The Usefulness of ’In Vivo’ Proton H1 Spectroscopy Mrs in Pretreatment Evaluation of Patients with Carcinoma of the Cervix

to determine the usefulness of "in vivo" Proton H1 MRS in the pretreatment evaluation of patients with carvical cancer. MRS was performed in 122 pts. with stage IA-IIB cervical cancer. 102 pts. had Wertheim’s hysterectomy,16 pts. were irradiated due to advanced stage, 4 had surgery in other institutions.The MR/ MRS images were correlated with microscopic findings of surgical specimen. In 16 irradiated pts. MRS was performed before , immediately after and 3 months after radiotherapy. The spectra from 102 pts treated with surgery ong resonance at ppm 1.3 and ppm 3.2 corresponding to triglicerides and choline. The presence of these peaks have correlated with tumor volume and stage. Peaks at ppm . 1.3 (trigliceride) were detected in 25% of stage IA pts, and in 78-89% of stage IB-IIA. The choline peaks at ppm . 3.2 were detected in 63% of stage IB1 pts. 76% -IB2 and 55% with stage IIA. The spectra in 16 irradiated pts.have shown a changing pattern in the course of RTH. Choline peak (ppm . 3.2) was detected in 68% of pts before RTH, 44% at the end and 31% 3 months after RTH. Trigliceride peak (ppm . 1.3) was detected in 93.7% before and in 18.7% after RTH. The results of this analysis have shown that choline amd trigliceride peaks detected by "in vivo" MRS are reliable markers for invasive carvical cancer. Their presence correlates well with tumor volume and clinical stage.The analysis of the spectra of irradiated pts. has shown a decrease in the fraction of tumors positive for the choline and trigliceride peaks.