This application is from DU. The overall goal of this proposal is to evaluate the ability of parameters derived from 31-P magnetic resonance spectroscopy (MRS) and 1H magnetic resonance imaging (MRI) to assess prognosis and monitor therapeutic effectiveness in patients with neoplastic disease. The applicants will study locally advanced breast cancer treated with preoperative chemotherapy and radiation + hyperthermia. To accomplish this goal, the applicants propose to investigate 1H MR1 image guided 31-P MRS in a study design which incorporates serial studies with robust three dimensional spectral localization with spatial correlation to MR images. This study will be undertaken as a prospective, cooperative clinical research trial incorporating well defined clinical endpoints and technical quality control. With 31-P MRS, the applicants will measure tumor phosphometabolite levels, pH and derive appropriate metabolic indicators. With 1H MR1, the applicants will measure tumor T@ and estimate initial tumor necrosis as the volume percent which does not enhance with a paramagnetic contrast agent, e.g. Magnevist or Prohance. Serial MR1 and MRS will be performed prior to initiation of chemotherapy, 0-48 hours prior to the first radiation treatment, 0-48 hours following the first hyperthermia treatment, and 24-96 hours prior to surgery. The MRAS and MR1 data will be correlated with clinical and histologic response to therapy. The working hypotheses are that pretherapy and proximal posththerapy 31-P MRS metabolite levels, pH, and t2 values will be prognostic of treatment outcome.
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