An NMR blood test for cancer: a critical assessment

Abstract

An evaluation of the reproducibility and accuracy of the NMR human blood test for cancer described by Fossel, E. T., Carr, J. M. and McDonagh, J., (New England Journal of Medicine 315, 1369-1376) in 1986 has been conducted jointly at the National Cancer Institute-Frederick Cancer Research Facility, Frederick, MD (NCI-FCRF) and the National Research Council, Ottawa, Canada (NRC). The influences on the test of the following were studied: (a) subject fasting; (b) sample collection, storage and handling; (c) use of plasma or serum; (d) variations of test results from the same individual with time; (e) NMR observation parameters including field strength and temperature; and (f) variations in obtaining the Fossel Index (FI) (a number defined by Fossel and co-workers as the average of the widths at half height of the regions in the NMR spectrum of human plasma at 1.3 and 0.88 ppm) by different people from the same plotted spectrum. This test was found to be reproducible but not accurate for screening a general asymptomatic population. The accuracy is defined in terms of the sensitivity, specificity, and predictive values of the test. The accuracy of the test results from our laboratories is compared with the accuracies from other laboratories including Fossel's. The correlation of the Fossel Index with total triglyceride content in the serum has been confirmed by analysing blood components using the following technologies: KBr density gradient centrifugation, high resolution agarose gel electrophoresis, high performance gel permeation chromatography, and chemical analysis.

Lipoproteins in heart transplantation: Proton magnetic resonance spectroscopy of plasma

“…However, if conventions are adopted and carefully followed by the same operator, accurate measurements can be achieved. All things considered, it appears in accordance with Chmurny et al ( 5 ) that the TLW is precise and reproducible when care is taken in the handling and storage conditions of samples and in the fasting of subjects.…”

“…Hyperlipidemia has been shown to affect TLW measurements (2,5,14). Three data sets have been rejected for patients with severe hyperlipidemia and frequently opalescent plasma where large CH2 and CH3 resonances (four-to fivefold the mean height for a transplanted patient) prevent detection of TLW variations.…”

The proton NMR of blood plasma and the test for cancer

“…The results from our similar investigations, reported here, are in accord with the previous studies. The effect of freeze-thawing on the lipoprotein -CH2-and -CH3 resonances is to cause about a 3-Hz broadening for each freeze-thaw cycle; this result confirms previous studies (11,12). The results of the fasting study are shown in Fig.…”

1H NMR metabonomics of plasma lipoprotein subclasses: elucidation of metabolic clustering by self‐organising maps

“…However, once the model has been built up, the most important resonances in the spectral data set with respect to the model can be determined and biochemically identified (9,40). In the 1 H NMR spectrum of plasma, the most pronounced resonances arise from lipoprotein lipids that are known to correlate with a number of pathologies, for example CHD (40,41,57) and cancer (58). It has also recently been indicated that an overall measure combining information from seven traditional lipid measures was a superior predictor of CHD risk compared with separate lipid measures (59).…”