1
|
Sharma U, Jagannathan NR. In vivo MR spectroscopy for breast cancer diagnosis. BJR Open 2019; 1:20180040. [PMID: 33178927 PMCID: PMC7592438 DOI: 10.1259/bjro.20180040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/02/2019] [Accepted: 06/14/2019] [Indexed: 12/23/2022] Open
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.
Collapse
Affiliation(s)
- Uma Sharma
- Department of NMR & MRI Facility, All India Institute of Medical Sciences , New Delhi, India
| | | |
Collapse
|
2
|
Abstract
Continued progress is being made in understanding the breast cancer metabolism using analytical magnetic resonance (MR)-based methods like nuclear magnetic resonance (NMR) and in-vivo MR spectroscopy (MRS). Analyses using these methods have enhanced the knowledge of altered biochemical pathways associated with breast cancer progression, regression, and pathogenesis. Comprehensive metabolic profiling of biological samples like tissues, cell lines, fine needle aspirate, and biofluids such as sera and urine enables identification of new biomarkers and abnormalities in biochemical pathways. These methods are not only useful for diagnosis, therapy monitoring, disease progression, and staging of cancer but also for the identification of new therapeutic targets and designing new treatment strategies. Additionally, in-vivo MRS studies have established choline-containing compounds (tCho) as biomarkers of malignancy, which is useful for enhancing the diagnostic specificity of magnetic resonance imaging (MRI). Recent technological developments related to in-vivo MRS such as increased magnetic field strength, multichannel phased array breast coils, and absolute quantification of tCho have provided a better understanding of the tumor heterogeneity, metabolism, and pathogenesis. This chapter focuses on providing the experimental aspects of in-vitro, ex-vivo, and in-vivo MR spectroscopy methods used for metabolomics studies of breast cancer.
Collapse
Affiliation(s)
- Uma Sharma
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India
| | | |
Collapse
|
3
|
Abstract
Magnetic resonance spectroscopy (MRS) can be performed in vivo using commercial MRI systems to obtain biochemical information about tissues and cancers. Applications in brain, prostate and breast aid lesion detection and characterisation (differential diagnosis), treatment planning and response assessment. Multi-centre clinical trials have been performed in all these tissues. Single centre studies have been performed in many other tissues including cervix, uterus, musculoskeletal and liver. While generally MRS is used to study endogenous metabolites it has also been used in drug studies, for example those that include 19F as part of their structure. Recently the hyperpolarisation of compounds enriched with 13C such as [1-13C] pyruvate has been demonstrated in animal models and now in preliminary clinical studies, permitting the monitoring of biochemical processes with unprecedented sensitivity. This review briefly introduces the underlying methods and then discusses the current status of these applications.
Collapse
Affiliation(s)
- Geoffrey S Payne
- University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, United Kingdom
| |
Collapse
|
4
|
van der Kemp WJ, Stehouwer BL, Boer VO, Luijten PR, Klomp DW, Wijnen JP. Proton and phosphorus magnetic resonance spectroscopy of the healthy human breast at 7 T. NMR IN BIOMEDICINE 2017; 30:e3684. [PMID: 28032377 PMCID: PMC5248643 DOI: 10.1002/nbm.3684] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 05/18/2023]
Abstract
In vivo water- and fat-suppressed 1 H magnetic resonance spectroscopy (MRS) and 31 P magnetic resonance adiabatic multi-echo spectroscopic imaging were performed at 7 T in duplicate in healthy fibroglandular breast tissue of a group of eight volunteers. The transverse relaxation times of 31 P metabolites were determined, and the reproducibility of 1 H and 31 P MRS was investigated. The transverse relaxation times for phosphoethanolamine (PE) and phosphocholine (PC) were fitted bi-exponentially, with an added short T2 component of 20 ms for adenosine monophosphate, resulting in values of 199 ± 8 and 239 ± 14 ms, respectively. The transverse relaxation time for glycerophosphocholine (GPC) was also fitted bi-exponentially, with an added short T2 component of 20 ms for glycerophosphatidylethanolamine, which resonates at a similar frequency, resulting in a value of 177 ± 6 ms. Transverse relaxation times for inorganic phosphate, γ-ATP and glycerophosphatidylcholine mobile phospholipid were fitted mono-exponentially, resulting in values of 180 ± 4, 19 ± 3 and 20 ± 4 ms, respectively. Coefficients of variation for the duplicate determinations of 1 H total choline (tChol) and the 31 P metabolites were calculated for the group of volunteers. The reproducibility of inorganic phosphate, the sum of phosphomonoesters and the sum of phosphodiesters with 31 P MRS imaging was superior to the reproducibility of 1 H MRS for tChol. 1 H and 31 P data were combined to calculate estimates of the absolute concentrations of PC, GPC and PE in healthy fibroglandular tissue, resulting in upper limits of 0.1, 0.1 and 0.2 mmol/kg of tissue, respectively.
Collapse
Affiliation(s)
| | | | - Vincent O. Boer
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Peter R. Luijten
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Dennis W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Jannie P. Wijnen
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| |
Collapse
|
5
|
Bolan PJ, Kim E, Herman BA, Newstead GM, Rosen MA, Schnall MD, Pisano ED, Weatherall PT, Morris EA, Lehman CD, Garwood M, Nelson MT, Yee D, Polin SM, Esserman LJ, Gatsonis CA, Metzger GJ, Newitt DC, Partridge SC, Hylton NM. MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial. J Magn Reson Imaging 2016; 46:290-302. [PMID: 27981651 DOI: 10.1002/jmri.25560] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/01/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To estimate the accuracy of predicting response to neoadjuvant chemotherapy (NACT) in patients with locally advanced breast cancer using MR spectroscopy (MRS) measurements made very early in treatment. MATERIALS AND METHODS This prospective Health Insurance Portability and Accountability Act (HIPAA)-compliant protocol was approved by the American College of Radiology and local-site institutional review boards. One hundred nineteen women with invasive breast cancer of ≥3 cm undergoing NACT were enrolled between September 2007 and April 2010. MRS measurements of the concentration of choline-containing compounds ([tCho]) were performed before the first chemotherapy regimen (time point 1, TP1) and 20-96 h after the first cycle of treatment (TP2). The change in [tCho] was assessed for its ability to predict pathologic complete response (pCR) and radiologic response using the area under the receiver operating characteristic curve (AUC) and logistic regression models. RESULTS Of the 119 subjects enrolled, only 29 cases (24%) with eight pCRs provided usable data for the primary analysis. Technical challenges in acquiring quantitative MRS data in a multi-site trial setting limited the capture of usable data. In this limited data set, the decrease in tCho from TP1 to TP2 had poor ability to predict either pCR (AUC = 0.53, 95% confidence interval [CI]: 0.27-0.79) or radiologic response (AUC = 0.51, 95% CI: 0.27-0.75). CONCLUSION The technical difficulty of acquiring quantitative MRS data in a multi-site clinical trial setting led to a low yield of analyzable data, which was insufficient to accurately measure the ability of early MRS measurements to predict response to NACT. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:290-302.
