bencivenga
authors.forename: Federico
authors.initials: F
authors.lastname: Boschi
authors.forename: Giamaica
authors.initials: G
authors.lastname: Conti
authors.forename: Andrea
authors.initials: A
authors.lastname: Sbarbati
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009092:Mucous Membrane / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011379:Prognosis; D011522:Protons
chemical_list: D014408:Biomarkers, Tumor; D011522:Protons
keywords: 1H MRS; Choline; Colorectal cancer; Lipids; Tumor metabolism