Literature DB >> 23931426

Noninvasive phosphorus magnetic resonance spectroscopic imaging predicts outcome to first-line chemotherapy in newly diagnosed patients with diffuse large B-cell lymphoma.

Fernando Arias-Mendoza1, Geoffrey S Payne, Kristen Zakian, Marion Stubbs, Owen A O'Connor, Hamed Mojahed, Mitchell R Smith, Adam J Schwarz, Amita Shukla-Dave, Franklyn Howe, Harish Poptani, Seung-Cheol Lee, Ruth Pettengel, Steven J Schuster, David Cunningham, Arend Heerschap, Jerry D Glickson, John R Griffiths, Jason A Koutcher, Martin O Leach, Truman R Brown.   

Abstract

RATIONALE AND
OBJECTIVES: Based on their association with malignant proliferation, using noninvasive phosphorus MR spectroscopic imaging ((31)P MRSI), we measured the tumor content of the phospholipid-related phosphomonoesters (PME), phosphoethanolamine and phospholcholine, and its correlation with treatment outcome in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) receiving standard first-line chemotherapy. EXPERIMENTAL
DESIGN: The PME value normalized to nucleoside triphosphates (PME/NTP) was measured using (31)P MRSI in tumor masses of 20 patients with DLBCL before receiving standard first-line chemotherapy. Response at 6 months was complete in 13 patients and partial in seven. Time to treatment failure (TTF) was ≤11 months in eight patients, from 18 to 30 months in three, and ≥60 months in nine.
RESULTS: On a t test, the pretreatment tumor PME/NTP mean value (SD, n) of patients with a complete response at 6 months was 1.42 (0.41, 13), which was significantly different from the value of 2.46 (0.40, 7) in patients with partial response (P < .00001). A Fisher test significantly correlated the PME/NTP values with response at 6 months (sensitivity and specificity at 0.85, P < .004) while a Cox proportional hazards regression significantly correlated the PME/NTP values with TTF (hazard ratio = 5.21, P < .02). A Kaplan-Meier test set apart a group entirely composed of patients with TTF ≤ 11 months (hazard ratio = 8.66, P < .00001).
CONCLUSIONS: The pretreatment tumor PME/NTP values correlated with response to treatment at 6 months and time to treatment failure in newly diagnosed patients with DLBCL treated with first-line chemotherapy, and therefore they could be used to predict treatment outcome in these patients.
Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  In vivo; MR spectroscopy; lymphoma; metabolic imaging; prediction of therapy outcome

Mesh:

Substances:

Year:  2013        PMID: 23931426      PMCID: PMC3810177          DOI: 10.1016/j.acra.2013.04.013

Source DB:  PubMed          Journal:  Acad Radiol        ISSN: 1076-6332            Impact factor:   3.173


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