Spectroscopy Analysis of Uterine Leiomyomas Before and
After Treatment with GnRH-a

Şeyma HASCALIK, Önder ÇELİK, Kaya SARAÇ, Alpay ALKAN, Bülent MIZRAK
Malatya-Turkey

MR spectroscopy uses the same hardware as magnetic resonance imaging but provides information at the biochemical level. It has been used to measure proton-containing compounds, such as amino acids, fatty acids, organic acids, sugars and other metabolic active compounds in tissue specimens. Before and after GnRH-a treatment we measured lipid, lactate, creatine and choline concentrations in two patients with uterine leiomyomas using single-voxel proton MR spectroscopy. Subcutaneous goserelin acetate injection was performed at least two times every 4 weeks before surgery. Spectroscopy was performed 3 weeks later last goserelin acetate injection. The MR spectroscopy results of leiomyomas before and after GnRH-a treatment were compared. Before GnRH-a treatment, spectral analysis of each patients showed only choline signals. After GnRH-a treatment, spectrum of both patients showed lipid peaks but the other signals were not observed. The presence of lipid signals and absence of other signals suggest a diffuse metabolic defect in association with GnRHa treatment, possibly consistent with decrease in myoflaments, and increase in apopitosis and necrosis. (Gynecol Obstet Reprod Med 2005; 11:141-144)

Key Words: Uterine leiomyoma, Gonadotropin-releasing hormone, Magnetic resonance spectroscopy