Collapse
Affiliation(s)
- Patrick J Bolan
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Eunhee Kim
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA.,American College of Radiology Imaging Network (ACRIN), Philadelphia, Pennsylvania, USA
| | - Benjamin A Herman
- American College of Radiology Imaging Network (ACRIN), Philadelphia, Pennsylvania, USA.,Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | | | - Mark A Rosen
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mitchell D Schnall
- American College of Radiology Imaging Network (ACRIN), Philadelphia, Pennsylvania, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Etta D Pisano
- Department of Radiology, Medical College of South Carolina, Charleston, South Carolina, USA
| | - Paul T Weatherall
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Constance D Lehman
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael Garwood
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael T Nelson
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Douglas Yee
- Masonic Cancer Center and Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sandra M Polin
- Washington Radiology Associates, P.C., Fairfax, Virginia, USA
| | - Laura J Esserman
- Department of Surgery, University of California, San Francisco, California, USA
| | - Constantine A Gatsonis
- American College of Radiology Imaging Network (ACRIN), Philadelphia, Pennsylvania, USA.,Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Gregory J Metzger
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - David C Newitt
- Department of Radiology, University of California, San Francisco, California, USA
| | | | - Nola M Hylton
- Department of Radiology, University of California, San Francisco, California, USA
| | | |
Collapse
|
6
|
Faeghi F, Baniasadipour B, Jalalshokouhi J. Comparative Investigation of Single Voxel Magnetic Resonance Spectroscopy and Dynamic Contrast Enhancement MR Imaging in Differentiation of Benign and Malignant Breast Lesions in a Sample of Iranian Women. Asian Pac J Cancer Prev 2016; 16:8335-8. [PMID: 26745081 DOI: 10.7314/apjcp.2015.16.18.8335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To make a comparison of single voxel magnetic resonance spectroscopy (SV-MRS) and dynamic contrast enhancement (DCE) MRI for differentiation of benign and malignant breast lesions in a sample of Iranian women. MATERIALS AND METHODS A total of 30 women with abnormal breast lesions detected in mammography, ultrasound, or clinical breast exam were examined with DCE and SV-MRS. tCho (total choline) resonance in MRS spectra was qualitatively evaluated and detection of a visible tCho peak at 3.2 ppm was defined as a positive finding for malignancy. Different types of DCE curves were persistent (type 1), plateau (type 2), and washout (type 3). At first, lesions were classified according to choline findings and types of DCE curve, finally being compared to pathological results as the standard reference. RESULTS this study included 19 patients with malignant lesions and 11 patients with benign ones. While 63.6 % of benign lesions (7 of 11) showed type 1 DCE curves and 36.4% (4 of 11) showed type 2, 57.9% (11of 19) of malignant lesions were type 3 and 42.1% (8 of 19) type 2. Choline peaks were detected in 18 of 19 malignant lesions and in 3 of 11 benign counterparts. 1 malignant and 8 benign cases did not show any visible resonance at 3.2 ppm so SV-MRS featured 94.7% sensitivity, 72.7 % specificity and 86.7% accuracy. CONCLUSIONS The present findings indicate that a combined approach using MRS and DCE MRI can improve the specificity of MRI for differentiation of benign and malignant breast lesions.
Collapse
Affiliation(s)
- Fariborz Faeghi
- Radiology Technology Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
| | | | | |
Collapse
|
7
|
Gajdošík M, Chadzynski GL, Hangel G, Mlynárik V, Chmelík M, Valkovič L, Bogner W, Pohmann R, Scheffler K, Trattnig S, Krššák M. Ultrashort-TE stimulated echo acquisition mode (STEAM) improves the quantification of lipids and fatty acid chain unsaturation in the human liver at 7 T. NMR IN BIOMEDICINE 2015; 28:1283-1293. [PMID: 26313737 DOI: 10.1002/nbm.3382] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/15/2015] [Accepted: 07/24/2015] [Indexed: 06/04/2023]
Abstract
Ultrahigh-field, whole-body MR systems increase the signal-to-noise ratio (SNR) and improve the spectral resolution. Sequences with a short TE allow fast signal acquisition with low signal loss as a result of spin-spin relaxation. This is of particular importance in the liver for the precise quantification of the hepatocellular content of lipids (HCL). In this study, we introduce a spoiler Gradient-switching Ultrashort STimulated Echo AcqUisition (GUSTEAU) sequence, which is a modified version of a stimulated echo acquisition mode (STEAM) sequence, with a minimum TE of 6 ms. With the high spectral resolution at 7 T, the efficient elimination of water sidebands and the post-processing suppression of the water signal, we estimated the composition of fatty acids (FAs) via the detection of the olefinic lipid resonance and calculated the unsaturation index (UI) of hepatic FAs. The performance of the GUSTEAU sequence for the assessment of UI was validated against oil samples and provided excellent results in agreement with the data reported in the literature. When measuring HCL with GUSTEAU in 10 healthy volunteers, there was a high correlation between the results obtained at 7 and 3 T (R(2) = 0.961). The test-retest measurements yielded low coefficients of variation for HCL (4 ± 3%) and UI (11 ± 8%) when measured with the GUSTEAU sequence at 7 T. A negative correlation was found between UI and HCL (n = 10; p < 0.033). The ultrashort TE MRS sequence (GUSTEAU; TE = 6 ms) provided high repeatability for the assessment of HCL. The improved spectral resolution at 7 T with the elimination of water sidebands and the offline water subtraction also enabled an assessment of the unsaturation of FAs. This all highlights the potential use of this MRS acquisition scheme for studies of hepatic lipid composition in vivo.
Collapse
Affiliation(s)
- Martin Gajdošík
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Grzegorz L Chadzynski
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Gilbert Hangel
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Vladimír Mlynárik
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Marek Chmelík
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ladislav Valkovič
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Wolfgang Bogner
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rolf Pohmann
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Klaus Scheffler
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
- High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Siegfried Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Martin Krššák
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
8
|
Soares AF, Lei H, Gruetter R. Characterization of hepatic fatty acids in mice with reduced liver fat by ultra-short echo time (1)H-MRS at 14.1 T in vivo. NMR IN BIOMEDICINE 2015; 28:1009-1020. [PMID: 26119835 DOI: 10.1002/nbm.3345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 06/04/2023]
Abstract
Alterations in the hepatic lipid content (HLC) and fatty acid composition are associated with disruptions in whole body metabolism, both in humans and in rodent models, and can be non-invasively assessed by (1)H-MRS in vivo. We used (1)H-MRS to characterize the hepatic fatty-acyl chains of healthy mice and to follow changes caused by streptozotocin (STZ) injection. Using STEAM at 14.1 T with an ultra-short TE of 2.8 ms, confounding effects from T2 relaxation and J-coupling were avoided, allowing for accurate estimations of the contribution of unsaturated (UFA), saturated (SFA), mono-unsaturated (MUFA) and poly-unsaturated (PUFA) fatty-acyl chains, number of double bonds, PU bonds and mean chain length. Compared with in vivo (1) H-MRS, high resolution NMR performed in vitro in hepatic lipid extracts reported longer fatty-acyl chains (18 versus 15 carbons) with a lower contribution from UFA (61 ± 1% versus 80 ± 5%) but a higher number of PU bonds per UFA (1.39 ± 0.03 versus 0.58 ± 0.08), driven by the presence of membrane species in the extracts. STZ injection caused a decrease of HLC (from 1.7 ± 0.3% to 0.7 ± 0.1%), an increase in the contribution of SFA (from 21 ± 2% to 45 ± 6%) and a reduction of the mean length (from 15 to 13 carbons) of cytosolic fatty-acyl chains. In addition, SFAs were also likely to have increased in membrane lipids of STZ-induced diabetic mice, along with a decrease of the mean chain length. These studies show the applicability of (1)H-MRS in vivo to monitor changes in the composition of the hepatic fatty-acyl chains in mice even when they exhibit reduced HLC, pointing to the value of this methodology to evaluate lipid-lowering interventions in the scope of metabolic disorders.
