31P MR Spectroscopy in the Pancreas: Repeatability, Comparison With Liver, and Pilot Pancreatic Cancer Data

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-03-14 DOI:10.1002/jmri.29326

Leonard W.F. Seelen MD, Lieke van den Wildenberg MS, Ayhan Gursan MS, Martijn Froeling PhD, Mark W.J.M. Gosselink MS, Wybe J.M. van der Kemp PhD, Nadia Haj Mohammad MD, PhD, I. Quintus Molenaar MD, PhD, Hjalmar C. van Santvoort MD, PhD, Dennis W.J. Klomp PhD, Jeanine J. Prompers PhD

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Abstract

Background

Non-invasive evaluation of phosphomonoesters (PMEs) and phosphodiesters (PDEs) by 31-phosphorus MR spectroscopy (³¹P MRS) may have potential for early therapy (non-)response assessment in cancer. However, ³¹P MRS has not yet been applied to investigate the human pancreas in vivo.

Purpose

To assess the technical feasibility and repeatability of ³¹P MR spectroscopic imaging (MRSI) of the pancreas, compare ³¹P metabolite levels between pancreas and liver, and determine the feasibility of ³¹P MRSI in pancreatic cancer.

Study Type

Prospective cohort study.

Population

10 healthy subjects (age 34 ± 12 years, four females) and one patient (73-year-old female) with pancreatic ductal adenocarcinoma.

Field Strength/Sequence

7-T, ³¹P FID-MRSI, ¹H gradient-echo MRI.

Assessment

³¹P FID-MRSI of the abdomen (including the pancreas and liver) was performed with a nominal voxel size of 20 mm (isotropic). For repeatability measurements, healthy subjects were scanned twice on the same day. The patient was only scanned once. Test–retest ³¹P MRSI data of pancreas and liver voxels (segmented on ¹H MRI) of healthy subjects were quantified by fitting in the time domain and signal amplitudes were normalized to γ-adenosine triphosphate. In addition, the PME/PDE ratio was calculated. Metabolite levels were averaged over all voxels within the pancreas, right liver lobe and left liver lobe, respectively.

Statistical Tests

Repeatability of test–retest data from healthy pancreas was assessed by paired t-tests, Bland–Altman analyses, and calculation of the intrasubject coefficients of variation (CoVs). Significant differences between healthy pancreas and right and left liver lobes were assessed with a two-way analysis of variance (ANOVA) for repeated measures. A P-value <0.05 was considered statistically significant.

Results

The intrasubject CoVs for PME, PDE, and PME/PDE in healthy pancreas were below 20%. Furthermore, PME and PME/PDE were significantly higher in pancreas compared to liver. In the patient with pancreatic cancer, qualitatively, elevated relative PME signals were observed in comparison with healthy pancreas.

Data Conclusion

In vivo ³¹P MRSI of the human healthy pancreas and in pancreatic cancer may be feasible at 7 T.

Evidence Level

Technical Efficacy

Stage 2

Abstract Image

查看原文本刊更多论文

胰腺中的 31 P MR 光谱：重复性、与肝脏的比较以及胰腺癌试验数据。

背景：通过31-磷磁共振波谱（31 P MRS）对磷单酯（PMEs）和磷二酯（PDEs）进行非侵入性评估，可用于癌症早期治疗（非）反应评估。目的：评估胰腺 31 P MR 光谱成像（MRSI）的技术可行性和可重复性，比较胰腺和肝脏的 31 P 代谢物水平，并确定 31 P MRSI 在胰腺癌中的可行性：研究类型：前瞻性队列研究：10 名健康受试者（年龄 34 ± 12 岁，4 名女性）和 1 名胰腺导管腺癌患者（73 岁，女性）：7-T、31 P FID-MRSI、1 H 梯度回波磁共振成像：对腹部（包括胰腺和肝脏）进行了 31 P FID-MRSI，标称体素大小为 20 毫米（各向同性）。为了测量重复性，健康受试者在同一天接受了两次扫描。患者只扫描一次。健康受试者胰腺和肝脏体素（在 1 H MRI 上分割）的测试-重复 31 P MRSI 数据通过时域拟合进行量化，信号振幅归一化为γ-三磷酸腺苷。此外，还计算了 PME/PDE 比率。代谢物水平分别取胰腺、右肝叶和左肝叶所有体素的平均值：通过配对 t 检验、Bland-Altman 分析和计算受试者内变异系数 (CoVs) 来评估健康胰腺测试-重复测试数据的可重复性。健康胰腺与左右肝叶之间的显著差异通过重复测量的双向方差分析（ANOVA）进行评估。A P值结果：健康胰腺中 PME、PDE 和 PME/PDE 的受试者内 CoV 值低于 20%。此外，胰腺中的 PME 和 PME/PDE 明显高于肝脏。与健康胰腺相比，在胰腺癌患者体内观察到的相对 PME 信号定性升高：数据结论：在 7 T 下对人体健康胰腺和胰腺癌进行体内 31 P MRSI 可能是可行的。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567