Preliminary observations and clinical value of lipid peak in high-grade uterine sarcomas using in vivo proton MR spectroscopy

Takeuchi, Mayumi; Matsuzaki, Kei; Harada, Masafumi

doi:10.1007/s00330-013-2856-4

Cited by 19 publications

(11 citation statements)

References 22 publications

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“…Interestingly, a recent study reported significantly lower choline concentration in carcinosarcomas than in endometrioid carcinomas (18). Tumor necrosis is reportedly more pronounced in non-endometrioid endometrial cancers (30) and tumors with necrosis are known to exhibit low choline concentrations, putatively due to the low numbers of viable tumor cells (31). Theoretically, microscopic tumor necrosis could, thus, explain the relatively low choline concentration observed in non-endometrioid tumors compared with grade 3 endometrioid tumors in our study.…”

Section: Discussionmentioning

confidence: 99%

In vivo MR spectroscopy predicts high tumor grade in endometrial cancer

et al. 2017

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Background In vivo magnetic resonance spectroscopy (MRS) enables non-invasive measurements of tumor metabolites. Choline-containing metabolites play a key role in tumor metabolism. Purpose To explore whether preoperative MRS-derived tumor choline levels are associated with clinical and histological features in endometrial carcinomas. Material and Methods Preoperative pelvic magnetic resonance imaging (MRI) (1.5T), including structural and diffusion-weighted imaging and localized multivoxel proton MR (1H-MR) spectroscopy, was performed in 77 prospectively included patients with histologically confirmed endometrial carcinomas. Relative levels of total choline-containing metabolites (tCho) in tumor and myometrium were measured using the ratios: tCho/Creatine; tCho/Water; and tCho/Noise. MRS parameters were analyzed in relation to histological subtype and grade, surgicopathological staging parameters, MRI-measured tumor volume, and tumor apparent diffusion coefficient (ADC) value and clinical outcome. Results Tumor tissue had significantly higher ratios for tCho/Creatine, tCho/Water, and tCho/Noise than normal myometrial tissue ( P < 0.001 for all). High tumor tCho/Water ratio was significantly associated with high tumor grade in endometrioid tumors ( P = 0.02). Tumor tCho/Creatine ratio was positively correlated to MRI-measured tumor volume (r = 0.25; P = 0.03). Conclusion High choline levels in tumor are associated with high-risk features. In vivo MRS may potentially aid in the preoperative risk stratification in endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

In vivo MR spectroscopy predicts high tumor grade in endometrial cancer

et al. 2017

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“…However, Takeuchi et al. also reported that high-grade malignant uterine tumors may often show massive necrosis and may cause low choline concentration due to the decrease in viable tumor cells, and the presence of high lipid peaks may be useful in distinguishing uterine sarcomas from benign leiomyomas (26). Lipid peaks arising from triglycerides and cholesterol esters in neutral lipid droplets may be observed both in viable and necrotic areas of the tumor, and are considered to be important biomarkers in the diagnosis of malignant tumors (27).…”

Section: Discussionmentioning

confidence: 99%

Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy

2016

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Large, exophytic heterogeneous endometrial mass containing strongly enhanced areas, which may exhibit "tumor delivery", is a suggestive of carcinosarcoma. Relatively high mean ADC and low choline concentration considering its highly malignant nature due to intra-tumoral heterogeneity with necrosis and epithelial cystic components, and the presence of necrosis-associated high lipid peak may be compatible with carcinosarcoma.

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“…In studies regarding the uterine tumors, Okada et al (59) and Celik et al (60) found that choline was present in benign and malignant lesions, while Takeuchi et al (61) reported that malignant lesions have higher levels of choline, and a cutoff of 7 mmol might distinguish between them with 83% sensitivity and 93% specificity. Lipid peaks also showed promising results for distinguishing uterine sarcomas from benign leiomyomas (62). In the case of tumors of the cervix, unfortunately choline is present in normal and tumor tissue without any detectable differences between them (58,(63)(64)(65)(66)(67).…”

Section: Genitourinary Tumors (Excluding Prostate)mentioning

confidence: 92%