Therapy monitoring in human and canine soft tissue sarcomas using magnetic resonance imaging and spectroscopy

Deborah M. Prescott, H. Cecil Charles, H. Dirk Sostman, Richard K. Dodge, Donald E. Thrall, Rodney L. Page, J. Allan Tucker, John M. Harrelson, Kenneth A. Leopold, James R. Oleson, Mark W. Dewhirst

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Purpose: The goals of this study were to determine whether magnetic resonance parameters (a) can identify early during therapy those patients most likely to respond to hyperthermia and radiotherapy, (b) can provide prior to or early during therapy information about the temperature distributions which can be obtained in patients receiving hyperthermia, and (c) can provide an understanding of the effects of hyperthermia on tumor metabolic status. Methods and Materials: Twenty-one human patients and 10 canine patients with soft tissue sarcomas treated with preoperative hyperthermia and radiation had a series of magnetic resonance imaging and phosphorus spectroscopy studies done. To address the goals for both the human and canine populations, changes in mean T2 relaxation times, pH, and various phosphometabolite ratios from the pretreatment (Study 1) to the post first hyperthermia study (Study 2) were correlated with treatment outcome; pretreatment magnetic resonance parameters and changes in magnetic resonance parameters (Study 2-Study 1) were compared with various cumulative thermal descriptors; and thermal descriptors of the first hyperthermia were compared with changes in magnetic resonance phosphometabolite ratios. Results: A decrease in adenosine triphosphate/phosphomonoester from study 1 to study 2 is associated with a greater chance of ≥ 95% necrosis in surgical resected tumors from human patients, but no significant relationships were observed between changes in tumor pH or phosphometabolite ratios and time to local failure in dogs. Pretreatment magnetic resonance parameters correlated with various thermal dose descriptors in canines but not in humans. Change in adenosine triphosphate/inorganic phosphate and phosphomonoester signal to noise ratio correlated with cumulative thermal descriptors in dogs and humans, respectively. In dogs only, increases in thermal dose resulted in decreases in high energy phosphometabolites. Conclusion: Changes in magnetic resonance parameters early during therapy may be predictive of treatment outcome. Pretreatment and changes in magnetic resonance parameters appear to predict how well a tumor will be heated during hyperthermia. Magnetic resonance spectroscopy also appears to be a useful tool to study the effects of various thermal doses on tumor metabolic status.

Original languageEnglish (US)
Pages (from-to)415-423
Number of pages9
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume28
Issue number2
DOIs
StatePublished - Jan 15 1994

Keywords

  • Canines
  • Humans
  • Hyperthermia
  • Magnetic resonance imaging
  • Magnetic resonance spectroscopy
  • Predictive assays
  • Soft tissue sarcomas
  • Therapy monitoring

ASJC Scopus subject areas

  • Radiation
  • Radiology Nuclear Medicine and imaging
  • Oncology

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