To assess the potential of in vivo magnetic resonance (MR) spectroscopy for breast cancer, hydrogen-1 and phosphorus-31 MR spectra of five malignant human breast tumors were compared with those of unaffected breast tissue. The water-to-fat ratio was high in the tumors (average, 2.2) but low in the unaffected tissue (average, 0.3). The P-31 spectrum of normal breast tissue showed low levels of phosphomonoesters (PMEs), inorganic phosphate, phosphodiesters (PDEs), and ATP. In addition, an intense phosphocreatine (PCr) signal was observed in breast tissue of young women: The relative intensities of the PCr and ATP signals had a mean value of 1.9. The tumor spectrum showed elevated levels of PMEs, Pi, and PDEs, while no PCr was seen (PCr/ATP less than 0.2). In two breast cancers treated with radiation therapy, resulting in a decrease of tumor volume of more than 50%, a similar change in the tumor P-31 spectrum was observed: An intense PCr signal developed (PCr/ATP = 1.1). Control experiments indicated that the appearance of PCr after radiation therapy was the result of a radiation-induced metabolic change in the tumor itself.
The aim of this study is to investigate and correct for machine- and object-related distortions in magnetic resonance images for use in radiotherapy treatment planning. Patients with brain tumours underwent magnetic resonance imaging (MRI) in the radiotherapy position with the head fixed by a plastic cast in a Perspex localization frame. The imaging experiments were performed on a 1.5 T whole body MRI scanner with 3 mT m-1 maximum gradient capability. Image distortions, caused by static magnetic field inhomogeneity, were studied by varying the direction of the read-out gradient. For purposes of accuracy assessment, external and internal landmarks were indicated. Tubes attached to the cast and in the localization frame served as external landmarks. In the midsagittal plane the brain-sinus sphenoidalis interface, the pituitary gland-sinus sphenoidalis interface, the sphenoid bone and the corpora of the cervical vertebra served as internal landmarks. Landmark displacements as observed in the reversed read-out gradient experiments were analysed with respect to the contributions of machine-related static magnetic field inhomogeneity and susceptibility and chemical shift artifacts. The machine-related static magnetic field inhomogeneity in the midsagittal plane was determined from measurements on a grid phantom. Distortions due to chemical shift effects were estimated for bone marrow containing structures such as the sphenoid bone and the corpora of the cervical vertebra using the values obtained from the literature. Susceptibility-induced magnetic field perturbations are caused by the patient and the localization frame. Magnetic field perturbations were calculated for a typical patient dataset.(ABSTRACT TRUNCATED AT 250 WORDS)
Following surgical treatment of a primary extra-abdominal desmoid tumour, the 5-year risk of local recurrence is modest and not influenced by microscopically clear resection margins or adjuvant radiotherapy.
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