Lung Tumor Metabolit Detection Using Magnetic Resonance Spectroscopy Lung in Vivo Technique: Correlation of Metabolite MR Spectroscopy with Cytology
Corresponding Author(s) : R. Yusuf Wibisono
ryusufwibisono1601@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 8 No. 2 (2020): 2020 Volume 8- Issue -2
Abstract
Background
Lung tumors are generally diagnosed by cytological examination via FNAB with guided CT Scan. Biopsy measures for cytology are still the gold standard for determining the type of lung cancer. Possible complications of FNAB CT are pneumothorax, bleeding, with the incidence of complications range between 7% and 62%. The use of MR spectroscopy allows assessing tumor function by measuring the concentration of metabolites in tumor tissue. MR spectroscopy metabolite spectrum can distinguish between benign and malignant tumors, by knowing the lung cancer tissue metabolites, the use of MR spectroscopy is expected to overcome obstacles to determine the type of lung cancer in patients when biopsy cannot be done.
Objective
To determine the correlation between MR spectroscopy metabolite values in lung tumors with lung tumor cytology.
Methods
Quasi-experimental study on MR spectroscopy of lung tumors with TE 135 ms in 19 patients with lung tumors by FNAB. Then we performed correlation and comparative analysis of the results of the metabolite values with cytology
Results
The NAA value and the NAA/Cho ratio, NAA/Cre obtained p-value < 0.001 Spearman r-value > 0.8 showed a significant correlation. Chi-Square Fisher Test with a 0.04 NAA cut-off point showed that there was no difference between metabolite values and cytology results in determining tumor types with a p-value of 0.005. NAA metabolites, NAA/Cho and NAA/Cre ratios can differentiate between benign tumors, adenocarcinoma and malignant squamous cell carcinoma in this study.
Conclusion
MR spectroscopy with TE 135 ms on NAA metabolite values, NAA/Cho ratio and NAA/Cre can be used to differentiate between benign tumors, adenocarcinoma and malignant squamous cell carcinoma in this study.
Keywords
MR Spectroscopy
TE 135 ms
Lung Tumor
Cytology
1.
R. Yusuf Wibisono. Lung Tumor Metabolit Detection Using Magnetic Resonance Spectroscopy Lung in Vivo Technique: Correlation of Metabolite MR Spectroscopy with Cytology. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2020 Aug. 15 [cited 2026 Apr. 22];8(2):305-16. Available from: https://ijamscr.com/ijamscr/article/view/867
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References
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[1]. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics, GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 68(6), 2018, 394-424. doi:10.3322/caac.21492
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doi:10.21037/tlcr.2018.05.06
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[6]. Manias KA, Peet A. What is MR spectroscopy? Arch Dis Child Educ Pract, 103(4), 2018, 213- 216. doi:10.1136/archdischild-2017-312839
[7]. Hajek M, Dezortova M. Introduction to clinical in vivo MR spectroscopy. Eur J Radiol. 67(2), 2008, 185-193. doi:10.1016/j.ejrad.2008.03.002
[8]. Zhu H, Barker PB. MR Spectroscopy and Spectroscopic Imaging of the Brain. 711(3), 2011, 145-174. doi:10.1007/978-1-61737- 992-5
[9]. Qiang JW, Cai SQ, Zhao SH, Zhang GF, Rao YM. MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors. 2015, 724- 730. doi:10.2214/AJR.14.13391 [10]. Travis WD, Brambilla E, Nicholson AG, the World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances since the 2004 Classification. J Thorac Oncol. 10(9), 2015, 1243-1260. doi:10.1097/JTO.0000000000000630
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[13]. Yoon SH, Park CM, Lee CH, Song I-C, Lee HJ, Goo JM. Feasibility of In vivo Proton Magnetic Resonance Spectroscopy for Lung Cancer. J Korean Soc Magn Reson Med. 16(1), 2012, 40.
doi:10.13104/jksmrm.2012.16.1.40
[14]. Barker PB, Bizzi A, Stefano N De, Lin DDM, Gullapalli R. Clinical MR Spectroscopy: Techniques and Applications. New York: Cambridge University Press; 2010.
[15]. Zappa C, Mousa SA. Non-small cell lung cancer: Current treatment and future advances. Transl Lung Cancer Res. 5(3), 20165, 288-300. doi:10.21037/tlcr.2016.06.07
[16]. Dahlan S. Statistic for Medicine and Health : Hypothesis Testing. 2014.
