Fine-needle biopsy specimens of benign breast lesions distinguished from invasive cancer ex vivo with proton MR spectroscopy.

Mackinnon, Wanda B.; Barry, Peter; Malycha, Peter; Gillett, David J.; Russell, Peter; Lean, Cynthia L.; Doran, Sinead; Barraclough, Bruce; Bilous, Michael; Mountford, Carolyn E.

doi:10.1148/radiology.204.3.9280241

Cited by 129 publications

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“…Absolute concentration of choline in breast lesions through in-vivo proton MRS have been determined (Roebuck et al, 1998). Mackinnon et al (1997) reported elevation of choline levels in malignant breast tumours compared to benign cases from in-vivo NMR of FNAB samples and evaluated its sensitivity and specificity in distinguishing benign lesions from invasive cancer. Of the various choline containing compounds that contribute to the peak at 3.2 ppm in in-vivo MRS (choline, glycerophosphocholine and phosphocholine), an increase in Table 2 Group specific distribution of patients in relation to the presence of choline along with its percentage and 95% confidence interval (CI) phosphocholine is highly probable (Katz-Brull et al, 1998;Roebuck et al, 1998).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

et al. 2001

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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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Section: Resultsmentioning

confidence: 99%

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

et al. 2001

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“…The MRS experiments in this study were performed in the Small Animal Imaging Facility, the Department of Radiology at the University of Pennsylvania. (a) Representative in vivo 31 P MR spectra of the CHOPB treated tumors before treatment, and after three cycles of CHOPB using non-decoupled one-pulse sequence. (b) Time courses of PME/βNTP of the control tumors (dashed line) and CHOPB treated tumors (solid line).…”

Section: Discussionmentioning

confidence: 99%

“…Figure 4a presents a set of representative in vivo 31 P MR spectra of the CHOPB treated tumors before treatment and after three cycles of CHOPB. A number of metabolites were observed in the 31 P MR spectra of the tumors.…”

Section: P Mrs Of Dlcl2 Tumorsmentioning

confidence: 99%

“…In contrast, 1 H MRS can detect much smaller tumors (1-2 cm 3 at 1.5 T) with the same signal-to-noise ratio as 31 P MRS at the same acquisition time (25). Proton MRS has been demonstrated to be useful in differentiating between cancer, necrosis, and normal tissue of various organs such as brain (26)(27)(28), prostate (29), neck (28), breast (30,31), kidney (32) and liver (33).…”

Section: Introductionmentioning

confidence: 99%

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In Vivo Monitoring Response to Chemotherapy of Human Diffuse Large B-Cell Lymphoma Xenografts in SCID Mice by 1H and 31P MRS

Huang¹,

Nelson²,

Pickup³

et al. 2007

Academic Radiology

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Rationale and Objectives-A reliable non-invasive method for in vivo detection of early therapeutic response of non-Hodgkin's lymphoma (NHL) patients would be of great clinical value. This study evaluates the feasibility of 1 H and 31 P magnetic resonance spectroscopy (MRS) for in vivo detection of response to combination chemotherapy of human diffuse large B-cell lymphoma (DLCL2) xenografts in SCID mice.Materials and Methods. C-ombination chemotherapy with Cyclophosphamide, Hydroxydoxorubicin, Oncovin, Prednisone, and Bryostatin 1 (CHOPB) was administered to tumorbearing SCID mice weekly for up to four cycles. Spectroscopic studies were performed before the initiation of treatment and after each cycle of the CHOPB. Proton MRS for detection of lactate and total choline was performed using a selective multiple-quantum-coherence-transfer (Sel-MQC) and a spin-echo-enhanced Sel-MQC (SEE-Sel-MQC) pulse sequence, respectively. Phosphorus-31 MRS utilizing a non-localized single-pulse sequence without proton decoupling was performed on these animals.Results-Significant decreases in lactate and total choline were detected in the DLCL2 tumors after one cycle of CHOPB chemotherapy. The ratio of phosphomonoesters to β-nucleoside triphosphate (PME/βNTP, measured by 31 P MRS) significantly decreased in the CHOPB treated tumors after two cycles of CHOPB. The control tumors did not exhibit any significant changes in either of these metabolites.Conclusions-This study demonstrates that 1 H MRS and 31 P MRS can detect in vivo therapeutic response of NHL tumors and that lactate and choline offer a number of advantages over PMEs as markers of early therapeutic response.

