Breast Magnetic Resonance Spectroscopy at 3 T in Biopsy-Proven Breast Cancers

Abstract

Objectives: The role of functional techniques, such as magnetic resonance spectroscopy ( 1 H-MRS), as noninvasive tools to increase breast MR imaging reliability has been widely investigated during the last 2 decades. Considering the growing interest in tumor biology and its influence on functional parameters, the aim of this study was to investigate the relationship between 1 H-MRS parameters and breast cancer biomarkers and to evaluate whether the results of 1 H-MRS at 3 T can correlate with established breast cancer prognostic factors in our clinical experience. Materials and Methods: One hundred two patients with biopsy-proven breast cancer underwent 3 T breast MR imaging. Single-voxel 1 H-MRS was performed after the T1-weighted sequence, using a PRESS water-suppressed sequence (BREASE). Data were collected from a single rectangular volume of interest that encompassed the lesion. Magnetic resonance images and spectra of 102 Breast Imaging Reporting and Data System 6 lesions were prospectively evaluated by 2 radiologists in consensus. 1 H-MRS results were considered positive if the choline peak signal-to-noise ratio was 2 or higher. 1 H-MRS findings were then compared with morphological features and to histological findings, such as lesion size, nuclear grade, Ki-67, hormone receptor status, and Her2 expression. Results: Elevated levels of total choline were detectable in 68/102 cases (66.67%) and undetectable in 34/102 (33.33%). A statistically significant association between the presence of choline peak and higher tumor grading (P < 0.0001), greater Ki-67 value (P < 0.0001), and larger lesion size (P < 0.0001) was found. No statistically significant associations were observed between choline peak and the luminal subgroups, even if higher levels of choline were more frequent in nonluminal A lesions. Conclusions: Our study confirms that 3 T breast 1 H-MRS can be a valid additional tool to obtain further information about breast cancer biology and to predict tumor aggressiveness, because the detection of elevated levels of total choline in the spectrum is associated with a biologically aggressive breast cancer phenotype (large dimensions, grade 3, high values of Ki-67). Our results need to be validated in standardized larger-scale studies.

Radiologic-pathologic correlation in breast cancer: do MRI biomarkers correlate with pathologic features and molecular subtypes?

“…Nowadays, a basic mpMRI protocol includes unenhanced sequences (T2 weighted and DWI) followed by the series of pre-and post-contrast T1-weighted acquisitions [13], since it was demonstrated that mpMRI including contrast-enhanced sequences and DWI increases diagnostic accuracy in BC diagnosis [16,24]. Also, magnetic resonance spectroscopy improves the diagnostic accuracy of breast MRI [25][26][27][28][29]; however, technical challenges and operator dependency have limited large-scale implementation of this technique [30].…”

Alter between gut bacteria and blood metabolites and the anti-tumor effects of Faecalibacterium prausnitzii in breast cancer

“…Therefore, 16S rDNA could be used as a characteristic nucleic acid sequence for revealing biological species, which was considered to be the most suitable index for bacterial phylogeny and classification identification [12]. As early as 2005, Lenkinski et al [13] incubated the stool sample extract, and found that the intestinal flora of premenopausal breast cancer patients was significantly different from that of normal women, the number of Escherichia coli, A. aerobicus, Lactobacilli and non-fermenting bacteria increased significantly. With the development of gene sequencing technology, the research on intestinal flora has entered a new stage.…”

Breast imaging: Beyond the detection

“…Several studies have demonstrated that MRS improves the diagnostic accuracy of breast MRI and the association between the detection of elevated total choline (tCho) levels and biological aggressive cancer phenotypes has been described [25,26,28,41]. In addition to tCho, in recent years MRS has been used to detect and monitor other metabolites, such as lipid metabolites, since lipid metabolism alterations have been associated with cancer development.…”