Magnetic resonance spectroscopy of premalignant and malignant endometrial disorders: a feasibility of in vivo study

Alterations of Choline Phospholipid Metabolism in Endometrial Cancer Are Caused by Choline Kinase Alpha Overexpression and a Hyperactivated Deacylation Pathway

“…These studies are limited by poor sensitivity because of the rapid excretion and accumulation of FDG within the bladder, the largest study reporting 74% sensitivity in detecting lymph node involvement (3). The use of MRS in assessing endometrial cancer is limited by poor spectral signal to noise ratio (7,44). We have recently shown the feasibility of imaging using […”

“…Celik and colleagues identified an abnormal choline signal in proliferating endometrium compared with endometrial cancer by spectroscopy (7). However, neither alterations in choline phospholipid metabolism in the development of endometrial cancer nor alterations in CHKA expression and activity have been considered in endometrial cancer, and may represent both a novel therapeutic target and imaging strategy.…”

“…CHK exists in at least three isoforms, a1, a2 (CHKA), and b (CHKB), of which the alpha but not beta isoforms have been associated with malignancy (5). CHKA overexpression, elevated Cho uptake, and PCho formation have been shown in a wide array of human cancers, including breast, ovarian, lung, and prostate cancer (6)(7)(8)(9)(10). These changes in choline handling have most commonly been studied using magnetic resonance spectroscopy (MRS).…”

“…Mechanisms of PCho accumulation within tumor cells can occur via a number of mechanisms including enhanced choline transport, CHKA dedicated phosphorylation, and activation of phosphatidylcholine-specific phospholipases. Furthermore, overexpression of CHKA (6)(7)(8) and abundance of choline metabolites (13)(14)(15) have been shown to be prognostic in a number of cancers including prostate, breast, lung, and ovarian cancer. More recently inhibition of CHKA, both by shRNA and small-molecule inhibitors, has been shown to have both an antimitogenic and antiproliferative effects in vitro and in vivo (16)(17)(18)(19)(20)(21).…”

Preliminary observations and diagnostic value of lipid peak in ovarian thecomas/fibrothecomas using in vivo proton MR spectroscopy at 3T

“…However, this finding is not always observed in thecomas/fibrothecomas undergoing chemical shift MRI. Proton MR spectroscopy provides metabolic information, and may add valuable information to the diagnosis (9–14). The lipid peak at 1.3 ppm may be observed in malignant tumors with necrosis such as uterine cervical cancer, whereas normal tissue and most of benign tumors do not show high lipid peak associated with necrosis (12–14).…”