Noninvasive phosphorus magnetic resonance spectroscopic imaging predicts outcome to first-line chemotherapy in newly diagnosed patients with diffuse large B-cell lymphoma Journal Article


Authors: Arias-Mendoza, F.; Payne, G. S.; Zakian, K.; Stubbs, M.; O'Connor, O. A.; Mojahed, H.; Smith, M. R.; Schwarz, A. J.; Shukla-Dave, A.; Howe, F.; Poptani, H.; Lee, S. C.; Pettengel, R.; Schuster, S. J.; Cunningham, D.; Heerschap, A.; Glickson, J. D.; Griffiths, J. R.; Koutcher, J. A.; Leach, M. O.; Brown, T. R.
Article Title: Noninvasive phosphorus magnetic resonance spectroscopic imaging predicts outcome to first-line chemotherapy in newly diagnosed patients with diffuse large B-cell lymphoma
Abstract: Rationale and Objectives: Based on their association with malignant proliferation, using noninvasive phosphorus MR spectroscopic imaging (31P MRSI), we measured the tumor content of the phospholipid-related phosphomonoesters (PME), phosphoethanolamine and phospholcholine, and its correlation with treatment outcome in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) receiving standard first-line chemotherapy. Experimental Design: The PME value normalized to nucleoside triphosphates (PME/NTP) was measured using 31P MRSI in tumor masses of 20 patients with DLBCL before receiving standard first-line chemotherapy. Response at 6months was complete in 13 patients and partial in seven. Time to treatment failure (TTF) was ≤11months in eight patients, from 18 to 30months in three, and ≥60months in nine. Results: On a t test, the pretreatment tumor PME/NTP mean value (SD, n) of patients with a complete response at 6months was 1.42 (0.41, 13), which was significantly different from the value of 2.46 (0.40, 7) in patients with partial response (P < .00001). A Fisher test significantly correlated the PME/NTP values with response at 6months (sensitivity and specificity at 0.85, P < .004) while a Cox proportional hazards regression significantly correlated the PME/NTP values with TTF (hazard ratio=5.21, P < .02). A Kaplan-Meier test set apart a group entirely composed of patients with TTF ≤ 11months (hazard ratio=8.66, P < .00001). Conclusions: The pretreatment tumor PME/NTP values correlated with response to treatment at 6months and time to treatment failure in newly diagnosed patients with DLBCL treated with first-line chemotherapy, and therefore they could be used to predict treatment outcome in these patients. © 2013 AUR.
Keywords: adult; cancer chemotherapy; cancer survival; clinical article; treatment outcome; treatment response; aged; aged, 80 and over; middle aged; retrospective studies; young adult; unclassified drug; prednisone; doxorubicin; cytarabine; methotrexate; rituximab; diagnostic accuracy; sensitivity and specificity; reproducibility of results; etoposide; antineoplastic combined chemotherapy protocols; tumor markers, biological; cyclophosphamide; vincristine; prediction; false negative result; lymphoma, b-cell; folinic acid; mitoxantrone; lymphoma; magnetic resonance spectroscopy; bleomycin; large cell lymphoma; drug treatment failure; false positive result; phosphorus nuclear magnetic resonance; predictive value; correlational study; phospholipids; metabolic imaging; phosphoethanolamine; phosphorus 31; phosphorus isotopes; diagnostic test accuracy study; nucleoside triphosphate; invivo; mr spectroscopy; time to treatment; prediction of therapy outcome; phospholcholine; phospholipid derivative; phospholipid related phosphomonoester; in vivo
Journal Title: Academic Radiology
Volume: 20
Issue: 9
ISSN: 1076-6332
Publisher: Elsevier Science, Inc.  
Date Published: 2013-09-01
Start Page: 1122
End Page: 1129
Language: English
DOI: 10.1016/j.acra.2013.04.013
PROVIDER: scopus
PUBMED: 23931426
PMCID: PMC3810177
DOI/URL:
Notes: --- - "Export Date: 4 September 2013" - "CODEN: ARADF" - "Source: Scopus"
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MSK Authors
  1. Amita Dave
    80 Dave
  2. Kristen L Zakian
    74 Zakian
  3. Jason A Koutcher
    236 Koutcher