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Investigations concerning the potential for using 1 h nmr relaxometry or high‐resolution spectroscopy of plasma as a screening test for malignant lung disease
Author(s) -
Schuhmacher Jochen H.,
Conrad Dorothea,
Manke Hans G.,
Clorius John H.,
Matys Edmund R.,
Hauser Harald,
Zuna Ivan,
MaierBorst Wolfgang,
Hull William E.
Publication year - 1990
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.1910130111
Subject(s) - chemistry , nuclear magnetic resonance spectroscopy , erythrocyte sedimentation rate , lung , nuclear magnetic resonance , fibrinogen , lung cancer , medicine , pathology , nuclear medicine , physics , organic chemistry
In 158 plasma samples, obtained from patients with lung carcinoma, lung metastases, and infectious or inflammatory lung diseases and from healthy controls, the NMR relaxation times T 1 , and T 2 of water protons were measured at a resonance frequency of 20 MHz by pulsed NMR techniques and adjusted to a standardized total plasma protein concentration. For one‐third of these samples water‐suppressed 500‐MHz 1 H NMR spectroscopy at 37°C was used (a) to determine the widths of the composite lipid methyl and methylene signals, and (b) to quantitate individual lipid methylene signal components that could be detected in resolution‐enhanced spectra. In addition, hematological parameters and the plasma levels of several acute phase proteins and apolipoprotein‐A were monitored. No diagnostically significant differences between lung carcinoma patients and patients with nonmalignant lung disease could be found for any of the plasma NMR parameters, nor could T 1 , or lipid line width data distinguish between any patient group and healthy controls. However, the mean T 2 , was significantly shortened by about 15% for any kind of lung disease compared to healthy controls. Similar but less significant results were found for apolipoprotein‐A levels. A linear discriminant function, calculated from the apolipoprotein‐A and T 2 , data, did not improve the differentiation between malignant and nonmalignant lung disease but did improve the discrimination between tumor patients and healthy controls up to a sensitivity and specificity of 80 and 96.5%, respectively. T , correlates inversely with plasma fibrinogen levels and the blood sedimentation rate and, therefore, appears to monitor a general inflammatory status of a tumor patient rather than the presence or absence of cancer. For all groups except healthy pregnant women, the lipid methylene composite signal line width correlates inversely with the fraction of mobile triglyceride present (mainly as VLDL), as estimated from resolution‐enhanced spectra.