Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2011; 17(47): 5133-5149
Published online Dec 21, 2011. doi: 10.3748/wjg.v17.i47.5133
In vivo magnetic resonance spectroscopy of liver tumors and metastases
EGW ter Voert, L Heijmen, HWM van Laarhoven, A Heerschap
EGW ter Voert, A Heerschap, Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
L Heijmen, HWM van Laarhoven, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Author contributions: ter Voert EGW wrote the manuscript; Heijmen L discussed and commented on the manuscript and the included articles; van Laarhoven HWM and Heerschap A supervised the project, discussed and commented on the manuscript and the included articles.
Supported by A grant from the Dutch Cancer Society (KWF Kankerbestrijding), No. KUN 2008-4098
Correspondence to: EGW ter Voert, MSc, Department of Radiology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. e.tervoert@rad.umcn.nl
Telephone: +31-24-3668392 Fax: +31-24-3540866
Received: January 10, 2011
Revised: February 4, 2011
Accepted: February 11, 2011
Published online: December 21, 2011
Abstract

Primary liver cancer is the fifth most common malignancy in men and the eighth in women worldwide. The liver is also the second most common site for metastatic spread of cancer. To assist in the diagnosis of these liver lesions non-invasive advanced imaging techniques are desirable. Magnetic resonance (MR) is commonly used to identify anatomical lesions, but it is a very versatile technique and also can provide specific information on tumor pathophysiology and metabolism, in particular with the application of MR spectroscopy (MRS). This may include data on the type, grade and stage of tumors, and thus assist in further management of the disease. The purpose of this review is to summarize and discuss the available literature on proton, phosphorus and carbon-13-MRS as performed on primary liver tumors and metastases, with human applications as the main perspective. Upcoming MRS approaches with potential applications to liver tumors are also included. Since knowledge of some technical background is indispensable to understand the results, a basic introduction of MRS and some technical issues of MRS as applied to tumors and metastases in the liver are described as well. In vivo MR spectroscopy of tumors in a metabolically active organ such as the liver has been demonstrated to provide important information on tumor metabolism, but it also is challenging as compared to applications on some other tissues, in particular in humans, mostly because of its abdominal location where movement may be a disturbing factor.

Keywords: Metastasis; Metabolism; Proton magnetic resonance spectroscopy; Phosphorus magnetic resonance spectroscopy; Carbon-13 magnetic resonance spectroscopy; Magnetic resonance spectroscopy; Magnetic resonance