PROTON MR AND HUMAN CERVICAL NEOPLASIA - EX-VIVO SPECTROSCOPY ALLOWS DISTINCTION OF INVASIVE-CARCINOMA OF THE CERVIX FROM CARCINOMA IN-SITUAND OTHER PREINVASIVE LESIONS

The concept that high-resolution (8.5-T) hydrogen-1 magnetic resonance (MR) spectroscopy can be used as an adjunct to conventional histologi c diagnosis of cervical neoplasia was investigated. Cervical biopsy sp ecimens (n = 159) were examined with H-1 MR spectroscopy and the resul ts compared with results of histopathologic analysis. A high-resolutio n lipid MR spectrum was observed in 39 of 40 invasive carcinomas, wher eas the 119 preinvasive samples showed little or no lipid spectrum but were characterized by a strong unresolved resonance between 3.8 and 4 .2 ppm. Peak ratios of the methylene/methyl and the unresolved/methyle ne resonances allowed accurate distinction between invasive and preinv asive epithelial malignancy (P < .0001). Since MR spectroscopic examin ation does not destroy the specimen, the specimens remained intact for further testing and histopathologic analysis. The authors conclude th at H-1 MR spectroscopy can independently allow distinction between inv asive and preinvasive lesions of the cervix and has the potential to a ssist in clinical management of cervical cancer.