ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2025-8-2-42-49ojrdrt-437Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEПервый опыт применения магнитно‑резонансной спектрометрии при нейроэндокринных неоплазиях поджелудочной железы.he first experience of using magnetic resonance spectrometry in neuroendocrine neoplasia of the pancreas.https://orcid.org/0009-0005-2532-1956БелозерскихА. М.BelozerskikhA. M.

Белозерских Анастасия Михайловна

115478 Москва, Каширское шоссе, 24

Anastasiya M. Belozerskikh

nastiabelozerka@mail.ruhttps://orcid.org/0000-0003-1779-003XМедведеваБ. М.MedvedevaB. M.

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-1295-4106ЛаптеваМ. Г.LaptevaM. G.

115478 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-2586-8562БердниковС. Н.BerdnikovS. N.

115478 Москва, Каширское шоссе, 24

Национальный медицинский исследовательский центp онкологии им. Н.Н. Блохина Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation202529062025824249Copyright © Белозерских А.М., Медведева Б.М., Лаптева М.Г., Бердников С.Н., 20252025Белозерских А.М., Медведева Б.М., Лаптева М.Г., Бердников С.Н.Belozerskikh A.M., Medvedeva B.M., Lapteva M.G., Berdnikov S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/437

Цель: Повышение точности выявления опухолей поджелудочной железы и дифференциальной диагностики нейроэндокринных неоплазий (НЭН) с аденокарциномами поджелудочной железы с помощью применения протокола двумерной (2D) мультивоксельной МР‑спектрометрии по водороду. Материалы и методы: В исследование были включены 76 пациентов, из которых 47 — с новообразованиями поджелудочной железы и 29 — без патологии поджелудочной железы. Образования поджелудочной железы были представлены 24 НЭН (G1 = 4, G2 = 19, G3 = 1) и 23 аденокарциномами. Диагноз устанавливался на основании морфологического исследования после выполненного хирургического вмешательства или биопсии опухоли. Были определены уровни следующих метаболитов, полученных при мультивоксельной МР‑спектрометрии: холин (Cho), креатин (Cr), глутамин/глутамат (Glx), N‑ацетиласпартат (NAA), лактат (Lac) и их соотношения Cho/Cr, Lac/Cr, Cho/NAA, Glx/Cr. Результаты: Результаты исследования показали более высокий уровень креатина в неизменённой ткани по сравнению с опухолями поджелудочной железы (p = 0,032): в неизменённой ткани поджелудочной железы — от 6,01 до 23 (медиана 12,4), в опухолях — от 3,04 до 13,55 (медиана 6,01). При пороговом уровне сигнала от креатина менее 16,1 чувствительность в выявлении опухоли поджелудочной железы составила 70,9 %, специфичность — 61,9 %. Уровень Cho/Cr был выше в опухолях по сравнению с неизменённой тканью поджелудочной железы (p = 0,031). Также было выявлено, что регистрируемое по данным МР‑спектрометрии присутствие глутамата и глутамина в опухоли более часто встречается при НЭН по сравнению с аденокарциномами поджелудочной железы (p = 0,029): присутствие глутамата и глутамина отмечалось в 66,7 % НЭН и в 34,8 % аденокарцином поджелудочной железы. Уровень Glx/Cr в НЭН также был выше по сравнению с аденокарциномами (p = 0,026). Заключение: МР‑спектрометрия может быть полезным дополнительным инструментом в выявлении опухолей поджелудочной железы и дифференциальной диагностике аденокарцином и НЭН поджелудочной железы.

Purpose: Improving the accuracy of pancreatic tumor detection and differential diagnosis of neuroendocrine neoplasia (NEN) with pancreatic adenocarcinomas using a two‑dimensional (2D) multivoxel hydrogen MR spectrometry protocol. Materials and methods: The study included 76 patients, including 47 cases of pancreatic tumors and 29 cases without pancreatic pathology. Pancreatic tumors were represented by 24 NEN (G1 = 4, G2 = 19, G3 = 1) and 23 adenocarcinomas. The diagnosis was established based on morphological examination after surgery or tumor biopsy. The levels of the following metabolites obtained by multivoxel MR spectrometry were determined: choline (Cho), creatine (Cr), glutamine/glutamate (Glx), N‑acetylaspartate (NAA), lactate (Lac) and their ratios Cho/Cr, Lac/Cr, Cho/NAA, Glx/Cr. Results: The results of the study showed a higher level of creatine in unchanged tissue compared to pancreatic tumors (p = 0.032): in unchanged pancreatic tissue — from 6.01 to 23 (median 12.4), in tumors — from 3.04 to 13.55. (median 6.01). At a threshold signal level from creatine of less than 16.1, the sensitivity in detecting pancreatic tumor was 70.9 %, specificity — 61.9 %. The Cho/Cr level was higher in tumors compared to unchanged pancreatic tissue (p = 0.031). It was also found that the presence of glutamate and glutamine in the tumor, recorded by MR spectrometry data, is more common in NEN compared to pancreatic adenocarcinomas (p = 0.029): the presence of glutamate and glutamine was noted in 66.7 % of NEN and in 34.8 % of pancreatic adenocarcinomas. The Glx/Cr level in NEN was also higher compared to adenocarcinomas (p = 0.026). Conclusion: MR spectrometry may be a useful adjunctive tool in the detection of pancreatic tumors and differential diagnosis of pancreatic adenocarcinomas and NENs, to improve the accuracy of pancreatic tumor detection and differential diagnosis of NENs with pancreatic adenocarcinomas using a two‑dimensional (2D) multivoxel 1H‑magnetic resonance spectrometry (MRS) protocol.

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The authors declare that there are no conflicts of interest present.