CANCER PATHOLOGY IN THE YEAR 2000

The last one hundred and fifty years has produced the mature and sophi sticated discipline of histopathology, yet still leaves the diagnosis of human cancer, by the best available technique, as more art than sci ence. Proton magnetic resonance spectroscopy (H-1 MRS) ex vivo identif ies the chemical markers of established pathobiological disorders with in excised biopsies and fine needle aspirates, in particular, those as sociated with the development and progression of malignant disease. Al terations to cellular chemistry monitored by H-1 MRS allow distinction between invasive and pre-invasive lesions of the uterine cervix [1], and separate truly benign follicular neoplasms from follicular carcino mas on analysis of fine needle aspirates containing as few as 10(6) ce lls [2,3]. H-1 chemical shift imaging (CSI) determines the spatial loc ation of these chemical changes and provides insight into the chemistr y of neoplastic transformation [4,5]. It is our hypothesis that, by th e year 2000, CSI will aid image guided biopsy techniques and that corr elation of biopsy histology with in vivo localised H-1 MRS data will: (a) lead to improved assessment of the extent of malignant disease and (b) establish the sensitivity and specificity of in vivo H-1 MRS for the simultaneous determination of the size, location and neoplastic po tential of a tumour mass. (C) 1997 Elsevier Science B.V.