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1H-magnetic resonance spectroscopy: a new technique to discriminate benign from malignant ovarian tumors
L F Massuger1, P B van Vierzen, U Engelke
1Department of Obstetrics and Gynecology, University Hospital Nijmegen, The Netherlands.
Background:
Currently used techniques such as ultrasound, computed tomography, and magnetic resonance imaging are not fully capable of differentiating benign from malignant ovarian tumors. Magnetic resonance spectroscopy (MRS) may help solve this clinical problem by analyzing the composition of fluid from ovarian cysts.
Methods:
The authors studied fluid samples from 28 different ovarian cysts. Nine patients were found to have a malignant ovarian tumor whereas 19 patients had benign cysts. Single pulse 1H-Nuclear Magnetic Resonance spectra were obtained in all fluid samples.
Results:
Compared with the group of benign epithelial cysts (n = 17) the 8 malignant epithelial ovarian cysts had significantly higher levels of lactate, isoleucine, valine, 3-hydroxybutyric acid, methionine, and alanine (P < 0.05). In two benign cysts (endometrioma and mature teratoma) surprisingly high levels were found for a large number of compounds. Values were as high as 100-fold the values in fluid from benign cysts.
Conclusions:
1H-NMR spectroscopy demonstrates significant differences in metabolite concentration between benign and malignant ovarian cysts. This ultimately may lead to the noninvasive differential diagnosis of ovarian tumors by in vivo MRS.