Studies of human tumors by MRS: A review

Abstract

The literature describing 31 P, 1 H, 13 C, 23 Na and 19 F MRS in vivo in human cancers is reviewed. Cancers have typical metabolic characteristics in 31 P and 1 H MRS including high levels of phospholipid metabolites and a cellular pH more alkaline than normal. These alone are not specific for cancer but are diagnostic in appropriate clinical settings. Some metabolic characteristics appear to be prognostic indices and correlation with treatment response is emerging as an important potentially cost‐effective use of MRS in oncology. 19 F MRS examines pharmacokinetics of 5‐fluorouracil and by demonstrating its retention predicts response of a cancer to treatment. Current needs include improvement of diagnostic specificity by use of techniques like multivoxel MRS, proton decoupling of 31 P, short echo time and fat‐suppressed 1 H MRS, 13 C MRS direct or via 1 H‐observe, and statistical analysis of multiple spectral features. Trials in large populations in well defined clinical settings are needed to determine if MRS can provide independent prognostic indices useful in cancer management.