In Vitro MRS applied to some other cancers

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There has been some application of in vitro MRS to other cancers, such as malignant melanomas and a variety of thyroid neoplasms.

15.7.1 Malignant melanoma

Melanoma metastases to lymph nodes have been analyzed using proton MRS by Lean et al [61]. The ratio of 1.8 to 2.5 ppm (containing lipid, lactate and other metabolites) to choline (3.2 ppm) was significantly higher in excised benign lymph nodes compared to those containing melanoma. Thompson et al. [62] suggest that "techniques such as in vivo proton MRS hold great promise" for assessment of sentinel nodes in patients with melanoma (p. 147S).

15.7.2 Cancer of the thyroid

Russell et al. [63] performed 1D and 2D in vitro proton MRS analysis of thyroid tissue from 53 patients who underwent partial or total thyroidectomy for solitary thyroid nodules. The major differences between normal thyroid tissue and papillary carcinomas were the absence of lipid (CH3 resonates at 0.86 ppm) and the presence of amino acid metabolites (methyl resonances from amino acids resonate at 0.9 ppm) in cancerous tissue. The ratio of the resonance at 1.7 ppm to that at 0.9 ppm was > 1.1 in all the normal thyroid specimens, whereas in all of the thyroid cancers (papillary, medullary and anaplastic) the ratio was < 1.1 and there was no overlap between normal and malignant tissue. With respect to the follicular neoplasms, those which were histologically or clinically clearly malignant all had a ratio of 1.7 ppm to 0.9 ppm < 1.1. This group of authors in a subsequent paper [43] illustrated the importance of MRSI applied in vitro to the thyroid, demonstrating the chemical heterogeneity of follicular thyroid neoplasms, which are morphologically homogeneous.


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