TY - JOUR
T1 - Prospective of 31 P MR Spectroscopy in Hepatopancreatobiliary Cancer
T2 - A Systematic Review of the Literature.
AU - Seelen, Leonard W F
AU - van den Wildenberg, Lieke
AU - van der Kemp, Wybe J M
AU - Mohamed Hoesein, Firdaus A A
AU - Mohammad, Nadia Haj
AU - Molenaar, I Quintus
AU - van Santvoort, Hjalmar C
AU - Prompers, Jeanine J
AU - Klomp, Dennis W J
N1 - Funding Information:
The authors thank the European Union, Dutch cancer society and Technical Sciences, and the St. Antonius Hospital Nieuwegein for financial support.
Publisher Copyright:
© 2022 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.
PY - 2023/4
Y1 - 2023/4
N2 - BACKGROUND: The incidence of liver and pancreatic cancer is rising. Patients benefit from current treatments, but there are limitations in the evaluation of (early) response to treatment. Tumor metabolic alterations can be measured noninvasively with phosphorus (
31 P) magnetic resonance spectroscopy (MRS).
PURPOSE: To conduct a quantitative analysis of the available literature on
31 P MRS performed in hepatopancreatobiliary cancer and to provide insight into its current and potential for therapy (non-) response assessment.
POPULATION: Patients with hepatopancreatobiliary cancer. FIELD STRENGTH/SEQUENCE:
31 P MRS.
ASSESSMENT: The PubMed, EMBASE, and Cochrane library databases were systematically searched for studies published to 17 March 17, 2022. All
31 P MRS studies in hepatopancreatobiliary cancer reporting
31 P metabolite levels were included.
STATISTICAL TESTS: Relative differences in
31 P metabolite levels/ratios between patients before therapy and healthy controls, and the relative changes in
31 P metabolite levels/ratios in patients before and after therapy were determined.
RESULTS: The search yielded 10 studies, comprising 301 subjects, of whom 132 (44%) healthy volunteers and 169 (56%) patients with liver cancer of various etiology. To date,
31 P MRS has not been applied in pancreatic cancer. In liver cancer, alterations in levels of
31 P metabolites involved in cell proliferation (phosphomonoesters [PMEs] and phosphodiesters [PDEs]) and energy metabolism (ATP and inorganic phosphate [Pi]) were observed. In particular, liver tumors were associated with elevations of PME/PDE and PME/Pi compared to healthy liver tissue, although there was a broad variety among studies (elevations of 2%-267% and 21%-233%, respectively). Changes in PME/PDE in liver tumors upon therapy were substantial, yet very heterogeneous and both decreases and increases were observed, whereas PME/Pi was consistently decreased after therapy in all studies (-13% to -76%).
DATA CONCLUSION:
31 P MRS has great potential for treatment monitoring in oncology. Future studies are needed to correlate the changes in
31 P metabolite levels in hepatopancreatobiliary tumors with treatment response.
EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.
AB - BACKGROUND: The incidence of liver and pancreatic cancer is rising. Patients benefit from current treatments, but there are limitations in the evaluation of (early) response to treatment. Tumor metabolic alterations can be measured noninvasively with phosphorus (
31 P) magnetic resonance spectroscopy (MRS).
PURPOSE: To conduct a quantitative analysis of the available literature on
31 P MRS performed in hepatopancreatobiliary cancer and to provide insight into its current and potential for therapy (non-) response assessment.
POPULATION: Patients with hepatopancreatobiliary cancer. FIELD STRENGTH/SEQUENCE:
31 P MRS.
ASSESSMENT: The PubMed, EMBASE, and Cochrane library databases were systematically searched for studies published to 17 March 17, 2022. All
31 P MRS studies in hepatopancreatobiliary cancer reporting
31 P metabolite levels were included.
STATISTICAL TESTS: Relative differences in
31 P metabolite levels/ratios between patients before therapy and healthy controls, and the relative changes in
31 P metabolite levels/ratios in patients before and after therapy were determined.
RESULTS: The search yielded 10 studies, comprising 301 subjects, of whom 132 (44%) healthy volunteers and 169 (56%) patients with liver cancer of various etiology. To date,
31 P MRS has not been applied in pancreatic cancer. In liver cancer, alterations in levels of
31 P metabolites involved in cell proliferation (phosphomonoesters [PMEs] and phosphodiesters [PDEs]) and energy metabolism (ATP and inorganic phosphate [Pi]) were observed. In particular, liver tumors were associated with elevations of PME/PDE and PME/Pi compared to healthy liver tissue, although there was a broad variety among studies (elevations of 2%-267% and 21%-233%, respectively). Changes in PME/PDE in liver tumors upon therapy were substantial, yet very heterogeneous and both decreases and increases were observed, whereas PME/Pi was consistently decreased after therapy in all studies (-13% to -76%).
DATA CONCLUSION:
31 P MRS has great potential for treatment monitoring in oncology. Future studies are needed to correlate the changes in
31 P metabolite levels in hepatopancreatobiliary tumors with treatment response.
EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.
KW - P-31 magnetic resonance spectroscopy
KW - cancer
KW - hepatopancreatobiliary cancer
KW - liver
KW - metabolites
KW - pancreas
KW - treatment response
KW - P magnetic resonance spectroscopy
UR - http://www.scopus.com/inward/record.url?scp=85139938541&partnerID=8YFLogxK
U2 - 10.1002/jmri.28372
DO - 10.1002/jmri.28372
M3 - Review article
C2 - 35916278
SN - 1053-1807
VL - 57
SP - 1144
EP - 1155
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 4
ER -