Collapse
Affiliation(s)
- Ana Francisca Soares
- Laboratory for Functional and Metabolic Imaging (LIFMET), École Polytechinque Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Hongxia Lei
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Department of Radiology, University of Geneva (UNIGE), Geneva, Switzerland
| | - Rolf Gruetter
- Laboratory for Functional and Metabolic Imaging (LIFMET), École Polytechinque Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Radiology, University of Geneva (UNIGE), Geneva, Switzerland
- Department of Radiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
9
|
Belkić K, Belkić D. Optimized spectral analysis in magnetic resonance spectroscopy for early tumor diagnostics. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/1742-6596/565/1/012002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
10
|
Belkić D, Belkić K. Proof-of-the-Concept Study on Mathematically Optimized Magnetic Resonance Spectroscopy for Breast Cancer Diagnostics. Technol Cancer Res Treat 2014; 14:277-97. [DOI: 10.1177/1533034614547446] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 06/25/2014] [Indexed: 12/22/2022] Open
Abstract
Magnetic resonance (MR)-based modalities aid breast cancer detection without exposure to ionizing radiation. Magnetic resonance imaging is very sensitive but costly and insufficiently specific. Molecular imaging through magnetic resonance spectroscopy (MRS) can provide information about key metabolites. Here, the measured/encoded time signals cannot be interpreted directly, necessitating mathematics for mapping to the more manageable frequency domain. Conventional applications of MRS are hampered by data analysis via the fast Fourier transform (FFT) and postprocessing by fitting techniques. Most in vivo MRS studies on breast cancer rely upon estimations of total choline (tCHO). These have yielded only incremental improvements in diagnostic accuracy. In vitro studies reveal richer metabolic information for identifying breast cancer, particularly in closely overlapping components of tCHO. Among these are phosphocholine (PC), a marker of malignant transformation of the breast. The FFT cannot assess these congested spectral components. This can be done by the fast Padé transform (FPT), a high-resolution, quantification-equipped method, which we presently apply to noisy MRS time signals consistent with those encoded in breast cancer. The FPT unequivocally and robustly extracted the concentrations of all physical metabolites, including PC. In sharp contrast, the FFT produced a rough envelope spectrum with a few distorted peaks and key metabolites absent altogether. As such, the FFT has poor resolution for these typical MRS time signals from breast cancer. Hence, based on Fourier-estimated envelope spectra, tCHO estimates are unreliable. Using even truncated time signals, the FPT clearly distinguishes noise from true metabolites whose concentrations are accurately extracted. The high resolution of the FPT translates directly into shortened examination time of the patient. These capabilities strongly suggest that by applying the FPT to time signals encoded in vivo from the breast, MRS will, at last, fulfill its potential to become a clinically reliable, cost-effective method for breast cancer detection, including screening/surveillance.
Collapse
Affiliation(s)
- Dževad Belkić
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - Karen Belkić
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA
- Institute for Prevention Research, Keck School of Medicine, University of Southern California, Alhambra, CA, USA
| |
Collapse
|
11
|
Prescot AP, Shi X, Choi C, Renshaw PF. In vivo T(2) relaxation time measurement with echo-time averaging. NMR IN BIOMEDICINE 2014; 27:863-869. [PMID: 24865447 PMCID: PMC4572890 DOI: 10.1002/nbm.3115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 02/04/2014] [Accepted: 03/11/2014] [Indexed: 05/29/2023]
Abstract
The accuracy of metabolite concentrations measured using in vivo proton ((1) H) MRS is enhanced following correction for spin-spin (T2 ) relaxation effects. In addition, metabolite proton T2 relaxation times provide unique information regarding cellular environment and molecular mobility. Echo-time (TE) averaging (1) H MRS involves the collection and averaging of multiple TE steps, which greatly simplifies resulting spectra due to the attenuation of spin-coupled and macromolecule resonances. Given the simplified spectral appearance and inherent metabolite T2 relaxation information, the aim of the present proof-of-concept study was to develop a novel data processing scheme to estimate metabolite T2 relaxation times from TE-averaged (1) H MRS data. Spectral simulations are used to validate the proposed TE-averaging methods for estimating methyl proton T2 relaxation times for N-acetyl aspartate, total creatine, and choline-containing compounds. The utility of the technique and its reproducibility are demonstrated using data obtained in vivo from the posterior-occipital cortex of 10 healthy control subjects. Compared with standard methods, distinct advantages of this approach include built-in macromolecule resonance attenuation, in vivo T2 estimates closer to reported values when maximum TE ≈ T2 , and the potential for T2 calculation of metabolite resonances otherwise inseparable in standard (1) H MRS spectra recorded in vivo.
Collapse
Affiliation(s)
- Andrew P. Prescot
- Brain Institute, University of Utah, Salt Lake City, UT, USA
- Department of Radiology, University of Utah School of Medicine, Salt lake City, UT, USA
| | - Xianfeng Shi
- Brain Institute, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah School of Medicine, Salt lake City, UT, USA
| | - Changho Choi
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Perry. F. Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah School of Medicine, Salt lake City, UT, USA
- VISN 19 MIRECC, Salt Lake City, UT, USA
| |
Collapse
|
12
|
Wijnen JP, Jiang L, Greenwood TR, van der Kemp WJM, Klomp DWJ, Glunde K. 1H/31P polarization transfer at 9.4 Tesla for improved specificity of detecting phosphomonoesters and phosphodiesters in breast tumor models. PLoS One 2014; 9:e102256. [PMID: 25036036 PMCID: PMC4103808 DOI: 10.1371/journal.pone.0102256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 06/17/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the ability of a polarization transfer (PT) magnetic resonance spectroscopy (MRS) technique to improve the detection of the individual phospholipid metabolites phosphocholine (PC), phosphoethanolamine (PE), glycerophosphocholine (GPC), and glycerophosphoethanolamine (GPE) in vivo in breast tumor xenografts. MATERIALS AND METHODS The adiabatic version of refocused insensitive nuclei enhanced by polarization transfer (BINEPT) MRS was tested at 9.4 Tesla in phantoms and animal models. BINEPT and pulse-acquire (PA) 31P MRS was acquired consecutively from the same orthotopic MCF-7 (n = 10) and MDA-MB-231 (n = 10) breast tumor xenografts. After in vivo MRS measurements, animals were euthanized, tumors were extracted and high resolution (HR)-MRS was performed. Signal to noise ratios (SNRs) and metabolite ratios were compared for BINEPT and PA MRS, and were also measured and compared with that from HR-MRS. RESULTS BINEPT exclusively detected metabolites with 1H-31P coupling such as PC, PE, GPC, and GPE, thereby creating a significantly improved, flat baseline because overlapping resonances from immobile and partly mobile phospholipids were removed without loss of sensitivity. GPE and GPC were more accurately detected by BINEPT in vivo, which enabled a reliable quantification of metabolite ratios such as PE/GPE and PC/GPC, which are important markers of tumor aggressiveness and treatment response. CONCLUSION BINEPT is advantageous over PA for detecting and quantifying the individual phospholipid metabolites PC, PE, GPC, and GPE in vivo at high magnetic field strength. As BINEPT can be used clinically, alterations in these phospholipid metabolites can be assessed in vivo for cancer diagnosis and treatment monitoring.