[17]. John R. Hesselink, MD F. Fundamentals of MR Spectroscopy. Compr Biomed Phys. 3, 2014, 257- 271. doi:10.1016/B978-0-444-53632-7.00316-6
[18]. Safriel Y, Pol-Rodriguez MA, Novotny EJ, Rothman DL, Fulbright RK. Reference values for long echo time MR spectroscopy in healthy adults. Am J Neuroradiol. 26(6), 2005, 1439-1445.
[19]. Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Transl Lung Cancer Res. 4(4), 2015, 327-338. doi:10.3978/j.issn.2218-6751.2015.08.04
[20]. Furrukh M. Tobacco smoking and lung cancer: Perception-changing facts. Sultan Qaboos Univ Med J. 13(3), 2013, 345-358. doi:10.12816/0003255
[21]. Bhimji SS, Wallen JM. Cancer, Lung, Adenocarcinoma. Stat Pearls. 2018, 30137862.
http://www.ncbi.nlm.nih.gov/pubmed/30137862.
[22]. Zheng M. Classification and Pathology of Lung Cancer. Surg Oncol Clin N Am. 25(3), 2016, 447- 468. doi:10.1016/j.soc.2016.02.003
[23]. Yokota H, Guo J, Matoba M, Higashi K, Tonami H, Nagao Y. Lactate, choline, and creatine levels measured by vitro 1H-MRS as prognostic parameters in patients with non-small-cell lung cancer. J Magn Reson Imaging. 25(5), 2007, 992- 999. doi:10.1002/jmri.20902
[24]. Dowling C, Bollen AW, Noworolski SM, et al. Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. Am J Neuroradiol. 22(4), 2001, 604-612.
[25]. Hourani R, Brant LJ, Rizk T, Weingart JD, Barker PB, Horská A. Can proton MR spectroscopic and perfusion imaging differentiate between neoplastic and no neoplastic brain lesions in adults? Am J Neuroradiol. 29(2), 2008, 366-372. doi:10.3174/ajnr.A0810
[26]. Suarez E, Knollmann- Ritschel BEC. Educational Case: Squamous Cell Carcinoma of the Lung. Acad Pathol. 4, 2017, 1-4.
Doi: 10.1177/2374289517705950
[27]. Lou TF, Sethuraman D, Dospoy P, et al. Cancer- specific production of n-acetyl aspartate via nat8l overexpression in non-small cell lung cancer and its potential as a circulating biomarker. Cancer Prev Res. 9(1), 2016, 43-52. doi:10.1158/1940- 6207.CAPR-14-0287
References
[1]. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics, GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 68(6), 2018, 394-424. doi:10.3322/caac.21492
[2]. De Groot PM, Wu CC, Carter BW, Munden RF. The epidemiology of lung cancer. Transl Lung Cancer Res. 7(3), 2018, 220-233.
doi:10.21037/tlcr.2018.05.06
[3]. Benjamin Anderson, MD F, Tracie Bertaut A, Freddie Bray P, Global Cancer Facts & Figures. Atlanta, Georgia: American Cancer Society; 3, 2012.
[4]. National KPK. Lung Cancer; 2017.
[5]. NATIONAL KPK. Lung Cancer Management Guidelines. Jakarta; 2017.
[6]. Manias KA, Peet A. What is MR spectroscopy? Arch Dis Child Educ Pract, 103(4), 2018, 213- 216. doi:10.1136/archdischild-2017-312839
[7]. Hajek M, Dezortova M. Introduction to clinical in vivo MR spectroscopy. Eur J Radiol. 67(2), 2008, 185-193. doi:10.1016/j.ejrad.2008.03.002
[8]. Zhu H, Barker PB. MR Spectroscopy and Spectroscopic Imaging of the Brain. 711(3), 2011, 145-174. doi:10.1007/978-1-61737- 992-5
[9]. Qiang JW, Cai SQ, Zhao SH, Zhang GF, Rao YM. MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors. 2015, 724- 730. doi:10.2214/AJR.14.13391 [10]. Travis WD, Brambilla E, Nicholson AG, the World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances since the 2004 Classification. J Thorac Oncol. 10(9), 2015, 1243-1260. doi:10.1097/JTO.0000000000000630
[11]. Wu CC, Maher MM, Shepard JAO. Complications of CT-guided percutaneous needle biopsy of the chest: Prevention and management. Am J Roentgenol. 196(6), 2011, 678-682. doi:10.2214/AJR.10.4659
[12]. Guimarães MD, de Andrade MQ, Da Fonte AC, Benevides G, Chojniak R, Gross JL. Predictive complication factors for ct-guided fine needle aspiration biopsy of pulmonary lesions. Clinics. 65(9), 2010, 847-850. doi:10.1590/S1807- 59322010000900006
[13]. Yoon SH, Park CM, Lee CH, Song I-C, Lee HJ, Goo JM. Feasibility of In vivo Proton Magnetic Resonance Spectroscopy for Lung Cancer. J Korean Soc Magn Reson Med. 16(1), 2012, 40.
doi:10.13104/jksmrm.2012.16.1.40
[14]. Barker PB, Bizzi A, Stefano N De, Lin DDM, Gullapalli R. Clinical MR Spectroscopy: Techniques and Applications. New York: Cambridge University Press; 2010.
