MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial

Bolan, Patrick J.; Kim, Eun‐Hee; Herman, Benjamin A.; Newstead, Gillian M.; Rosen, Mark; Schnall, Mitchell D.; Pisano, Etta D.; Weatherall, Paul T.; Morris, Elizabeth A.; Lehman, Constance D.; Garwood, Michael; Nelson, Michael T.; Yee, Douglas; Polin, Sandra M.; Esserman, Laura J.; Gatsonis, Constantine; Metzger, Gregory J.; Newitt, David C.; Partridge, Savannah C.; Hylton, Nola M.

doi:10.1002/jmri.25560

Cited by 49 publications

(107 citation statements)

References 35 publications

(44 reference statements)

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“…These focuses have included: unedited, short-TE MRS (Deelchand et al, 2015); low-field MRS (Träber et al, 2006); ultra-high field MRS (van de Bank, 2015); absolute quantification (Bovée et al, 1998; De Beer et al, 1998; Keevil et al, 1998; Soher et al, 1996); MRSI (Sabati et al, 2015; Wijnen et al, 2010); body MRS (Bolan et al, 2016; Scheenen et al, 2011); brain tumor classification (García-Gómez et al, 2009; Julià-Sapé et al, 2006; Tate et al, 2003; Vicente et al, 2013); and HIV-associated dementia (Chang et al, 2004; Lee et al, 2003; Sacktor et al, 2005). Even for short-TE methods, the degree of agreement between sites and scanners is highly dependent on the degree of acquisition homogeneity.…”

Section: Discussionmentioning

confidence: 99%

Big GABA: Edited MR spectroscopy at 24 research sites

et al. 2017

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Magnetic resonance spectroscopy (MRS) is the only biomedical imaging method that can noninvasively detect endogenous signals from the neurotransmitter γ-aminobutyric acid (GABA) in the human brain. Its increasing popularity has been aided by improvements in scanner hardware and acquisition methodology, as well as by broader access to pulse sequences that can selectively detect GABA, in particular J-difference spectral editing sequences. Nevertheless, implementations of GABA-edited MRS remain diverse across research sites, making comparisons between studies challenging. This large-scale multi-vendor, multi-site study seeks to better understand the factors that impact measurement outcomes of GABA-edited MRS. An international consortium of 24 research sites was formed. Data from 272 healthy adults were acquired on scanners from the three major MRI vendors and analyzed using the Gannet processing pipeline. MRS data were acquired in the medial parietal lobe with standard GABA+ and macromolecule- (MM-) suppressed GABA editing. The coefficient of variation across the entire cohort was 12% for GABA+ measurements and 28% for MM-suppressed GABA measurements. A multilevel analysis revealed that most of the variance (72%) in the GABA+ data was accounted for by differences between participants within-site, while site-level differences accounted for comparatively more variance (20%) than vendor-level differences (8%). For MM-suppressed GABA data, the variance was distributed equally between site- (50%) and participant-level (50%) differences. The findings show that GABA+ measurements exhibit strong agreement when implemented with a standard protocol. There is, however, increased variability for MM-suppressed GABA measurements that is attributed in part to differences in site-to-site data acquisition. This study’s protocol establishes a framework for future methodological standardization of GABA-edited MRS, while the results provide valuable benchmarks for the MRS community.

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Section: Discussionmentioning

confidence: 99%

Big GABA: Edited MR spectroscopy at 24 research sites

et al. 2017

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“…Several in vivo MRS studies 24,71,78,79 have also reported that the water-to-fat ratio in invasive ductal carcinomas was higher compared with that in benign lesions or normal breast parenchyma. The water-to-fat ratio was also shown to be useful for monitoring the response of breast cancer to neoadjuvant chemotherapy.…”

Section: Differentiation Of Malignant Lesions From Benign Lesions Usimentioning

confidence: 99%

“…As in the diagnostic setting, factors such as poor shimming of the magnetic field, patient motion, and even the presence of gadolinium contrast can limit metabolic quantitative measurements for assessing treatment response …”

Section: Clinical Applicationsmentioning

confidence: 99%

“…The water-to-fat ratio was also shown to be useful for monitoring the response of breast cancer to neoadjuvant chemotherapy. 78,80 In a feasibility study, Freed et al 81 analyzed spectroscopic data to investigate the associations between fatty acid fractions in breast adipose tissue and breast cancer status with further stratification with respect to pre-and postmenopausal status. Monounsaturated fatty acid (MUFA) was significantly lower and saturated fatty acid (SFA) was significantly higher in women with invasive ductal carcinoma than in postmenopausal women with benign tissue.…”

