Proton spectroscopy provides accurate pathology on biopsy and in vivo

Abstract

In the last 25 years, MR spectroscopy (MRS) has moved from being a basic research tool into routine clinical use. The spectroscopy method reports on those chemicals that are mobile on the MR time scale. Many of these chemicals reflect specific pathological processes but are complicated by the fact that many chemicals change at one time. There are currently two clinical applications for spectroscopy. The first is in the pathology laboratory, where it can be an adjunct to, and in some cases replacement, for difficult pathologies like Barrett's esophagus and follicular adenoma of the thyroid. The spectroscopy method on a breast biopsy can also report on prognostic indicators, including the potential for spread, from information present in the primary tumor alone. The second application for spectroscopy is in vivo to provide a preoperative diagnosis and this is now achievable for several organs including the prostate. The development of spectroscopy for clinical purposes has relied heavily on the serially-sectioned histopathology to confirm the high accuracy of the method. The combination of in vivo MRI, in vivo MRS, and ex vivo MRS on biopsy samples offers a modality of very high accuracy for preoperative diagnosis and provision of prognostic information for human cancers.

Chronic Hematoma Mimicing Recurrent Breast Carcinoma and Contribution of Magnetic Resonance Imaging to the Diagnosis

“…Pathological situations change the chemical contents of tissues and organ (13,14). Choline takes part in cellular membrane turn-over and is a marker of cellular proliferation.…”

Nivel de orientación empática en los estudiantes de terapia física y rehabilitación de una universidad estatal

“…Es por tanto que dentro de las variaciones de imágenes propuestas para mejorar la especificidad de la RM, se plantea la aplicación de Espectroscopía, técnica que aporta información sobre la composición bioquímica del tejido estudiado. Su valor se basa en la detección de niveles elevados de Colina, como marcador metabólico tumoral elevado ante la presencia de cáncer de mama (28) .…”

“…Adicionalmente permite realizar monitorización de respuesta a quimioterapia en lesiones de 1,5 cm con una sensibilidad del 89% y especificidad del 100% (25,28) . Existe como alternativa adicional suplementaria la técnica de difusión ponderada (cuantificación determinada por el valor del coeficiente de difusión aparente), la cual permite la detección de tumores de mama y la distinción entre lesiones benignas y malignas.…”

Functional Imaging of Cancer with Emphasis on Molecular Techniques

“…The data are typically displayed as a grid of spectra of chemical compound abundances obtained at either single or multiple locations in a tissue or organ of interest. These spectra are collected from spinning nuclei (spins), most often 1 H given the abundance of water in tissue, although they can be collected from other nuclei such as 13 C or 31 P with more 100 Unfortunately, there is no one cancer signature on MRS, but there are MRS findings that are seen more often in cancer. 99 For example, increased concentrations of cell membrane metabolites such as phosphocholine may be seen due to increased membrane synthesis, a higher concentration of lactate may be seen due to increased metabolism through the glycolytic pathway, and lower concentrations of normal tissue metabolites (such as N-acetyl aspartate in cerebral tissue or citrate in prostatic tissue) may be encountered (Figure 2).…”