In vivo characterisation of soft tissue tumours by 1.5-T proton MR spectroscopy

Abstract

• 1H-MRS may allow differentiation between benign and malignant soft tissue lesions • Absence of choline peak is highly predictive of benign soft tissue lesions • Malignant tumours with a mitotic index >2/10 HPF had a positive choline peak • A choline peak may still be identified in some benign tumours.

Magnetic resonance imaging biomarkers in musculoskeletal soft tissue tumors: Review of conventional features and focus on nonmorphologic imaging

“…MRS is a technique that is used to noninvasively detect and distinguish metabolite activity in a tissue of interest, such as a soft tissue tumor, based on the intrinsic resonant frequencies of various metabolites, and analyze its biochemical composition . MRS enables the detection of metabolic markers of malignancy, including the trimethyl aluminium (TMA) compounds, which present as a composite spectral resonance consisting of free choline, phosphocholine, and glycerophosphocholine; TMA is typically elevated in malignancies, including malignant soft tissue tumors.…”

“…However, qualitative MRS assessment is limited in its reproducibility and generalizability in a clinical setting. Prior qualitative investigations of 1 H‐MRS reported high sensitivities (88–92%) and relatively lower specificities (57–82%) for the characterization of soft tissue masses . For example, the qualitative presence of a total choline peak has been described in 50% of benign PNSTs, making the qualitative approach to MRS data less useful.…”

“…Interestingly, two histological subtypes (PNST and giant cell tumors) accounted for the majority of benign soft tissues masses with a detectable choline peal . With semiquantitative analysis, a threshold choline/Cr ratio of 12.5 offered a sensitivity of 85%, specificity of 83.3%, positive predictive value of 89.5%, and negative predictive value of 76.9% for distinguishing benign from malignant soft tissue masses . Using quantitative absolute choline concentration of greater than 0.3 mmol/kg as a biomarker for malignancy resulted in a sensitivity of 100%, specificity of 81%, PPV of 73%, and NPV of 100% .…”

Proton magnetic resonance spectroscopy in oncology: the fingerprints of cancer?

“…Absence of choline peak is highly predictive of benign soft tissue lesions as shown by Russo et al (75) using SVS and long TE. Previously, Subhawong et al (76) revealed that a discrete choline peak had 88% sensitivity and 68% specificity in detection of malignant musculoskeletal lesions (Fig.…”

Multiparametric Magnetic Resonance Imaging of Prostate Cancer: Association of Quantitative Magnetic Resonance Parameters with Histopathologic Findings

“…The ratio of the sum of the citrate and choline peaks to the citrate peak can differentiate prostate cancer from normal parenchyma (43). MRI is the most accurate imaging investigation for evaluating soft tissue tumors (44). Preliminary studies have shown that 1H-MRS using 1.5 or 3 T MR equipment is capable of discriminating between malignant and benign soft tissue tumors (45,46).…”