Abstract
Background
It is common to treat patients with metastatic disease from gastrointestinal neuroendocrine (NE) tumors with surgical reduction to prolong survival. This can be combined with hepatic arterial embolization (HAE) and medical treatment to reduce hormonal symptoms. Today there are no rapid and reliable methods to evaluate the efficacy of HAE in the treatment of neuroendocrine liver metastasis.
Purpose
To investigate metabolic changes in hepatic metastases of NE tumors following HAE, and to establish if there are any early spectral patterns that might indicate therapeutic efficacy based on in vivo 31P MRS data.
Material and Methods
Volume selective 31P MRS was used to study 11 patients with disseminated NE tumors with regional lymph nodes and bilobar liver metastases. Measurements were performed before and 1 and 3 days after HAE.
Results
Non-responders had significantly higher PME/Pi and aNTP/SNTP ratios than the responders before HAE (P < 0.05). Three days after HAE, non-responders still had significantly higher aNTP/SNTP than the responders did (P < 0.05). We also observed trends for increased PME ratios 3 days after HAE, decreased ATP-levels, and liberated Pi in responders.
Conclusion
This 31P-MRS study showed significant differences in PME/Pi and aNTP/SP ratios between responders and non-responders on the day before HAE, which is an interesting finding that may reflect intrinsic properties of the tumor tissue. We also observed trends for cell membrane renewal and increased energy consumption in responders after HAE. These results demonstrate potentials for 31P-MRS to predict individual responsiveness prior to HAE.
Keywords
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