In vivo 31P MR spectral patterns and reproducibility in cancer patients studied in a multi-institutional trial

The standardization and reproducibility of techniques required to acquire anatomically localized P-31 MR spectra non-invasively while studying tumors in cancer patients in a multi-institutional group at 1.5 T are reported. This initial group of patients was studied from 1995 to 2000 to test the feasibility of acquiring in vivo localized P-31 MRS in clinical MR spectrometers. The cancers tested were non-Hodgkin's lymphomas, sarcomas of soft tissue and bone, breast carcinomas and head and neck carcinomas. The best accrual and spectral quality were achieved with the non-Hodgkin's lymphomas. The initial analysis of the spectral values of the sum of phosphoethanolamine plus phosphocholine normalized by the content of nucleotide triphosphates in a homogeneous sample of 32 NHL patients studied by in vivo P-31 MRS showed good reproducibility among different institutions. No statistical differences were found between the institution with the largest number of cases accrued and the rest of the multi-institutional NHL data (2.28+/-0.64, mean+/-standard error; n = 17, vs 2.08+/-0.14, n = 15). The preliminary data reported demonstrate that the institutions involved in this trial are obtaining reproducible P-31, MR spectroscopic data non-invasively from human tumors. This is a fundamental prerequisite for the international cooperative group to be able to demonstrate the clinical value of the normalized determination of phosphoethanolamine plus phosphocholine by P-31 MRS as predictor for treatment response in cancer patients. Copyright (C) 2006 John Wiley & Sons, Ltd.