Study of lipid metabolism by estimating the fat fraction in different breast tissues and in various breast tumor sub-types by in vivo 1 H MR spectroscopy

Agarwal, Khushbu; Sharma, Uma; Mathur, Sandeep; Seenu, V.; Parshad, Rajinder; Jagannathan, Naranamangalam R.

doi:10.1016/j.mri.2018.02.004

Cited by 18 publications

(23 citation statements)

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“…These yielded promising results. More recent studies reported that the L13 + L16 peak or fat fraction is significantly smaller in malignant lesions than in normal breast tissue. While these studies observed no significant difference in water/fat ratios in benign lesions and normal parenchyma, the AUC of the water/fat ratio was significantly higher in malignant lesions, reflecting lower L13 peak area and increased tumor tissue water levels.…”

Section: Discussionmentioning

confidence: 96%

“…This may provide an additional imaging biomarker for breast cancer diagnosis, characterization, and prognosis, with the ultimate goal of implementation in clinical routine. At higher field strengths, ie, 3 T and 7 T, an improved assessment of L21, L23, L41, and L43 peaks with higher signal sensitivity and more accurate calculation of saturate and unsaturated fatty acid fractions would be facilitated; therefore, prospective studies at higher field strengths are warranted to validate these results. In addition, these metabolites relate to obesity that has been linked to cancer development .…”

Section: Discussionmentioning

confidence: 99%

“…However, in addition to Cho metabolites, other relevant metabolites including lipids can be detected and monitored with 1 H‐MRS. Initial ex vivo and in vivo MRS studies demonstrated differences in fat and water between malignant, benign, and normal tissue, showing that cancerous tissue display higher water concentrations and lower methylene lipid peaks at 1.3 ppm …”

mentioning

confidence: 99%

“…Initial ex vivo and in vivo MRS studies demonstrated differences in fat and water between malignant, benign, and normal tissue, showing that cancerous tissue display higher water concentrations and lower methylene lipid peaks at 1.3 ppm. 21,[23][24][25][26][27] So far, although most of the research on lipid metabolites has focused on the detection of the 1.3 ppm lipid peaks from in vivo MRS, a whole spectrum of 9-10 lipid peaks with different chemical shifts can also be detected with MRS. 28 A few studies have looked at L21, L23, and L28 resonances in the adipose tissue in breast controls 29 and contralateral breast adipose tissue in breast cancer patients. 8 Thus, we hypothesized that through the noninvasive quantitative assessment of lipid metabolism with 1 H-MRS, insights into tumor biology are feasible that might be useful for breast cancer diagnosis, characterization, and prognosis.…”

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confidence: 99%

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Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis

