Volume localizedin vivo proton MR spectroscopy of breast carcinoma: variation of water–fat ratio in patients receiving chemotherapy

Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy

“…This study shows that MRS parameters provide substantial prognostic information, and slightly more than that provided by volume measurements alone, thus supporting the conclusions of Jagannathan et al (1998). This study also suggests that water T 2 plays a dominant part in driving the observed treatment changes in water : fat ratios (at TP 2 ) and it is, therefore, possible that imagebased T 2 mapping techniques (Liney et al, 1996) might provide the same prognostic information as %W MRS but with the combined benefits of greatly increased spatial resolution, wider availability in clinical MRI centres and a reduced likelihood of technical failure in a given examination.…”

“…Although water : fat ratios have been shown to contain substantial prognostic power, in both this and another study (Jagannathan et al, 1998), it is noted that a number of groups are now focusing on measurements of choline-containing compounds using water-suppressed MRS, as the choline moiety is potentially a more sensitive, and probably a more biochemically relevant marker, of cancer cell viability. Such studies have recently been carried out in breast cancer (Jagannathan et al, 2001;Meisamy et al, 2004), lymphoma and germ cell tumours (Schwarz et al, 2002), and glioma (Preul et al, 2000), where positive treatment response has been associated with reduction in the levels of total choline.…”

“…The use of spectroscopic imaging at both short and long echo times represents a significant extension to the methodology of Jagannathan et al (1998): firstly through permitting greater post-examination control over intra-voxel partial volume effects and secondly by permitting the effects of T 2 relaxation to be revealed. It was also hoped that the 30 ms TE spectra would permit investigation of the relative proportions of the 1.3 and 0.9 p.p.m.…”

“…Proton magnetic resonance spectroscopy (MRS) can be used to characterise breast lesions through differences in the ratio of fat and water signals (Chu et al, 1987;Sijens et al, 1988) or the intensity of signal from choline-containing compounds (Bradamante et al, 1988;Katz-Brull et al, 2002;Bolan et al, 2003;Jacobs et al, 2004;Jacobs et al, 2005). Both fat : water ratios (Jagannathan et al, 1998) and choline levels (Preul et al, 2000;Jagannathan et al, 2001;Schwarz et al, 2002;Meisamy et al, 2004) have also been used to monitor treatment-induced changes, and phosphorous MRS has been used to predict response using differences in the levels of phosphocholine or phosphomonoesters (Shukla-Dave et al, 2002a, b;Arias-Mendoza et al, 2004). Sodium MRI might also be useful in monitoring treatment response (Kline et al, 2000;Schepkin et al, 2005).…”

Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

“…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.…”