Breast cancer is the commonest cancer among women the world over. In India, the reported age adjusted incidence of breast cancer in women is about 26.7/1 00 000 population (NCRP, 1992). Unlike the West, in India, majority of the patients (about 60%) present with locally advanced breast cancer (LABC) or disseminated disease (Goel et al, 1995). In LABC, the treatment policy followed at most centres, is neoadjuvant chemotherapy (NACT) followed by surgery and local or locoregional radiotherapy. The response to NACT is assessed by clinical evaluation and supplemented by radiological measurement of reduction in tumour volume by mammography and/or ultra sonography. None of the currently available indicators of response (clinical and radiological) correlate well with the actual response as assessed on histopathological examination of the tumour.MR imaging (MRI) is a valuable new tool for diagnostic mammography (Orel et al, 1996;Friedrich, 1998; Harms, 1998;Orel, 1998). Recently, dynamic contrast enhanced MRI techniques have also been developed for differentiation between benign and malignant tumours (Kaiser, 1991;Harms et al, 1993; Haywang-Kobrunner et al, 1997;Piccoli, 1997;Daniel et al, 1998). The above techniques, however, do not provide any metabolic/ biochemical information. On the contrary, magnetic resonance spectroscopy (MRS) permits non-invasive detection of metabolic (biochemical) differences between tumours and normal tissues, and can also be used to monitor response to different treatment regimens. Recently, we have shown that in LABC, the assessment of response to NACT can be made using water-to-fat ratio calculated from volume localized proton MRS (Jagannathan et al, 1998(Jagannathan et al, , 1999. In addition, we also reported the presence of choline in a majority of the breast cancer patients (Jagannathan et al, 1998).In this study, results of evaluation of choline in LABC and its response to NACT using in-vivo proton MRS are presented. The objectives are: (i) to evaluate the potential of proton MRS in the study of breast cancer, and (ii) to investigate further, the recent observation of choline containing compounds in malignant breast tissues and its response to NACT. To the best of our knowledge, this is the first report assessing the response of breast cancer to NACT in a large cohort of patients using in-vivo proton MRS. PATIENTS AND METHODS Patients67 women with cytologically confirmed infiltrating ductal carcinoma (IDC) were recruited. Necessary clearance from the Institute ethical committee and written informed consent were obtained prior to examination from patients and controls. Patients were evaluated clinically and tumour size was measured using Vernier calipers. Metastatic workup included liver function tests, chest

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The statistically based classification rule developed indicated that PAs have an important role in the detection of PZ prostate cancer. With commercial software, this method can be applied in clinical settings.

PurposeTo evaluate the use of the water‐to‐fat (W‐F) value obtained from in vivo proton (1H) MR spectroscopy (MRS) as a response indicator of cytologically confirmed patients with locally advanced breast cancer (LABC), and to monitor the therapeutic response of such patients to neoadjuvant chemotherapy (NACT)Materials and MethodsSerial 1H MR spectra were recorded both before and after the completion of chemotherapy in 33 LABC patients (with infiltrating ductal carcinoma (IDC)) at 1.5T. In addition, spectra from normal breast tissues of 28 healthy volunteers were recorded.ResultsMalignant breast tissues showed elevated W‐F values compared to normal breast tissues of controls. Statistically significant higher pretherapy W‐F value (P < 0.01) was observed in patients compared to controls. In patients who received NACT resulting in the reduction of the primary tumor size, the W‐F value showed a decrease that was statistically significant (P < 0.01). Analysis of the MR data further indicates that the W‐F value had no correlation with the menstrual status of the patients. A comparison of pretherapy W‐F value with pretherapy tumor volume showed a fair correlation (P = 0.05), while the posttherapy W‐F value showed no such correlation with the posttherapy tumor volume.ConclusionThis study demonstrates that simple, conventional in vivo 1H MRS is a useful technique for monitoring the therapeutic response of breast cancer patients. The observed trend in the reduction of W‐F value provides a noninvasive response indicator to monitor the clinical outcome of locally advanced breast cancer patients to NACT J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.

This study investigates the comparative changes in the sodium MRI signal and proton diffusion following treatment using a 9L rat glioma model to develop markers of earliest response to cancer therapy. Sodium MRI and proton diffusion mapping were performed on untreated (n ‫؍‬ 5) and chemotherapy 1,3-bis(2-chloroethyl)-1-nitrosourea-treated rats (n ‫؍‬ 5). Animals were scanned serially at 2-to 3-day intervals for up to 30 days following therapy. The time course of Na concentration in a tumor showed a dramatic increase in the treated brain tumor compared to the untreated tumor, which correlates in time with an increase in tumor water diffusion. The largest posttreatment increase in sodium signal occurred 7-9 days following treatment and correlated to the period of the greatest chemotherapy-induced cellular necrosis based on diffusion and histopathology. Both Na MRI and proton ADC mapping revealed early changes in tumor sodium content and cellularity. This study demonstrates the possibility of Na MRI to function as a