[15]. Zappa C, Mousa SA. Non-small cell lung cancer: Current treatment and future advances. Transl Lung Cancer Res. 5(3), 20165, 288-300. doi:10.21037/tlcr.2016.06.07
[16]. Dahlan S. Statistic for Medicine and Health : Hypothesis Testing. 2014.
[17]. John R. Hesselink, MD F. Fundamentals of MR Spectroscopy. Compr Biomed Phys. 3, 2014, 257- 271. doi:10.1016/B978-0-444-53632-7.00316-6
[18]. Safriel Y, Pol-Rodriguez MA, Novotny EJ, Rothman DL, Fulbright RK. Reference values for long echo time MR spectroscopy in healthy adults. Am J Neuroradiol. 26(6), 2005, 1439-1445.
[19]. Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Transl Lung Cancer Res. 4(4), 2015, 327-338. doi:10.3978/j.issn.2218-6751.2015.08.04
[20]. Furrukh M. Tobacco smoking and lung cancer: Perception-changing facts. Sultan Qaboos Univ Med J. 13(3), 2013, 345-358. doi:10.12816/0003255
[21]. Bhimji SS, Wallen JM. Cancer, Lung, Adenocarcinoma. Stat Pearls. 2018, 30137862.
http://www.ncbi.nlm.nih.gov/pubmed/30137862.
[22]. Zheng M. Classification and Pathology of Lung Cancer. Surg Oncol Clin N Am. 25(3), 2016, 447- 468. doi:10.1016/j.soc.2016.02.003
[23]. Yokota H, Guo J, Matoba M, Higashi K, Tonami H, Nagao Y. Lactate, choline, and creatine levels measured by vitro 1H-MRS as prognostic parameters in patients with non-small-cell lung cancer. J Magn Reson Imaging. 25(5), 2007, 992- 999. doi:10.1002/jmri.20902
[24]. Dowling C, Bollen AW, Noworolski SM, et al. Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. Am J Neuroradiol. 22(4), 2001, 604-612.
[25]. Hourani R, Brant LJ, Rizk T, Weingart JD, Barker PB, Horská A. Can proton MR spectroscopic and perfusion imaging differentiate between neoplastic and no neoplastic brain lesions in adults? Am J Neuroradiol. 29(2), 2008, 366-372. doi:10.3174/ajnr.A0810
[26]. Suarez E, Knollmann- Ritschel BEC. Educational Case: Squamous Cell Carcinoma of the Lung. Acad Pathol. 4, 2017, 1-4.
Doi: 10.1177/2374289517705950
[27]. Lou TF, Sethuraman D, Dospoy P, et al. Cancer- specific production of n-acetyl aspartate via nat8l overexpression in non-small cell lung cancer and its potential as a circulating biomarker. Cancer Prev Res. 9(1), 2016, 43-52. doi:10.1158/1940- 6207.CAPR-14-0287
[2]. De Groot PM, Wu CC, Carter BW, Munden RF. The epidemiology of lung cancer. Transl Lung Cancer Res. 7(3), 2018, 220-233.
doi:10.21037/tlcr.2018.05.06
[3]. Benjamin Anderson, MD F, Tracie Bertaut A, Freddie Bray P, Global Cancer Facts & Figures. Atlanta, Georgia: American Cancer Society; 3, 2012.
[4]. National KPK. Lung Cancer; 2017.
[5]. NATIONAL KPK. Lung Cancer Management Guidelines. Jakarta; 2017.