Thakur

Horvat

Hancu

et al. 2019

Magnetic Resonance Imaging

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Background Breast magnetic resonance spectroscopy (1H‐MRS) has been largely based on choline metabolites; however, other relevant metabolites can be detected and monitored. Purpose To investigate whether lipid metabolite concentrations detected with 1H‐MRS can be used for the noninvasive differentiation of benign and malignant breast tumors, differentiation among molecular breast cancer subtypes, and prediction of long‐term survival outcomes. Study Type Retrospective. Subjects In all, 168 women, aged ≥18 years. Field Strength/Sequence Dynamic contrast‐enhanced MRI at 1.5 T: sagittal 3D spoiled gradient recalled sequence with fat saturation, flip angle = 10°, repetition time / echo time (TR/TE) = 7.4/4.2 msec, slice thickness = 3.0 mm, field of view (FOV) = 20 cm, and matrix size = 256 × 192. 1H‐MRS: PRESS with TR/TE = 2000/135 msec, water suppression, and 128 scan averages, in addition to 16 reference scans without water suppression. Assessment MRS quantitative analysis of lipid resonances using the LCModel was performed. Histopathology was the reference standard. Statistical Tests Categorical data were described using absolute numbers and percentages. For metric data, means (plus 95% confidence interval [CI]) and standard deviations as well as median, minimum, and maximum were calculated. Due to skewed data, the latter were more adequate; unpaired Mann–Whitney U‐tests were performed to compare groups without and with Bonferroni correction. ROC analyses were also performed. Results There were 111 malignant and 57 benign lesions. Mean voxel size was 4.4 ± 4.6 cm3. Six lipid metabolite peaks were quantified: L09, L13 + L16, L21 + L23, L28, L41 + L43, and L52 + L53. Malignant lesions showed lower L09, L21 + L23, and L52 + L53 than benign lesions (P = 0.022, 0.027, and 0.0006). Similar results were observed for Luminal A or Luminal A/B vs. other molecular subtypes. At follow‐up, patients were split into two groups based on median values for the six peaks; recurrence‐free survival was significantly different between groups for L09, L21 + L23, and L28 (P = 0.0173, 0.0024, and 0.0045). Data Conclusion Quantitative in vivo 1H‐MRS assessment of lipid metabolism may provide an additional noninvasive imaging biomarker to guide therapeutic decisions in breast cancer. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:239–249.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis

Thakur

Horvat

Hancu

et al. 2019

Magnetic Resonance Imaging

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“…In an in vivo study, Agarwal et al studied lipid metabolism by estimating the fat fraction in different breast tissues and in various breast tumor subtypes using 1 H‐MRS. They reported a significantly lower fat fraction in malignant lesions (median 0.12; range 0.01–0.70) compared with benign lesions (median 0.28; range 0.02–0.71) and normal breast tissue (median 0.39; range 0.06–0.76).…”

Section: Clinical Applicationsmentioning

confidence: 99%

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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MR spectroscopy in breast cancer metabolomics

Sharma

Jagannathan

2021

Analytical Science Advances

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Breast cancer poses a significant health care challenge worldwide requiring early detection and effective treatment strategies for better patient outcome. A deeper understanding of the breast cancer biology and metabolism may help developing better diagnostic and therapeutic approaches. Metabolomic studies give a comprehensive analysis of small molecule metabolites present in human tissues in vivo. The changes in the level of these metabolites provide information on the complex mechanism of the development of the disease and its progression. Metabolomic approach using analytical techniques such as magnetic resonance spectroscopy (MRS) has evolved as an important tool for identifying clinically relevant metabolic biomarkers. The metabolic characterization of breast lesions using in-vivo MRS has shown that malignant breast tissues contain elevated levels of choline containing compounds (tCho), suggesting rapid proliferation of cancer cells and alterations in membrane metabolism. Also, tCho has been identified as one of the important biomarkers that help to enhance the diagnostic accuracy of dynamic contrast enhanced magnetic resonance imaging and also for monitoring treatment response. Further, metabolome of malignant tissues can be studied using ex vivo and in vitro MRS at high magnetic fields. This provided the advantage of detection of a large number of compounds that facilitated more comprehensive insight into the altered metabolic pathways associated with the cancer development and progression and also in identification of several metabolites as potential biomarkers. This article briefly reviews the role of MRS based metabolic profiling in the discovery of biomarkers and understanding of the altered metabolism in breast cancer. K E Y W O R D Sbiomarker, breast cancer, ex vivo, in vitro, in vivo, in vivo magnetic resonance spectroscopy (MRS), metabolomics, therapeutic response INTRODUCTIONBreast cancer is a major healthcare concern for women globally. 1 Early diagnosis of breast cancer plays an important role in effective therapeutic management and in improving survival and quality-of-life. The radiological imaging techniques such as mammography and ultrasoundThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Study of lipid metabolism by estimating the fat fraction in different breast tissues and in various breast tumor sub-types by in vivo 1 H MR spectroscopy

Cited by 18 publications

References 40 publications

Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis

Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis

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

MR spectroscopy in breast cancer metabolomics

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