PREDICTING HUMAN TUMOR RESPONSE BY 31P MRS

通过 31P MRS 预测人类肿瘤反应

• 批准号: 2667965
• 负责人: MARTIN O LEACH
• 金额: $ 30.78万
• 依托单位: THE INSTITUTE OF CANCER RESEARCH: ROYAL CANCER HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-06-20 至 2000-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2667965
• 关键词: acidity /alkalinity; breast neoplasms; cooperative study; creatine phosphate; head /neck injury; human subject; human therapy evaluation; longitudinal human study; metabolism; neoplasm /cancer therapy; nonHodgkin's lymphoma; nuclear magnetic resonance spectroscopy; phosphorus; prognosis; radionuclides; sarcoma

DESCRIPTION: In vivo 31-P MR spectroscopy provides a means of non- invasively monitoring tissue metabolism, providing new information about tumor biochemistry, and providing the opportunity to monitor changes occurring in patients during treatment. A number of preliminary studies of human tumors have now been completed. These show that 31-P MR spectra of human cancers in vivo typically have metabolic characteristics which differ from those of normal tissues. These include raised levels of phosphomonoesters (PME), phosphodiesters (PDE) and cellular pH, and reduced phosphocreatine (PCr). In recent studies, these characteristics have provided prognostic information, or early indicators of response to chemotherapy or radiotherapy. In some studies combination of metabolic information with quantitative T2 measurements derived from 1H MR images has increased the accuracy of prediction. Whilst these preliminary studies provide consistent information, they have been relatively small scale single institution studies, with the study size limited by access to machine time and limited patient populations. Recently, there have been significant advances in technology, permitting the wide spread application of chemical shift imaging, decoupling and optimized coil design. Based on these developments and preliminary studies, it is now timely to undertake a definitive trial of the value of 31 P MRS in the management of cancer patients. To achieve this end, a cooperative prospective study in substantial patient groups with appropriate tumors for 31-P MRS investigation is proposed. This proposal is one of 8 Interactive R01 proposals from 8 institutions collaborating to study over 1500 patients with non-Hodgkin's lymphoma, primary breast cancer, soft tissue sarcoma and head and neck carcinoma. This institution will contribute to the first three tumor groups, and will provide an instrument quality control central resource. State of the art techniques will be established at all institutions, including double tuned surface coils designed specifically to access the range of anatomical locations in these diseases; proton decoupling of 31-P to distinguish individual phospholipid metabolites; image guided 3 dimensional chemical shift imaging to accurately localize 31-P MR spectra to tumor; quantification of metabolite levels; and the application of pattern recognition to spectral analysis and characterization. The study will test the hypotheses that a baseline in vivo 31-P MR spectra can predict tumor response to treatment, and that comparison between the baseline spectrum and further spectra taken early in the course of treatment can provide an early indicator of response to treatment. The study will establish standards for cooperative MRS trials in other cancers and treatments, and will provide a basis for use of the technique in accelerating the evaluation of new treatments and in applying the technique in the management of individual patients.

描述：体内31-P MR光谱法提供了一种非 - 侵入性监测组织代谢，提供有关 肿瘤生物化学，并提供监控变化的机会 在治疗期间发生在患者中。 许多初步研究 现在已经完成了人类肿瘤。 这些表明31-P MR 体内人类癌的光谱通常具有代谢 与正常组织不同的特征。 这些 包括磷酸植物（PME），磷酸化器（PDE）的升高水平 和细胞pH，并减少磷酸氨酸（PCR）。 在最近的研究中 这些特征提供了预后信息，或 对化学疗法或放疗的反应指标。 在一些研究中 代谢信息与定量T2测量的组合 从1H MR图像得出的提高了预测的准确性。 尽管这些初步研究提供了一致的信息，但它们 已经是相对较小的单一机构研究， 学习尺寸有限受到机器时间和有限的患者的限制 人群。 最近，在 技术，允许化学转移的广泛应用 成像，脱钩和优化的线圈设计。 基于这些 发展和初步研究，现在及时进行 在癌症管理中的价值31 P的最终试验 患者。 为了实现这一目标，一项合作的前瞻性研究 具有适当肿瘤31-P MRS的大量患者组 提出了调查。 该提案是8个互动R01之一 来自8个机构合作研究1500多名患者的提案 非霍奇金淋巴瘤，原发性乳腺癌，软组织肉瘤 以及头部和颈部癌。 该机构将有助于 前三个肿瘤组，将提供仪器质量控制 中央资源。 最先进的技术将在 所有机构，包括设计的双调节表面线圈 专门用于访问这些解剖位置的范围 疾病； 31-P的质子去耦以区分个体 磷脂代谢产物；图像指导3尺寸化学位移 成像以准确地将31-P MR光谱定位于肿瘤；定量 代谢物水平；以及将模式识别的应用到 光谱分析和表征。 该研究将测试 假设基线体内31-P MR光谱可以预测肿瘤 对治疗的反应，以及基线光谱之间的比较 在治疗过程中早期进行的更多光谱可以提供 对治疗反应的早期指标。 该研究将建立 其他癌症和治疗中合作MRS试验的标准， 并将为使用该技术加速提供基础 评估新疗法并将技术应用于 个人患者的管理。