[6]. Manias KA, Peet A. What is MR spectroscopy? Arch Dis Child Educ Pract, 103(4), 2018, 213- 216. doi:10.1136/archdischild-2017-312839
[7]. Hajek M, Dezortova M. Introduction to clinical in vivo MR spectroscopy. Eur J Radiol. 67(2), 2008, 185-193. doi:10.1016/j.ejrad.2008.03.002
[8]. Zhu H, Barker PB. MR Spectroscopy and Spectroscopic Imaging of the Brain. 711(3), 2011, 145-174. doi:10.1007/978-1-61737- 992-5
[9]. Qiang JW, Cai SQ, Zhao SH, Zhang GF, Rao YM. MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors. 2015, 724- 730. doi:10.2214/AJR.14.13391 [10]. Travis WD, Brambilla E, Nicholson AG, the World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances since the 2004 Classification. J Thorac Oncol. 10(9), 2015, 1243-1260. doi:10.1097/JTO.0000000000000630
[11]. Wu CC, Maher MM, Shepard JAO. Complications of CT-guided percutaneous needle biopsy of the chest: Prevention and management. Am J Roentgenol. 196(6), 2011, 678-682. doi:10.2214/AJR.10.4659
[12]. Guimarães MD, de Andrade MQ, Da Fonte AC, Benevides G, Chojniak R, Gross JL. Predictive complication factors for ct-guided fine needle aspiration biopsy of pulmonary lesions. Clinics. 65(9), 2010, 847-850. doi:10.1590/S1807- 59322010000900006
[13]. Yoon SH, Park CM, Lee CH, Song I-C, Lee HJ, Goo JM. Feasibility of In vivo Proton Magnetic Resonance Spectroscopy for Lung Cancer. J Korean Soc Magn Reson Med. 16(1), 2012, 40.
doi:10.13104/jksmrm.2012.16.1.40
[14]. Barker PB, Bizzi A, Stefano N De, Lin DDM, Gullapalli R. Clinical MR Spectroscopy: Techniques and Applications. New York: Cambridge University Press; 2010.
[15]. Zappa C, Mousa SA. Non-small cell lung cancer: Current treatment and future advances. Transl Lung Cancer Res. 5(3), 20165, 288-300. doi:10.21037/tlcr.2016.06.07
[16]. Dahlan S. Statistic for Medicine and Health : Hypothesis Testing. 2014.
[17]. John R. Hesselink, MD F. Fundamentals of MR Spectroscopy. Compr Biomed Phys. 3, 2014, 257- 271. doi:10.1016/B978-0-444-53632-7.00316-6
[18]. Safriel Y, Pol-Rodriguez MA, Novotny EJ, Rothman DL, Fulbright RK. Reference values for long echo time MR spectroscopy in healthy adults. Am J Neuroradiol. 26(6), 2005, 1439-1445.
[19]. Islami F, Torre LA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Transl Lung Cancer Res. 4(4), 2015, 327-338. doi:10.3978/j.issn.2218-6751.2015.08.04
[20]. Furrukh M. Tobacco smoking and lung cancer: Perception-changing facts. Sultan Qaboos Univ Med J. 13(3), 2013, 345-358. doi:10.12816/0003255
[21]. Bhimji SS, Wallen JM. Cancer, Lung, Adenocarcinoma. Stat Pearls. 2018, 30137862.
http://www.ncbi.nlm.nih.gov/pubmed/30137862.
[22]. Zheng M. Classification and Pathology of Lung Cancer. Surg Oncol Clin N Am. 25(3), 2016, 447- 468. doi:10.1016/j.soc.2016.02.003
[23]. Yokota H, Guo J, Matoba M, Higashi K, Tonami H, Nagao Y. Lactate, choline, and creatine levels measured by vitro 1H-MRS as prognostic parameters in patients with non-small-cell lung cancer. J Magn Reson Imaging. 25(5), 2007, 992- 999. doi:10.1002/jmri.20902
[24]. Dowling C, Bollen AW, Noworolski SM, et al. Preoperative proton MR spectroscopic imaging of brain tumors: Correlation with histopathologic analysis of resection specimens. Am J Neuroradiol. 22(4), 2001, 604-612.
[25]. Hourani R, Brant LJ, Rizk T, Weingart JD, Barker PB, Horská A. Can proton MR spectroscopic and perfusion imaging differentiate between neoplastic and no neoplastic brain lesions in adults? Am J Neuroradiol. 29(2), 2008, 366-372. doi:10.3174/ajnr.A0810
[26]. Suarez E, Knollmann- Ritschel BEC. Educational Case: Squamous Cell Carcinoma of the Lung. Acad Pathol. 4, 2017, 1-4.
Doi: 10.1177/2374289517705950
[27]. Lou TF, Sethuraman D, Dospoy P, et al. Cancer- specific production of n-acetyl aspartate via nat8l overexpression in non-small cell lung cancer and its potential as a circulating biomarker. Cancer Prev Res. 9(1), 2016, 43-52. doi:10.1158/1940- 6207.CAPR-14-0287