In Vitro and In Vivo 1H-MR Spectroscopic Examination of the Renal Cell Carcinoma

Background: Paraneoplastic effects are some of the major side effects of advanced renal cell carcinoma (RCC). Magnetic resonance spectroscopy (MRS) is known as a powerful tool to study cancer cell metabolism and cancer cell – host interactions. Aim of this study was to assess tumor cell metabolism and systemic effects using 1H-MRS. Methods: Spectroscopic analysis of 10 patients with RCC was compared with those of 15 healthy volunteers. Local tumor metabolism was assessed using image-guided 1H-in-vivo-spectroscopy in a 1.5 Tesla MR whole body tomograph. Systemic effects of RCC were measured using 1H-High-Resolution (HR) spectra of blood plasma samples in a 500 MHz Bruker DRX 500 spectrometer. Results: In-vivo-spectroscopy can significantly differentiate tumor tissue from healthy renal tissue by comparing their lipid composition. Moreover after detailed assignment of the various metabolites in blood plasma in the in-vitro-HR-spectra significant systemic alterations could be identified in patients with RCC especially regarding lipid and amino acid metabolism. Conclusion: This work indicates that using 1H-MRS both changes in tumor metabolism and resulting systemic/paraneoplastic effects can be assessed in patients with RCC. This approach therefore offers scope for diagnosis and therapy evaluation.