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“…In addition to MRI, magnetic resonance spectroscopy (MRS) is becoming increasingly attractive for the detection or monitoring of breast cancer (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). MRS detects elevated levels of cholinecontaining compounds in breast cancer tissue, which yield a signal at a chemical shift of 3.2 ppm (25). Choline by MRS and enhancement curves by DMRI represent common methods for dealing with non-morphological diagnostic parameters.…”

Section: Introductionmentioning

confidence: 99%

Choline by magnetic spectroscopy and dynamic contrast enhancement curve by magnetic resonance imaging in neoadjuvant chemotherapy for invasive breast cancer

Murata¹

2008

Mol Med Rep

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Abstract. This study investigated the relationship between choline by magnetic resonance spectroscopy (MRS) and late enhancement curves by dynamic magnetic resonance imaging (DMRI) in determining therapeutic response to neoadjuvant chemotherapy (NAC) among invasive breast cancer patients. Subjects comprised 21 women (22 breasts) with biopsyconfirmed invasive breast cancer (mean age 54 years) who underwent MRS with choline and gadolinium-enhanced DMRI at 1.5 T before and after NAC. Choline signals on MRS were classified into 2 patterns: choline-positive or cholinenegative, while late enhancement curves were classified as 'plateau' or 'washout' (type A), or 'persistent' (type B) according to the consensus of 2 radiologists. Maximum tumor diameters and clinical tumor reduction rates were assessed by MRI. Before NAC, choline-positive results were found in all 22 tumors, 21 of which were type A and 1 of which was type B. After NAC, a change from choline-positive to cholinenegative was observed with MRS in 11 tumors, while another 11 remained choline-positive. According to DMRI, enhancement curves changed from type A to type B in 14 tumors, remained type A in 7 tumors, and remained type B in 1 tumor. Tumor reduction rates were significantly greater for cholinenegative tumors than for choline-positive tumors after NAC (p=0.0115). Following NAC, no significant correlation was noted between enhancement curves and reduction rates (p=0.1210), although a significant correlation was noted between enhancement curves and choline signals (p=0.0014). Changes in choline signals as noted using MRS might offer advantages over changes in enhancement curves by DMRI when evaluating response to NAC in terms of the tumor reduction rate in invasive breast cancer. IntroductionAmong conventional modalities such as ultrasonography, mammography and computed tomography (1-3), magnetic resonance imaging (MRI) has priority for the detection of breast cancer and for the evaluation of breast cancer response to neoadjuvant chemotherapy (NAC) (4-11). Enhancement curves by dynamic MRI (DMRI) are known to be useful for detecting or monitoring breast cancer (4,12,13). In addition to MRI, magnetic resonance spectroscopy (MRS) is becoming increasingly attractive for the detection or monitoring of breast cancer (14-24). MRS detects elevated levels of cholinecontaining compounds in breast cancer tissue, which yield a signal at a chemical shift of 3.2 ppm (25). Choline by MRS and enhancement curves by DMRI represent common methods for dealing with non-morphological diagnostic parameters. The present study therefore assessed the correlation between MRS and enhancement curves from DMRI in determining response to NAC. Materials and methodsPatients. The present study was performed at our institution between January 2007 and Feburary 2008. Subjects comprised 21 patients with invasive ductal breast carcinoma (unilateral n=20; bilateral n=1) diagnosed by ultrasonography-guided fine needle biopsy. Mean subject age was 54 years (range 40-67 years).Neoadjuvant chemo...

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Fine-needle biopsy specimens of benign breast lesions distinguished from invasive cancer ex vivo with proton MR spectroscopy.

Abstract: Proton MR spectroscopy of fine-needle biopsy specimens provides objective diagnostic information that complements findings of conventional preoperative investigations of breast lesions.

Cited by 129 publications

References 0 publications

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

In Vivo Monitoring Response to Chemotherapy of Human Diffuse Large B-Cell Lymphoma Xenografts in SCID Mice by 1H and 31P MRS

Choline by magnetic spectroscopy and dynamic contrast enhancement curve by magnetic resonance imaging in neoadjuvant chemotherapy for invasive breast cancer

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