Section: Differentiation Of Malignant Lesions From Benign Lesions Usimentioning

confidence: 99%

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Proton MR spectroscopy in the breast: Technical innovations and clinical applications

Fardanesh

Marino

Avendaño

et al. 2019

Magnetic Resonance Imaging

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Proton magnetic resonance spectroscopy (MRS) is a promising noninvasive diagnostic technique for investigation of breast cancer metabolism. Spectroscopic imaging data may be obtained following contrast‐enhanced MRI by applying the point‐resolved spectroscopy sequence (PRESS) or the stimulated echo acquisition mode (STEAM) sequence from the MR voxel encompassing the breast lesion. Total choline signal (tCho) measured in vivo using either a qualitative or quantitative approach has been used as a diagnostic test in the workup of malignant breast lesions. In addition to tCho metabolites, other relevant metabolites, including multiple lipids, can be detected and monitored. MRS has been heavily investigated as an adjunct to morphologic and dynamic MRI to improve diagnostic accuracy in breast cancer, obviating unnecessary benign biopsies. Besides its use in the staging of breast cancer, other promising applications have been recently investigated, including the assessment of treatment response and therapy monitoring. This review provides guidance on spectroscopic acquisition and quantification methods and highlights current and evolving clinical applications of proton MRS. Level of Evidence 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019.

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“…In particular the levels of PCho appear to increase during cell proliferation . For these reasons the tCho signal was explored as biomarker to monitor response to therapy …”

Section: Introductionmentioning

confidence: 99%

Levels of choline‐containing compounds in normal liver and liver metastases of colorectal cancer as recorded by ¹H MRS

Voert

Heijmen²,

Asten

et al. 2018

NMR in Biomedicine

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Purpose A relatively high signal for choline‐containing compounds (total choline, tCho) is commonly found in 1H MR spectra of malignant tumors, but it is unclear if this also occurs in tumors in the liver. We evaluated the potential of the tCho signal in single voxel 1H MR spectra of the human liver to assess metastases of colorectal cancers. Experiment MR spectra of an 8 cm3 PRESS‐localized voxel were obtained at 3 T from the livers of 12 healthy volunteers and from metastatic lesions in 20 patients in two different sessions. To correct for motion artifacts, sequentially recorded spectra were individually phased and frequency aligned before averaging. Spectra were analyzed using LCModel and tissue levels estimated by water referencing. Repeatability was assessed with Bland–Altman analyses. To estimate tumor necrosis, diffusion‐weighted imaging of the liver was performed. High resolution magic angle spinning (HRMAS) spectra of tumor and normal liver samples were obtained at 11.7 T. Results With increasing tumor volumes, tCho levels decreased, indicating a partial volume effect. Mean tCho content in tumors larger than the PRESS voxel (>8 cm3) was significantly lower (p < 0.01) than for normal liver: 1.6 (range 0.0–3.4) versus 6.9 (range 4.9–11.1) mmol/kg wet weight, while it was comparable for tumors smaller than 8 cm3: 7.0 (range 3.8–9.3) mmol/kg. The higher 90th percentile apparent diffusion coefficient value in the larger lesions indicates more necrosis. Measurement repeatability was average in normal livers and poor in tumors. HRMAS did not show substantial differences in choline‐containing compounds between normal liver and metastasis. Conclusion An increased tCho content was not observed in 1H MR spectra of liver metastasis of colorectal cancer, compared with normal liver. This may be due to the background of a high tCho signal in spectra of normal liver or to an intrinsic lower tCho content in these tumors, but is most likely the result of necrosis in metastatic tumor tissue.

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MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial

Cited by 49 publications

References 35 publications

Big GABA: Edited MR spectroscopy at 24 research sites

Big GABA: Edited MR spectroscopy at 24 research sites

Proton MR spectroscopy in the breast: Technical innovations and clinical applications

Levels of choline‐containing compounds in normal liver and liver metastases of colorectal cancer as recorded by ¹H MRS

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MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial

Cited by 49 publications

References 35 publications

Big GABA: Edited MR spectroscopy at 24 research sites

Big GABA: Edited MR spectroscopy at 24 research sites

Proton MR spectroscopy in the breast: Technical innovations and clinical applications

Levels of choline‐containing compounds in normal liver and liver metastases of colorectal cancer as recorded by 1H MRS

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Product

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Levels of choline‐containing compounds in normal liver and liver metastases of colorectal cancer as recorded by ¹H MRS