Collapse
Affiliation(s)
- Jannie P. Wijnen
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Lu Jiang
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Tiffany R. Greenwood
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | | | - Dennis W. J. Klomp
- Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Kristine Glunde
- Johns Hopkins University In vivo Cellular and Molecular Imaging Center, The Russell H. Morgan Department of Radiology and Radiological Science, Division of Cancer Imaging Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Sidney Kimmel Comprehensive Cancer, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| |
Collapse
|
13
|
Corum CA, Idiyatullin D, Snyder CJ, Garwood M. Gap cycling for SWIFT. Magn Reson Med 2014; 73:677-82. [PMID: 24604286 DOI: 10.1002/mrm.25141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/27/2013] [Accepted: 01/02/2014] [Indexed: 11/05/2022]
Abstract
PURPOSE SWIFT (SWeep Imaging with Fourier Transformation) is a non-Cartesian MRI method with unique features and capabilities. In SWIFT, radiofrequency (RF) excitation and reception are performed nearly simultaneously, by rapidly switching between transmit and receive during a frequency-swept RF pulse. Because both the transmitted pulse and data acquisition are simultaneously amplitude-modulated in SWIFT (in contrast to continuous RF excitation and uninterrupted data acquisition in more familiar MRI sequences), crosstalk between different frequency bands occurs in the data. This crosstalk leads to a "bulls-eye" artifact in SWIFT images. We present a method to cancel this interband crosstalk by cycling the pulse and receive gap positions relative to the un-gapped pulse shape. We call this strategy "gap cycling." THEORY AND METHODS We carry out theoretical analysis, simulation and experiments to characterize the signal chain, resulting artifacts, and their elimination for SWIFT. RESULTS Theoretical analysis reveals the mechanism for gap-cycling's effectiveness in canceling interband crosstalk in the received data. We show phantom and in vivo results demonstrating bulls-eye artifact free images. CONCLUSION Gap cycling is an effective method to remove bulls-eye artifact resulting from interband crosstalk in SWIFT data.
Collapse
Affiliation(s)
- Curtis A Corum
- Center for Magnetic Resonance Research, Department of Radiology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | | |
Collapse
|
14
|
Inazu M. Choline transporter-like proteins CTLs/SLC44 family as a novel molecular target for cancer therapy. Biopharm Drug Dispos 2014; 35:431-49. [PMID: 24532461 DOI: 10.1002/bdd.1892] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 01/31/2014] [Accepted: 02/07/2014] [Indexed: 12/13/2022]
Abstract
Choline is essential for the synthesis of the major membrane phospholipid phosphatidylcholine (PC), the methyl donor betaine and the neurotransmitter acetylcholine (ACh). Elevated levels of choline and up-regulated choline kinase activity have been detected in various cancers. Thus, the intracellular accumulation of choline through choline transporters is the rate-limiting step in phospholipid metabolism and a prerequisite for cancer cell proliferation. Previous studies have demonstrated abnormalities in choline uptake and choline phospholipid metabolism in cancer cells using the imaging of cancer with positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). The aberrant choline metabolism in cancer cells is strongly correlated with their malignant progression. Using quantitative real-time PCR, the mRNA expression of choline transporters was measured, and it was found that choline transporter-like proteins CTLs/SLC44 family are highly expressed in various cancer cell lines. Choline uptake through CTLs is associated with cell viability, and the functional inhibition of CTLs could promote apoptotic cell death. Furthermore, non-neuronal cholinergic systems that include CTLs-mediated choline transport are associated with cell proliferation and their inhibition promotes apoptotic cell death in colon cancer, small cell lung cancer and human leukemic T-cells. The identification of this new CTLs-mediated choline transport system provides a potential new target for cancer therapy.
Collapse
Affiliation(s)
- Masato Inazu
- Institute of Medical Science, Department of Molecular Preventive Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
15
|
Feasibility of MR spectroscopy for characterizing malignant breast lesions using a clinical 3-T scanner. Breast Cancer 2014; 22:510-9. [DOI: 10.1007/s12282-013-0514-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
|
16
|
Novel functional magnetic resonance imaging biomarkers for assessing response to therapy in hepatocellular carcinoma. Clin Transl Oncol 2013; 16:599-605. [PMID: 24356932 DOI: 10.1007/s12094-013-1147-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/26/2013] [Indexed: 12/19/2022]
Abstract
The established and adapted image biomarkers based on size for tumor burden measurement continue to be applied to hepatocellular carcinoma (HCC) as size measurement can easily be used in clinical practice. However, in the setting of novel targeted therapies and liver directed treatments, simple tumor anatomical changes can be less informative and usually appear later than biological changes. Functional magnetic resonance imaging (MRI) has a potential to be a promising technique for assessment of HCC response to therapy. In this review, we discuss various functional MRI biomarkers that play an increasingly important role in evaluation of HCC response after treatment.
Collapse
|
17
|
Ramadan S, Lin A, Stanwell P. Glutamate and glutamine: a review of in vivo MRS in the human brain. NMR IN BIOMEDICINE 2013; 26:1630-46. [PMID: 24123328 PMCID: PMC3849600 DOI: 10.1002/nbm.3045] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/08/2013] [Accepted: 09/08/2013] [Indexed: 05/21/2023]
Abstract
Our understanding of the roles that the amino acids glutamate (Glu) and glutamine (Gln) play in the mammalian central nervous system has increased rapidly in recent times. Many conditions are known to exhibit a disturbance in Glu-Gln equilibrium, and the exact relationships between these changed conditions and these amino acids are not fully understood. This has led to increased interest in Glu/Gln quantitation in the human brain in an array of conditions (e.g. mental illness, tumor, neuro-degeneration) as well as in normal brain function. Accordingly, this review has been undertaken to describe the increasing number of in vivo techniques available to study Glu and Gln separately, or pooled as 'Glx'. The present MRS methods used to assess Glu and Gln vary in approach, complexity, and outcome, thus the focus of this review is on a description of MRS acquisition approaches, and an indication of relative utility of each technique rather than brain pathologies associated with Glu and/or Gln perturbation. Consequently, this review focuses particularly on (1) one-dimensional (1)H MRS, (2) two-dimensional (1)H MRS, and (3) one-dimensional (13)C MRS techniques.
Collapse
Affiliation(s)
- Saadallah Ramadan
- School of Health Sciences, Faculty of Health, Hunter Building, University of Newcastle, Callaghan NSW 2308, Australia
| | - Alexander Lin
- Alexander Lin: Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 4 Blackfan Street, HIM-820, Boston MA 02115
| | - Peter Stanwell
- School of Health Sciences, Faculty of Health, Hunter Building, University of Newcastle, Callaghan NSW 2308, Australia
| |
Collapse
|
18
|
Abstract
In vivo magnetic resonance spectroscopy (MRS) of the breast can be used to measure the level of choline-containing compounds, which is a biomarker of malignancy. In the diagnostic setting, MRS can provide high specificity for distinguishing benign from malignant lesions. MRS also can be used as an early response indicator in patients undergoing neoadjuvant chemotherapy. This article describes the acquisition and analysis methods used for measuring total choline levels in the breast using MRS, reviews the findings from clinical studies of diagnosis and treatment response, and discusses problems, limitations, and future developments for this promising clinical technology.
