Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, South Korea.
Magn Reson Imaging. 2012 Jul;30(6):848-53. doi: 10.1016/j.mri.2012.02.013. Epub 2012 Apr 12.
To diagnose rectal cancer and monitor treatment response after preoperative concurrent chemoradiotherapy (CCRT) in rectal cancer patients using proton-1 magnetic resonance spectroscopy ((1)H-MRS).
We enrolled 134 rectal cancer patients before treatment, of whom 34 underwent preoperative CCRT and follow-up MR spectroscopy before surgery. (1)H-MRS was performed using a six-channel phased-array coil at 3.0 T. We evaluated the presence of a choline peak at 3.2 ppm, and lipid peaks at 0.9 and 1.3 ppm, and glutamine and glutamate peaks at 2.1-2.3 and 2.7 ppm seen at two TEs (40 and 135 ms). We divided MR spectra patterns into two groups (A and B).
A choline peak at 3.2 ppm seen in both TEs was characteristic for rectal cancer before treatment. Of 103 patients, 55 (53%) showed an elevated choline peak before treatment (type A). Type A spectra were seen in 68% of patients (23/34) before preoperative CCRT. After CCRT, the choline peak disappeared, resulting in only the lipid peak at 1.3 ppm (type B) in 97% of patients (33/34).
We optimized a localized in vivo(1)H-MRS method for detection of rectal adenocarcinoma and monitoring treatment response after preoperative CCRT. The method appears to be a promising and feasible noninvasive modality.
使用质子-1 磁共振波谱((1)H-MRS)诊断直肠癌患者术前同期放化疗(CCRT)后的直肠癌及监测治疗反应。
我们在治疗前纳入了 134 例直肠癌患者，其中 34 例行术前 CCRT 及术前磁共振波谱随访。(1)H-MRS 采用 3.0 T 六通道相控阵线圈进行。我们评估了在两个 TE（40 和 135ms）处 3.2ppm 处的胆碱峰、0.9ppm 和 1.3ppm 处的脂质峰以及 2.1-2.3ppm 和 2.7ppm 处的谷氨酰胺和谷氨酸峰的存在情况。我们将 MR 光谱模式分为两组（A 和 B）。
在治疗前，两种 TE 处均可见 3.2ppm 的胆碱峰是直肠癌的特征。在 103 例患者中，55 例（53%）在治疗前出现胆碱峰升高（A 型）。A 型谱在术前 CCRT 前的 68%患者（23/34）中可见。CCRT 后，胆碱峰消失，97%的患者（33/34）仅在 1.3ppm 处出现脂质峰（B 型）。
我们优化了一种用于检测直肠腺癌的局部体内(1)H-MRS 方法，并监测术前 CCRT 后的治疗反应。该方法似乎是一种很有前途和可行的非侵入性方法。
