Human breast lesions: characterization with proton MR spectroscopy.

Roebuck, Joseph R.; Cecil, Kim M.; Schnall, Mitchell D.; Lenkinski, Robert E.

doi:10.1148/radiology.209.1.9769842

Cited by 220 publications

(256 citation statements)

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“…The spectra are seen to be different from the normal breast tissue, the water peak dominating with a much lower contribution from lipid protons. This observation is in line with the general hypothesis that tumours have considerably higher water content (Sijens et al, 1988;Gilligam et al, 1997;Jagannathan et al, 1998Jagannathan et al, , 1999Roebuck et al, 1998). Recently, we documented elevated water-to-fat ratios (W/F) in malignant breast tissues compared to normal breast tissues which showed a statistically significant reduction in patients receiving NACT (Jagannathan et al, 1998(Jagannathan et al, , 1999.…”

Section: Resultssupporting

confidence: 84%

“…An increase in phosphomonoester peak in lactating women has also been documented by Twelves et al (1994) through 31 P MRS. Payne et al (1994) have documented that the level of phosphomonoesters changes significantly in normal breast tissues during menstrual cycle. 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.…”

Section: Resultsmentioning

confidence: 99%

“…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%

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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: Resultssupporting

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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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“…Concerning MR protocols other than DCE-MRI, diffusion-weighted MR imaging (DWI) and MR spectroscopy (MRS) have recently been reported to demonstrate usefulness in differentiating benign from malignant breast lesions (11)(12)(13)(14)(15)(16)(17)(18). Since the report by Kinoshita et al (11) in 2002, recent studies using DWI have shown that apparent diffusion coefficient (ADC) values can be useful in differentiating between benign and malignant breast lesions (11)(12)(13)(14)(15).…”

mentioning

confidence: 99%

Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images

Yabuuchi

Matsuo

Okafuji

et al. 2008

Magnetic Resonance Imaging

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Purpose:To evaluate the diagnostic accuracy of a combination of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted MR imaging (DWI) in characterization of enhanced mass on breast MR imaging and to find the strongest discriminators between carcinoma and benignancy. Materials and Methods:We analyzed consecutive breast MR images in 270 patients; however, 13 lesions in 93 patients were excluded based on our criteria. We analyzed tumor size, shape, margin, internal mass enhancement, kinetic curve pattern, and apparent diffusion coefficient (ADC) values. We applied univariate and multivariate analyses to find the strongest indicators of malignancy and calculate a predictive probability for malignancy. We added the corresponding categories to these prediction probabilities for malignancy and calculated diagnostic accuracy when we consider category 4b, 4c, and 5 lesions as malignant and category 4a, 3, and 2 lesions as benign. In a validation study, 75 enhancing lesions in 71 patients were examined consecutively.Results: Irregular margin, heterogeneous internal enhancement, rim enhancement, plateau time-intensity curve (TIC) pattern, and washout TIC pattern were the strongest indicators of malignancy as well as past studies, and ADC values less than 1.1 ϫ 10 Ϫ3 mm 2 /s were also the strongest indicators of malignancy. In a validation study, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92% (56/61), 86% (12/14), 97% (56/58), 71% (12/17), and 91% (68/75), respectively. Conclusion:The combination of DWI and DCE-MRI could produce high diagnostic accuracy in the characterization of enhanced mass on breast MR imaging.

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“…Breast cancer can be distinguished from benign lesions and from normal breast tissues by a dramatic increase (from undetectable to clearly visible at 1.5 T) of the choline (Cho) signal in 1 H MRS [18][19][20][21][22][23][24][25][26][27][28][29]. Cho, consisting of free, phospho-, glycerophospho-and phospholipidcholine, is a classic in vivo biomarker for cellular proliferation.…”

Section: Introductionmentioning

confidence: 99%

A high spatial resolution 1H magnetic resonance spectroscopic imaging technique for breast cancer with a short echo time

Kou

et al. 2008

Magnetic Resonance Imaging

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The high sensitivity but low specificity of breast MRI has prompted exploration of breast 1 H MRS for breast cancer detection. However, several obstacles still prevent the routine application of in vivo breast 1 H MRS, including poor spatial resolution, long acquisition time associated with conventional multi-voxel MRS imaging (MRSI) techniques, and the difficulty of "extra" lipid suppression in a magnetic field with relatively poor achievable homogeneity compared to the brain. Using a combination of a recently developed echo-filter (EF) suppression technique and an elliptical sampling scheme, we demonstrate the feasibility of overcoming these difficulties. It is robust (the suppression technique is insensitive to magnetic field inhomogeneity), fast (acquisition time of about 12 min) and offers high spatial resolution (up to 0.6 cm 3 per voxel at 1.5 T with a TE of only 60 ms). This approach should be even better at 3 T with higher resolution and/or shorter TE.

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Human breast lesions: characterization with proton MR spectroscopy.

Cited by 220 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

Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images

A high spatial resolution 1H magnetic resonance spectroscopic imaging technique for breast cancer with a short echo time

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