Spektroskopische Bildgebung der menschlichen Leber mittels 3D-CSI: Etablierung und Anwendung bei Patienten mit metastasiertem Aderhautmelanom

PURPOSE: 31 P MR spectroscopy (MRS) allows the noninvasive assessment of metabolic alterations in tumors. Due to physical as well as technical limitations, mostly large and single voxels are used. We used a spatially resolved 31 P MRS technique to characterize metabolic abnormalities inside and adjacent to liver metastases of patients with uvea melanoma. MATERIALS AND METHODS: Optimization of 3D chemical shift imaging (3D CSI) was performed in healthy volunteers (n = 19; voxel size 25 ml). Patients (n = 8) with liver metastases were then examined. Cross sectional imaging was available for all patients. RESULTS: Compared to healthy volunteers, the PME/PDE ratios of patients with liver metastasis were significantly higher (0.56 ± 0.30 vs. 0.39 ± 0.21; p < 0.05). A trend towards increased PME/beta ATP ratios (2.07 ± 1.83 vs. 1.02 ± 0.45; p = 0.12) and decreased Pi/PME ratios (0.57 ± 0.29 vs. 1.06 ± 0.58; p = 0.06) was also observed. Patients with metastases ≥ 5 cm showed significantly higher PME/PDE ratios (0.68 ± 0.17 vs. 0.45 ± 0.03; p < 0.05). Liver parenchyma adjacent to metastases did not show any significant changes compared to non-diseased tissue. CONCLUSION: 3D CSI allows the simultaneous analysis of metabolic alterations in diseased as well as in healthy human liver. Metastases show significant metabolic alterations. Thus, 31 P MRS opens new possibilities for therapeutic monitoring.