Collapse
Affiliation(s)
- Patrick J Bolan
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55419, USA.
| |
Collapse
|
19
|
Proton CSI without solvent suppression with strongly reduced field gradient related sideband artifacts. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2012; 26:183-92. [PMID: 22926685 DOI: 10.1007/s10334-012-0338-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 08/17/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECT Non-water-suppressed MRSI (magnetic resonance spectroscopy imaging) offers a number of advantages; however, spectra are hampered by the sideband artifacts. The origin of those is associated with the vibration of the gradient coils, and most of the sidebands are assumed to be related to the crusher gradients. The aim was to examine the dependency between the physical direction of the crushers and the sidebands. Additionally, the possibilities of optimization of the point resolved spectroscopy sequence (PRESS) were investigated. MATERIALS AND METHODS For the assessment of the sidebands, spectra at short echo time (TE) were collected at 3 T from standard water phantom. A homemade agar phantom was used to test the optimal strength of the crusher gradients. Optimized PRESS sequence was tested in vivo. RESULTS The greatest sidebands were found to be associated with the crusher gradient in x-direction. Agar phantom and in vivo measurements revealed that reduction of the crusher's strength to 5 mT/m could provide a significant minimization of the sidebands without raising the unwanted signals produced by volume selection. CONCLUSION This study demonstrates that crusher gradients in different directions produce a unique pattern of the sidebands. Moreover, optimization of the strength of crushers has been found to decrease sidebands so, the remaining part could be reduced in postprocessing.
Collapse
|
20
|
Mizukoshi W, Kozawa E, Inoue K, Saito N, Nishi N, Saeki T, Kimura F. (1)H MR spectroscopy with external reference solution at 1.5 T for differentiating malignant and benign breast lesions: comparison using qualitative and quantitative approaches. Eur Radiol 2012; 23:75-83. [PMID: 22777619 DOI: 10.1007/s00330-012-2555-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 05/03/2012] [Accepted: 05/25/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the diagnostic capability of proton ((1)H) magnetic resonance spectroscopy (MRS) in differentiating benign from malignant breast lesions on the basis of qualitative and quantitative approaches. METHODS We performed single-voxel (1)H MRS for 208 breast lesions, identified a clear total composite choline compounds (tCho) peak of signal-to-noise of ≥2 to represent malignancy (qualitative approach), and regarded tCho concentration equal to or greater than the cut-off value to represent malignancy (quantitative approach). We compared the diagnostic ability of both approaches using the Akaike information criterion (AIC) and McFadden's R (2). RESULTS Histologically, 169 lesions were malignant; 39 were benign. The qualitative approach demonstrated 84.6 % sensitivity and 51.3 % specificity for differentiating malignant and benign lesions. The mean tCho concentration was 1.13 mmol/kg for malignancy, 0.43 mmol/kg for benignity. The optimal cut-off point was 0.61 mmol/kg, use of which achieved 68.1 % sensitivity and 79.4 % specificity. Calculated AIC and R (2) score suggested the superiority of the quantitative approach for differentiating malignancy. CONCLUSIONS Quantitative MRS provides higher specificity than qualitative MRS for differentiating malignant from benign lesions and could be more useful as an additional examination in routine breast MR imaging.
Collapse
Affiliation(s)
- Waka Mizukoshi
- Department of Diagnostic Radiology, International Medical Center of Saitama Medical University, 1397-1 Yamane, Hidaka City, Saitama, Japan.
| | | | | | | | | | | | | |
Collapse
|
21
|
Zhao C, Bolan PJ, Royce M, Lakkadi N, Eberhardt S, Sillerud L, Lee SJ, Posse S. Quantitative mapping of total choline in healthy human breast using proton echo planar spectroscopic imaging (PEPSI) at 3 Tesla. J Magn Reson Imaging 2012; 36:1113-23. [PMID: 22782667 DOI: 10.1002/jmri.23748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 06/01/2012] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To quantitatively measure tCho levels in healthy breasts using Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI). MATERIALS AND METHODS The two-dimensional mapping of tCho at 3 Tesla across an entire breast slice using PEPSI and a hybrid spectral quantification method based on LCModel fitting and integration of tCho using the fitted spectrum were developed. This method was validated in 19 healthy females and compared with single voxel spectroscopy (SVS) and with PRESS prelocalized conventional Magnetic Resonance Spectroscopic Imaging (MRSI) using identical voxel size (8 cc) and similar scan times (∼7 min). RESULTS A tCho peak with a signal to noise ratio larger than 2 was detected in 10 subjects using both PEPSI and SVS. The average tCho concentration in these subjects was 0.45 ± 0.2 mmol/kg using PEPSI and 0.48 ± 0.3 mmol/kg using SVS. Comparable results were obtained in two subjects using conventional MRSI. High lipid content in the spectra of nine tCho negative subjects was associated with spectral line broadening of more than 26 Hz, which made tCho detection impossible. Conventional MRSI with PRESS prelocalization in glandular tissue in two of these subjects yielded tCho concentrations comparable to PEPSI. CONCLUSION The detection sensitivity of PEPSI is comparable to SVS and conventional PRESS-MRSI. PEPSI can be potentially used in the evaluation of tCho in breast cancer. A tCho threshold concentration value of ∼0.7 mmol/kg might be used to differentiate between cancerous and healthy (or benign) breast tissues based on this work and previous studies.
Collapse
Affiliation(s)
- Chenguang Zhao
- Department of Neurology and UNM Cancer Center, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131, USA.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Nuclear Magnetic Resonance as a Diagnostic Tool in Breast Cancer. ACTA MEDICA MARTINIANA 2012. [DOI: 10.2478/v10201-011-0029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nuclear Magnetic Resonance as a Diagnostic Tool in Breast CancerThe early detection and treatment of breast cancer is of direct benefit to patients. Magnetic resonance imaging (MRI) is a promising modality for detection, diagnosis, and staging of breast cancer. MRI enables two methods: the diffusion-weighted MRI (DW MRI) and the dynamic contrast enhanced MRI (DCE MRI). DW MRI reflects the diffusion of water molecules in the extracellular fluid space and allows the estimation of cellularity and tissue structure. The value of the diffusion of water in tissue is called the apparent diffusion coefficient (ADC). ADC values in malignant lesions are smaller than in benign tissue. DCE MRI yields appropriate pharmacokinetic data of physiological parameters that relate to tissue perfusion, microvascular vessel wall permeability and extracellular volume fraction. Gadolinium based contrast agent is usually used in breast DCE MRI diagnostics. Changes in the post-contrast signal intensity help to distinguish lesions according to characteristically enhanced accumulation of contrast agent. Malignant lesions are characterized by a faster and stronger signal enhancement than benign lesions which relate to their neoangiogenesis. Over the last few years, there has been appreciable interest in the use of magnetic resonance spectroscopy (MRS) for the non-invasive analysis of breast tisue metabolites. One of the spectroscopic hallmarks of the neoplastic process appears to be the presence of total choline signal in thein vivospectrum. Despite the fact that MRI and MRS achieve excellent results, they are still not so frequently used in comparison to mammography and breast ultrasound.
