In vivo MR spectroscopy for breast cancer diagnosis

Abstract

Breast cancer is a significant health concern in females, worldwide. In vivo proton (1H) MR spectroscopy (MRS) has evolved as a non-invasive tool for diagnosis and for biochemical characterization of breast cancer. Water-to-fat ratio, fat and water fractions and choline containing compounds (tCho) have been identified as diagnostic biomarkers of malignancy. Detection of tCho in normal breast tissue of volunteers and in lactating females limits the use of tCho as a diagnostic marker. Technological developments like high-field scanners, multi channel coils, pulse sequences with water and fat suppression facilitated easy detection of tCho. Also, quantification of tCho and its cut-off for objective assessment of malignancy have been reported. Meta-analysis of in vivo 1H MRS studies have documented the pooled sensitivities and the specificities in the range of 71–74% and 78–88%, respectively. Inclusion of MRS has been shown to enhance the diagnostic specificity of MRI, however, detection of tCho in small sized lesions (≤1 cm) is challenging even at high magnetic fields. Potential of MRS in monitoring the effect of chemotherapy in breast cancer has also been reported. This review briefly presents the potential clinical role of in vivo 1H MRS in the diagnosis of breast cancer, its current status and future developments.

The contribution of the 1H-MRS lipid signal to cervical cancer prognosis: a preliminary study

“…As a result of these metabolic changes, high PCho and tCho content is often observed in actively growing tumours. With limitations due to poor sensitivity, tCho have been identified as diagnostic biomarkers of malignancy in prostate, breast and brain cancer and as predictors of tumour aggressiveness in breast cancer [31][32][33][34]. These authors found an association of tCho levels with higher grading, higher Ki-67 value and large-sized lesions.…”

Fat Composition Measured by Proton Spectroscopy: A Breast Cancer Tumor Marker?

“…Invasive carcinomas are high in water content with very low levels of lipid when compared to normal fibroglandular tissue. Generally, however, such parameters had limited diagnostic utility due to significant overlap between benign and malignant lesions, and to the variability of water content, which is dependent on breast composition and menstrual cycle [ 26 ].…”

Advanced Magnetic Resonance Imaging Modalities for Breast Cancer Diagnosis: An Overview of Recent Findings and Perspectives

“…Numerous studies have shown that incorporating MRS into routine breast MR examinations enhances diagnostic performance and decreases the probability of needless biopsies. MRS has sufficient sensitivity of 71–74% and specificity of 78–88% for differentiating benign from malignant lesions [ 92 , 93 , 94 ]. Numerous findings have established a link between raised tCho concentrations and biologically aggressive cancer characteristics attributed to high grade, large dimensions, and a high Ki67 proliferation rate [ 95 ].…”