Page 49 - GTM-2-3

Global Translational Medicine Deep learning by NMR-biochemical

and definite external beam radiation therapy. A analysis 12 patients with tumor recurrence, elevated Cho/NAA
Z
of T2wt MRI+MRSI improved the diagnostic accuracy and and Cho/Cr ratios were observed . The MRS method
[93]
detection of locally recurrent prostate cancer . shows the accuracy of assessing metabolites and rCBV in
[90]
The MRS-guided radiation administration of higher primary brain tumors or metastases and recurrent necrotic
dose delivery is precise to treat metabolically active prostate tumors in patients. The author suggests that the MRS with
tumor areas. MRS-compatible implants are available to MRI technique will improve diagnostic accuracy using
deliver high radiation doses in metabolically active regions multimodal multicenter trials in the future.
of tumors. In vivo single-voxel H-MRS showed brain metabolite
1
differences as low NAA in putamen due to loss of neuronal
The diagnostic accuracy of MRS, DCE-MRI, and
DWI localizes malignancy and prostate abnormalities integrity in early HD and pre‑HD against controls; high
in negative prostate biopsies. Multiparametric T2wt glial myo-inositol cell marker in pre-HD and early-HD
MRI+MRS, transrectal ultrasound‑guided biopsy T2wt against controls with Unified Huntington’s Disease Rating
MRI, with DCE/DW-MRI images, and histopathological Scale (UHDRS) motor score, tongue pressure task, and
assessment of prostate biopsy tissue showed high disease burden score as neuropsychological biomarkers of
sensitivity and specificity of MRS than T2wt MRI to detect HD onset and progression to establish an association with
motor performance in TRACK‑HD study . The lower
[94]
moderate or high-risk cancer . A few multi-parametric putaminal tNAA and high MI in early HD compared
[91]
MRS, DCE-MRI/DW-MRI imaging approaches with to controls established putamen MRS as HD onset and
MR-guided biopsy, and extended 14-core ultrasound- progression biomarker in a cross-section of subjects.
guided biopsy showed better diagnostic accuracy against
a reference biopsy obtained by histopathology biopsy, The role of MRS is wide in the classification of human
template biopsy, or prostatectomy specimens. MRS is brain tumors, the distinction of tumors versus non-
useful in the differential diagnosis of dermatomyositis and neoplastic lesions, prediction of survival, treatment
polymyositis. planning, and monitoring of post-therapy effects in tumor
diagnosis and treatment response .
[95]
6.1.2. The clinical evidence is inconclusive on the MRS
of CNS cancer 6.1.3. Non-invasive in vivo H-MRS in breast cancer
1
The National Comprehensive Cancer Network (NCCN, Breast proton 3T MRS differentiated the benign tumors
2016) gave guidelines on CNS cancer imaging. The from malignant lesions by 1D single-voxel spatially
MRS examination may be useful to differentiate resolved MRS high choline peak high sensitivity and
anaplastic gliomas from radiation-induced necrosis or variable specificity. Details are given in Section 3.1.
“pseudoprogression.” The MRS marginally differentiated MRS with breast MRI enhances the cancer diagnostic
the glioma recurrence from radiation necrosis. The MRS accuracy to avoid repeat benign biopsies. MRS clearly
data statistics in glioma showed elevated Cho/Cr, Cho/ visualizes the choline peaks in the evaluation of suspicious
NAA ratio in favor of high sensitivity, specificity, areas non-cancer mass otherwise non-visible on breast MRI. MRS
under receiver operative curves for heterogeneity test, still remains an investigational tool due to ethical concerns,
and threshold effect test as moderate diagnostic value but it monitors the outcome and response of therapy.
to distinguish radiation-induced necrosis from glioma
recurrence . 6.1.4. Non-invasive in vivo 31-phosphorous ( P)-MRS
[92]
31
Furthermore, MR perfusion and MRS successfully in myocardium
distinguished the primary brain tumors, radiation-induced MRS showed the metabolic state and biochemical score
necrosis, and brain metastasis in patients by analyzing of the myocardial molecular imaging in ischemic heart
cerebral blood volume (rCBV), the ratios of Cho/tCr, Cho/ disease and valvular disease to assess the effectiveness
NAA, and conducting a chi-square-based heterogeneity of metabolic modulating agents. Limited research, low
test using Cochran’s Q statistics. Among 12 patients with temporal and spatial resolution, poor reproducibility, and
[96]
tumor recurrence, elevated Cho/NAA and Cho/Cr ratios longer data collection time are the major bottlenecks .
were observed. Furthermore, MR perfusion and MRS The author believes that MRS will be a multi-modal non-
successfully distinguished the primary brain tumors, invasive cardiac assessment in the future.
radiation-induced necrosis, and brain metastasis in patients
by analyzing cerebral blood volume (rCBV), the ratios of 6.2. Neurophysiological diseases
Cho/tCr, Cho/NAA, and conducting a chi-square-based Neuro-metabolic changes in glucose metabolism, ionic
heterogeneity test using Cochran’s Q statistics. Among shifts, the release of neurotransmitters, altered cerebral

Volume 2 Issue 3 (2023) 17 https://doi.org/10.36922/gtm.337