1. Phase One Pilot Study Using Magnetic Resonance Spectroscopy to Predict the Histology of Radiofrequency-Ablated Renal Tissue
- Author
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Stern, Joshua M., Merritt, Mathew E., Zeltser, Ilia, Raman, Jay D., and Cadeddu, Jeffrey A.
- Subjects
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RENAL biopsy , *NUCLEAR magnetic resonance spectroscopy , *CATHETER ablation , *CROSS-sectional imaging , *TOMOGRAPHY , *KIDNEY disease diagnosis , *MEDICAL care research , *KIDNEY tumors - Abstract
Abstract: Introduction and Objective: Recent advances in magnetic resonance (MR) technology have allowed for high-resolution ex vivo spectroscopy on small, intact tissue samples. We examined the capability of 1H magnetic resonance magic angle spinning (MR-MAS) to correctly characterize post–radiofrequency ablation (RFA) renal biopsies from human samples, compared with standard histology and cross-sectional imaging. Methods: A minimum of two, 18G, percutaneous renal biopsies were obtained from ten biopsy-confirmed renal tumors at a mean 26.6 mo (range, 15–48) post-RFA. All patients were considered free of disease by computed tomography criteria. A portion of each sample was immediately frozen at −80°C for spectroscopy and the remainder used for pathological analysis. 1H MR-MAS was performed blinded with a 14.1-tesla field strength. Prior renal biopsies from nonablated tissue were used as positive controls for the spectral analysis. Concordance between, computed tomography, histology, and MR-MAS was analyzed. All spectroscopy was processed with VNMR software. Results: Histological analysis of all ten post-RFA biopsies demonstrated no cancer or viable tissue. All MR-MAS spectral peaks for each biopsy were consistent with necrosis and, more importantly, indicated an absence of small molecule metabolites characteristic of both normal and malignant renal tissue. Both MR-MAS and histology confirmed, in each case, the conventional computed tomography determination of complete ablation. Conclusions: MR spectroscopy can correctly diagnose the molecular absence of disease in post-RFA tissue biopsies. This proof of principle study warrants in vivo evaluation to confirm the clinical correlates of this modality. [Copyright &y& Elsevier]
- Published
- 2009
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