P-31-MR SPECTROSCOPY OF THE HUMAN LIVER - SPECTRAL HINTS ON HEPATIC LYMPHOMA INFILTRATION

P-31-MR spectroscopy of the human liver - spectral hints on hepatic ly mphoma infiltration. Purpose: To evaluate whether phosphorus magnetic resonance spectroscopy (P-31-MRS) enables a non-invasive detection of liver involvement in systemic diseases like Hodgkin's lymphoma. Materi als and methods: Using a clinical 1.5 Tesla whole-body MR system image -guided localised phosphorus MR spectra from the anatomically defined volumes of interests were measured. A combination of surface coil, adi abatic excitation pulse and modified image-selected in vivo spectrosco py (ISIS)-sequence was applied. The spectroscopy data were evaluated q uantitatively with a time-domain fit programme using non-linear optimi sation algorithms to quantify peak areas. After establishment of the e x; amination protocol, 22 healthy volunteers and 13 patients with susp ected lymphoma infiltration of the liver were examined. Results: Liver spectra of patients suffering from lymphoma infiltration differed sig nificantly from spectra of persons with normal liver: 1. The peak area ratio of phosphomonoesters (PME) to beta-NTP was elevated in all pati ents with histologically confirmed liver lymphoma. 2. Patients sufferi ng from Hodgkin's disease with specific or unspecific liver infiltrati on (n=7) could be differentiated from patients without liver involveme nt. In case of infiltrated liver, the peak area ratio PME to beta-NTP was increased, and the pH value was shifted to lower values. Unambiguo us differentiation between non-specific (n=3) and specific (n=4) infil tration of the liver was not possible. 3. In patients after cytostatic treatment (n=3), an increase of the peak area ratio of inorganic phos phate to beta-NTP was observed. Conclusion: Our preliminary results in dicate that P-31-MRS can yield pointers to liver involvement in patien ts with systemic diseases such as Hodgkin's disease, which may be hard ly detected by imaging methods.