Collapse
|
23
|
Wijnen JP, van der Kemp WJM, Luttje MP, Korteweg MA, Luijten PR, Klomp DWJ. Quantitative 31P magnetic resonance spectroscopy of the human breast at 7 T. Magn Reson Med 2011; 68:339-48. [PMID: 22213214 DOI: 10.1002/mrm.23249] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 09/12/2011] [Accepted: 09/13/2011] [Indexed: 11/08/2022]
Abstract
This study presents quantified levels of phosphorylated metabolites in glandular tissue of human breast using (31)P magnetic resonance spectroscopy at 7 T. We used a homebuilt (1)H/(31)P radiofrequency coil to obtain artifact-free (31)P MR spectra of glandular tissue of healthy females by deploying whole breast free induction decay (FID) detection with adiabatic excitation and outer volume suppression. Using progressive saturation, the estimated apparent T(1) relaxation time of (31)P spins of phosphocholine and phosphoethanolamine was 4.4 and 5.7 s, respectively. Quantitative measures for phosphocholine and phosphoethanolamine levels in glandular tissue were established based on MR imaging. We used a 3D (1)H image of the breast to segment the glandular tissue; this was matched to a 3D (31)P image of the B1- field of the (31)P coil to correct for differences in glandular tissue volume and B(1) inhomogeneity of the (31)P coil. The (31)P MR spectra were calibrated using a phantom with known concentration. Average levels of phosphocholine and phosphoethanolamine in 11 volunteers were 0.84 ± 0.21 mM and 1.18 ± 0.41 mM, respectively. In addition, data of three patients with breast cancer showed higher levels of phosphocholine and phosphoethanolamine compared with healthy volunteers. This may indicate a potential role for the use of (31)P magnetic resonance spectroscopy for characterization, prognosis, and treatment monitoring in breast cancer.
Collapse
Affiliation(s)
- Jannie P Wijnen
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
24
|
Yao X, Zeng M, Wang H, Fei S, Rao S, Ji Y. Metabolite detection of pancreatic carcinoma by in vivo proton MR spectroscopy at 3T: initial results. Radiol Med 2011; 117:780-8. [PMID: 22095426 DOI: 10.1007/s11547-011-0757-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 05/04/2011] [Indexed: 12/14/2022]
Abstract
PURPOSE The authors sought to identify metabolic features of pancreatic carcinoma by in vivo proton magnetic resonance (MR) spectroscopy at 3 Tesla. MATERIALS AND METHODS Forty healthy volunteers and 40 patients with pancreatic carcinoma confirmed by histopathology underwent T2-weighted imaging for localisation of the single voxel. Respiration-triggered (1)H MR spectroscopy was used to detect metabolites in normal pancreas and cancerous tissue. All spectral data were processed with SAGE software. Unsuppressed water at 4.7 ppm was used as an internal reference to determine metabolite concentrations. Each ratio among the different peak areas was statistically evaluated between normal pancreas and pancreatic carcinoma. RESULTS The following five groups of spectra were detected: unsaturated fatty acids (-CH = CH-) at 5.4 ppm; residual water at 4.7 ppm; choline metabolites at 3.2 ppm; unsaturated fatty acids (-CH2-CH = CH-) or a combination of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), glutamine, glutamate, macromolecules and unsaturated fatty acids (-CH2-CH = CH-) at 2.0 ppm and lipids at 1.3 ppm. Ratio of lipids to unsuppressed water in normal pancreas was statistically greater than that in pancreatic cancer (p=0.004). Ratio of choline to unsuppressed water in normal pancreas was statistically greater than that in pancreatic cancer (p=0.0001). Ratio of fatty acids (-CH = CH-) to lipids in normal pancreas was statistically lower than that in pancreatic cancer (p=0.006). CONCLUSIONS Compared with normal pancreas, pancreatic carcinoma has a higher ratio of fatty acids (-CH = CH-) to lipids and lower ratios of lipids to unsuppressed water and choline to unsuppressed water at 3T.
Collapse
Affiliation(s)
- X Yao
- Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, Shanghai, China
| | | | | | | | | | | |
Collapse
|
25
|
McLaughlin R, Hylton N. MRI in breast cancer therapy monitoring. NMR IN BIOMEDICINE 2011; 24:712-720. [PMID: 21692116 PMCID: PMC4509744 DOI: 10.1002/nbm.1739] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 03/29/2011] [Accepted: 03/31/2011] [Indexed: 05/29/2023]
Abstract
Breast MRI has several roles in the clinical management of breast cancer, including as a screening method for high-risk women, as a diagnostic tool used as an adjunct to mammography and ultrasound, and for the staging of disease extent prior to treatment. In addition to these uses, MRI is also employed to track small changes in tumor size and microenvironment. MRI has produced several early indicators of treatment response in clinical trials over the last 10 years, including initial lesion pattern, changes in lesion size, kinetic parameters, apparent diffusion coefficient and T(2) value; the related technique of (1) H MRS has also shown that choline concentration, T(2) value and water-to-fat ratio are response indicators. In addition to measuring anatomical changes in the lesion size, as performed in traditional radiology, MRI has the ability to track vascular and cellular changes using dynamic contrast-enhanced MRI and diffusion-weighted MRI, respectively. By adding (1) H MRS to MRI examinations, metabolic changes can also be determined. These functional imaging techniques allow studies to focus on early time points relative to neoadjuvant treatment. Early treatment response predictors may allow therapy to be tailored to individual patients and thus aid in the realization of the goal of personalized medicine.
Collapse
Affiliation(s)
- Rebekah McLaughlin
- The UC Berkeley–UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California Berkeley, CA, USA
| | - Nola Hylton
- The UC Berkeley–UCSF Graduate Program in Bioengineering, University of California San Francisco and University of California Berkeley, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, CA, USA
| |
Collapse
|
26
|
Dimitrov IE, Douglas D, Ren J, Smith NB, Webb AG, Sherry AD, Malloy CR. In vivo determination of human breast fat composition by ¹H magnetic resonance spectroscopy at 7 T. Magn Reson Med 2011; 67:20-6. [PMID: 21656551 DOI: 10.1002/mrm.22993] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/07/2011] [Accepted: 04/14/2011] [Indexed: 11/08/2022]
Abstract
The role of diet and fat consumption in the pathogenesis of breast cancer is an important subject. We report a method for noninvasive determination of lipid composition in human breast by proton magnetic resonance spectroscopy (MRS) at 7 T. Two respiratory-triggered TE-averaged stimulated echo acquisition mode (STEAM) acquisitions were performed on the adipose tissue of 10 healthy volunteers where the second acquisition had all gradients inverted. This acquisition protocol allows the suppression of modulation sidebands that complicate spectral analysis at the short TE(avg) = 24.5 ms. The entire acquisition takes ∼10 min. Ten lipid peaks were typically resolved. T(1) and T(2) were also measured and used to correct the peak intensities. The calculated average lipid composition for saturated was 28.7 ± 8.4%, monounsaturated, 48.5 ± 7.9%, and polyunsaturated, 22.7 ± 3.1%, in close agreement with reported values from subcutaneous adipose measurements. Intrasubject variability was 2.0, 1.6, and 3.6% for the saturated, monounsaturated, and polyunsaturated fractions, respectively. In conclusion, we have shown that a chemical analysis of lipids in breast tissue can be determined quite simply, quickly, and noninvasively by proton MRS at 7 T.
