Correlation between choline level and Gd-DTPA enhancement in patients with brain metastases of mammary carcinoma

Single voxel 1HH double spin-echo MR spectroscopy was used to examine 15 cases of brain metastasis of mammary carcinoma (18 lesions) in relation to Gd-DTPA enhanced MR imaging. For lesions larger than 50% of MRS voxel size, there was significant correlation between Gd-DTPA-enhanced MRI signal and MRS-detected signal of choline (Cho) containing compounds (r = 0.86, P < 0.01; n = 8). The observed loss of correlation when including the smaller lesions was overcome by correcting for partial volume effects (r = 0.69, P < 0.002; n = 18). Metastasis spectra showed increased Cho compared with control spectra, except for those lesions showing detectable lactate (Lact) signal. The detection of Lact in four of the larger lesions coincided with comparatively low levels of creatine (Cr) and Cho and heterogeneous Gd-DTPA enhancement (ring-enhancement). It was concluded that in brain metastases of mammary carcinoma Lact represents a product of ischemia preceding/during tissue decay resulting in central necrosis, rather than tumor specific metabolism resulting in increas

Adenosine triphosphate infusion increases liver energy status in advanced lung cancer patients: an in vivo 31P magnetic resonance spectroscopy study

We recently observed inhibition of weight loss in patients with advanced nonsmall-cell lung cancer after intravenous infusion of ATP. Because liver ATP levels were found to be decreased in lung cancer patients with weight loss, the present 31P magnetic resonance spectroscopy (MRS) study was aimed at investigating whether ATP infusion restores liver energy status in these patients. Nine patients with advanced nonsmall-cell lung cancer (stage IIIB/IV) were studied 1 week before (baseline) and at 22 to 24 hours of continuous ATP infusion (37-75 microg/kg/min). Localized hepatic 31P MR spectra (repetition time 15 seconds), obtained in the overnight-fasted state, were analyzed for ATP and P(i) content. Ten healthy subjects (without ATP infusion) served as control. Liver ATP levels in lung cancer patients increased from 8.8 +/- 0.7% (relative to total MR-detectable phosphate; mean +/- SE) at baseline to 12.2 +/- 0.9% during ATP infusion (P or = 5% weight loss (baseline: 7.9 +/- 0.7%, during ATP infusion: 12.8 +/- 1.0%, P < 0.01). In conclusion, ATP infusion restores hepatic energy levels in patients with advanced lung cancer, especially in weight-losing patients. These changes may contribute to the previously reported beneficial effects of ATP infusion on the nutritional status of lung cancer patients

Decreased energy and phosphorylation status in the liver of lung cancer patients with eight loss

Background/Aims: Altered energy status has been reported in the liver of tumour-bearing animals, but data on energy status in humans are scarce. Therefore, bioenergetics in tumour-free liver of lung cancer patients were monitored using P-31 magnetic resonance spectroscopy (MRS) with infusion of L-alanine as a gluconeogenic challenge. Methods: Twenty-one overnight-fasted lung cancer patients without liver metastases, with (CaWL) or without weight loss (CaWS), and 12 healthy control subjects (C) were studied. Hepatic energy status was monitored before and during an i.v. L-alanine infusion of 1.4-2.8 mmol/kg + 2.8 mmol . kg(-1). h(-1) for 90 min by P-31 MR spectroscopy. Results: Baseline levels of ATP in WL lung cancer patients, expressed relative to total MR-detectable phosphate, were reduced (CaWL, 9.5+/-0.9% vs. CaWS, 12.6+/-0.8% and C, 12.4+/-0.8%;

Hepatic sugar phosphate levels reflect gluconeogenesis in lung cancer: simultaneous turnover measurements and 31P magnetic resonance spectroscopy in vivo

Stable-isotope tracers were used to assess whether levels of phosphomonoesters (PME) and phosphodiesters (PDE) in the livers of lung cancer patients, as observed by P-31 magnetic resonance (MR) spectroscopy, reflect elevated whole-body glucose turnover and gluconeogenesis from alanine. Patients with advanced non-small-cell lung cancer without liver metastases (n = 24;weight loss 0-24%) and healthy control subjects (n = 13) were stud led after an overnight fast. P-31 MR spectra of the liver in vivo were obtained, and glucose turnover and gluconeogenesis from alanine were determined simultaneously using primed-constant infusions of [6,6-H-2(2)]glucose and [3-C-13]alanine. Liver PME concentrations were 6% higher in lung cancer patients compared with controls (not significant); PME levels in patients with greater than or equal to 5% weight loss were significantly higher than in patients with <5% weight loss (P <0.01). PDE levels did not differ between the groups. In lung cancer patients, whole-body glucose production was 19% higher (not significant) and gluconeogenesis from alanine was 42% higher (P <0.05) compared with healthy subjects; turnover rates in lung cancer patients with greater than or equal to 5% weight loss were significantly elevated compared with both patients with <5% weight loss and healthy subjects (P <0.05). PME levels were significantly correlated with glucose turnover and gluconeogenesis from alanine in lung cancer patients (r = 0.48 and r = 0.48 respectively; P <0.05). In conclusion, elevated PME levels in lung cancer patients appear to reflect increased glucose flux and gluconeogenesis from alanine. These results are consistent with the hypothesis that elevated PME levels are due to contributions from gluconeogenic intermediates