Collapse
Affiliation(s)
- Ivan E Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | | | | | | |
Collapse
|
27
|
Gonenc A, Govind V, Sheriff S, Maudsley AA. Comparison of spectral fitting methods for overlapping J-coupled metabolite resonances. Magn Reson Med 2011; 64:623-8. [PMID: 20597119 DOI: 10.1002/mrm.22540] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
There is increasing interest in the use of two-dimensional J-resolved spectroscopic acquisition (multiecho) methods for in vivo proton magnetic resonance spectroscopy due to the improved discrimination of overlapping J-coupled multiplet resonances that is provided. Of particular interest is the potential for discrimination of the overlapping resonances of glutamate and glutamine. In this study, a new time-domain parametric spectral model that makes use of all available data is described for fitting the complete two-dimensional multiecho data, and the performance of this method was compared with fitting of one-dimensional spectra obtained following averaging multiecho data (echo time-averaged) and single-echo time PRESS (Point Resolved Spectroscopy) acquired spectra. These methods were compared using data obtained from a phantom containing typical brain metabolites and a human brain. Results indicate that improved performance and accuracy is obtained for the two-dimensional acquisition and spectral fitting model.
Collapse
Affiliation(s)
- A Gonenc
- Department of Radiology, University of Miami School of Medicine, Miami, Florida 33136, USA
| | | | | | | |
Collapse
|
28
|
Lipnick S, Liu X, Sayre J, Bassett LW, Debruhl N, Thomas MA. Combined DCE-MRI and single-voxel 2D MRS for differentiation between benign and malignant breast lesions. NMR IN BIOMEDICINE 2010; 23:922-930. [PMID: 20878970 DOI: 10.1002/nbm.1511] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and proton (1H) magnetic resonance spectroscopy (MRS) provide structural and biochemical information, including vascular volume, vascular permeability and tissue metabolism. In this study, we performed analysis of the enhancement characteristic from DCE-MRI and the biochemical information provided by two-dimensional (2D) Localized Correlated Spectroscopy (L-COSY) MRS to determine the sensitivity and specificity of using DCE-MRI alone compared to the combination with 2D MRS. The metabolite ratios from the 2D MRS spectra were analyzed using multivariate statistical analyses to determine a method capable of automatic separation of the patient cohort into malignant and benign lesions. A total of 24 lesions were studied with 21 diagnosed accurately using the enhancement characteristics alone resulting in sensitivity and specificity of 100% and 73%, respectively. Analysis of the 2D MRS data demonstrated a significant difference (p < 0.05) in 12 of 18 metabolite ratios analyzed for malignant compared to benign lesions. Previous research focused on utilizing the choline signal to noise ratio (SNR) as a marker for malignancy has been verified using 2D MRS in this study. Using Fisher's linear discriminant test using water (WAT)/olefinic fat diagonal (UFD), choline (CHO)/fat (FAT), CHO/UFD, and FAT/methyl fat (FMETD) as predictors the sensitivity and specificity increased to 92% and 100%, respectively. Using the Classification and Regression Tree (CART) statistical analysis the resulting sensitivity and specificity were 100% and 91%, respectively, with the most accurate predictor for differentiating malignant and benign determined to be FAT/FMETD. The cases within the study that presented a indeterminate diagnosis using DCE-MRI alone were able to be accurately diagnosed when the metabolic information from 2D MRS was incorporated. The results suggest improved breast cancer detection through the combination of morphological and enhancement information from DCE-MRI and metabolic information from 2D MRS.
Collapse
Affiliation(s)
- Scott Lipnick
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | | | | | | | | | | |
Collapse
|
29
|
Chadzynski GL, Klose U. Chemical shift imaging without water suppression at 3 T. Magn Reson Imaging 2010; 28:669-75. [DOI: 10.1016/j.mri.2010.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 12/22/2009] [Accepted: 01/08/2010] [Indexed: 10/19/2022]
|
30
|
|
31
|
Lin M, Chen X, Cai S, Chen Z. High-resolution magnetic resonance spectroscopy in unstable fields via intermolecular zero-quantum coherences. Phys Chem Chem Phys 2010; 12:6014-20. [DOI: 10.1039/b920180g] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
32
|
Corum CA, McIntosh AD, Bolan PJ, Nelson M, Snyder AL, Powell NJ, Boyum J, Emory TH, Yee D, Tuttle TM, Everson LI, Garwood M. Feasibility of single-voxel MRS measurement of apparent diffusion coefficient of water in breast tumors. Magn Reson Med 2009; 61:1232-7. [PMID: 19235916 DOI: 10.1002/mrm.21932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We report initial results with single voxel spectroscopy (SVS) using diffusion weighting and localization by adiabatic selective refocusing (LASER) in breast tumors to measure the apparent diffusion coefficient of water (ADCw). This is a quick (30 s) and relatively easy method to implement compared with image-based diffusion measurements, and is insensitive to lipid signal contamination. The ADCw and concentration of total choline containing compounds [tCho] were evaluated for associations with each other and final pathologic diagnosis in 25 subjects. The average (+/- SD) ADCw in benign and malignant lesions was 1.96 +/- 0.47 mm(2)/s and 1.26 +/- 0.29 x 10(-3) mm(2)/s, respectively, P< 0.001. Receiver operating characteristic curve analysis showed an area under the curve of 0.92. Analysis of the single voxel (SV) ADCw and [tCho] showed significant correlation with a R(2) of 0.56, P< 0.001. Compared with more commonly used image-based methods of measuring water ADC, SV-ADCw is faster, more robust, insensitive to fat, and potentially easier to implement on standard clinical systems.
Collapse
Affiliation(s)
- C A Corum
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN 55455, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Pharmacodynamic markers for choline kinase down-regulation in breast cancer cells. Neoplasia 2009; 11:477-84. [PMID: 19412432 DOI: 10.1593/neo.81430] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 02/11/2009] [Accepted: 02/12/2009] [Indexed: 12/19/2022] Open
Abstract
High levels of choline kinase (ChoK) expression and choline phospholipid metabolites are often associated with malignant transformation, invasion, and metastasis, particularly in breast cancer. These findings have led to the development of novel pharmacologic or gene therapeutic interventions for ChoK-targeted inhibition. To identify pharmacodynamic markers for the therapeutic evaluation of ChoK down-regulation, we investigated the uptake and efflux of [(3)H]choline, a natural substrate of ChoK, and two other important metabolic indicators of malignancy, namely, [(3)H]thymidine and [(3)H]fluorodeoxyglucose, which measure proliferation and glucose metabolic changes, respectively, in ChoK-downregulated cells. Choline uptake in nonmalignant and malignant breast epithelial cell lines expressing graded levels of ChoK showed a ChoK-dependent uptake, retention, and efflux of [(3)H]choline. Reduced proliferation observed because of ChoK down-regulation resulted in reduced [(3)H]thymidine uptake and incorporation into DNA within 48 hours of treatment. Reduced [(3)H]thymidine incorporation levels were consistent with a decreased cell cycle S-phase fraction. No change in [(3)H]fluorodeoxyglucose uptake was observed between ChoK-downregulated and control cells in any of the three cell lines tested. These results demonstrate the utility of radiolabeled choline or choline analogs and proliferation imaging agents as pharmacodynamic markers for ChoK-targeted therapies and suggest a ChoK-mediated mechanism for tumor sequestration of choline-based imaging agents.
Collapse
|
34
|
In vivo proton MR spectroscopy of the breast using the total choline peak integral as a marker of malignancy. AJR Am J Roentgenol 2009; 192:1608-17. [PMID: 19457825 DOI: 10.2214/ajr.07.3521] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The purpose of our study was to use the total choline-containing compound (tCho) peak integral as a marker of malignancy in breast MR spectroscopy (MRS). SUBJECTS AND METHODS Forty-eight single-voxel water- and fat-suppressed 1.5-T MRS measurements were performed in 42 patients, obtaining both absolute tCho peak integral and tCho peak integral normalized for the volume of interest (VOI). Our reference standard was histology for lesions with BI-RADS category 4 and 5 and histology or at least a 2-year follow-up for findings with BI-RADS 2 and 3 and normal glands. Receiver operating characteristic (ROC) analysis, Mann-Whitney U test, and Spearman's rank correlation were used. RESULTS Three of 48 measurements (6%) failed. Of the remaining 45 spectra, 18 nonmalignant tissues showed no tCho peak, eight nonmalignant tissues showed a tCho peak integral from 0.99 to 9.03 arbitrary units (AU), and 19 malignant lesions showed a tCho peak integral from 1.26 to 19.80 AU. The diameter of nonmalignant tissues was 16.9 +/- 7.4 mm; that of malignant lesions was 15.3 +/- 6.9 mm (p = 0.308). At ROC analysis, the optimal threshold was 1.90 AU for absolute tCho peak, with 0.895 (17/19) sensitivity, 0.923 (24/26) specificity, and an AUC (area under the curve) of 0.917 (95% CI, 0.822-1.000); the optimal threshold was 0.85 AU/mL for the normalized tCho peak integral with 0.842 (16/19) sensitivity, 0.885 (23/26) specificity, and an AUC of 0.941 (0.879-1.000) (p = 0.470). A negative correlation (p = 0.011) was found between the VOI and the normalized tCho peak integral of malignant tissues. CONCLUSION Breast MRS using tCho peak integral reaches a high level of diagnostic performance.
Collapse
|
35
|
Abstract
Magnetic resonance imaging (MRI) of the breast has emerged as a highly sensitive modality. In addition to morphologic and kinetic analysis obtained from contrast-enhanced breast MRI, functional information has been needed for diagnosis of breast disease. In vivo proton (hydrogen 1 [(1)H]) MR spectroscopy of the breast has demonstrated that choline (Cho) can be detected in breast cancers, whereas Cho is generally undetectable in normal breast tissue. Thus, breast MR spectroscopy has shown great promise as a way to differentiate between benign and malignant lesions and to gauge the effect of chemotherapeutic agents in patients with locally advanced breast cancer. Prior studies performed on 1.5-T MR imagers have reported sensitivities of 70-100% (average 89%; 149/168) and specificity of 67-100% (average 87%; 97/112) for breast MR spectroscopy. Moreover, the presence of a Cho peak in breast cancer may reflect the increased cell proliferation, with a decrease in this peak after treatment reflecting decreased viability of the tumor. With further development and the assessment of Cho quantity in the tumor, breast MR spectroscopy may be helpful in the elucidation of the biology of breast cancer.
Collapse
Affiliation(s)
- Mitsuhiro Tozaki
- Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
| |
Collapse
|
36
|
Thomas MA, Lipnick S, Velan SS, Liu X, Banakar S, Binesh N, Ramadan S, Ambrosio A, Raylman RR, Sayre J, DeBruhl N, Bassett L. Investigation of breast cancer using two-dimensional MRS. NMR IN BIOMEDICINE 2009; 22:77-91. [PMID: 19086016 DOI: 10.1002/nbm.1310] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Proton (1H) MRS enables non-invasive biochemical assay with the potential to characterize malignant, benign and healthy breast tissues. In vitro studies using perchloric acid extracts and ex vivo magic angle spinning spectroscopy of intact biopsy tissues have been used to identify detectable metabolic alterations in breast cancer. The challenges of 1H MRS in vivo include low sensitivity and significant overlap of resonances due to limited chemical shift dispersion and significant inhomogeneous broadening at most clinical magnetic field strengths. Improvement in spectral resolution can be achieved in vivo and in vitro by recording the MR spectra spread over more than one dimension, thus facilitating unambiguous assignment of metabolite and lipid resonances in breast cancer. This article reviews the recent progress with two-dimensional MRS of breast cancer in vitro, ex vivo and in vivo. The discussion includes unambiguous detection of saturated and unsaturated fatty acids, as well as choline-containing groups such as free choline, phosphocholine, glycerophosphocholine and ethanolamines using two-dimensional MRS. In addition, characterization of invasive ductal carcinomas and healthy fatty/glandular breast tissues non-invasively using the classification and regression tree (CART) analysis of two-dimensional MRS data is reviewed.
Collapse
Affiliation(s)
- M Albert Thomas
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1721, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Haddadin IS, McIntosh A, Meisamy S, Corum C, Styczynski Snyder AL, Powell NJ, Nelson MT, Yee D, Garwood M, Bolan PJ. Metabolite quantification and high-field MRS in breast cancer. NMR IN BIOMEDICINE 2009; 22:65-76. [PMID: 17957820 PMCID: PMC2628417 DOI: 10.1002/nbm.1217] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In vivo 1H MRS is rapidly developing as a clinical tool for diagnosing and characterizing breast cancers. Many in vivo and in vitro experiments have demonstrated that alterations in concentrations of choline-containing metabolites are associated with malignant transformation. In recent years, considerable efforts have been made to evaluate the role of 1H MRS measurements of total choline-containing compounds in the management of patients with breast cancer. Current technological developments, including the use of high-field MR scanners and quantitative spectroscopic analysis methods, promise to increase the sensitivity and accuracy of breast MRS. This article reviews the literature describing in vivo MRS in breast cancer, with an emphasis on the development of high-field MR scanning and quantitative methods. Potential applications of these technologies for diagnosing suspicious lesions and monitoring response to chemotherapy are discussed.
Collapse
Affiliation(s)
- Ihab S. Haddadin
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Adeka McIntosh
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sina Meisamy
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Curt Corum
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Angela L. Styczynski Snyder
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nathaniel J. Powell
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael T. Nelson
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Douglas Yee
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael Garwood
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Patrick J. Bolan
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota Cancer Center, University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
38
|
Mountford C, Ramadan S, Stanwell P, Malycha P. Proton MRS of the breast in the clinical setting. NMR IN BIOMEDICINE 2009; 22:54-64. [PMID: 19086012 DOI: 10.1002/nbm.1301] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Information for determining whether a primary breast lesion is invasive and its receptor status and grade can be obtained before surgery by performing proton MRS on a fine-needle aspiration biopsy (FNAB) specimen and analyzing the MRS information by a pattern recognition method. Two-dimensional MRS, on either specimens or cells, allows the unambiguous assignment of most resonances. When correlated with the spectral regions selected by the pattern recognition method, there are strong indications for the biochemical markers responsible for prognostic information of invasive capacity and metastatic spread. Spectral assignments and biological correlations can be made using cell models. In vivo MRS can distinguish invasive from benign lesions. This pathological distinction can be made from the presence of resonances at discrete frequencies. To achieve this level of spectral resolution and signal-to-noise ratio, there are stringent requirements when acquiring and processing the data. The challenge now is to implement two-dimensional MRS in vivo. Until this is realized, the combination of in vivo MR, for diagnosis and spatial location, and MRS, for image-guided biopsy to provide information on tumor spread, promises to provide a higher level of preoperative diagnosis than previously achieved.
Collapse
Affiliation(s)
- Carolyn Mountford
- Centre for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | | | | | | |
Collapse
|
39
|
Future applications and innovations of clinical breast magnetic resonance imaging. Top Magn Reson Imaging 2008; 19:171-6. [PMID: 18941397 DOI: 10.1097/rmr.0b013e31818a4090] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Magnetic resonance imaging (MRI) of the breast has become a valuable diagnostic tool for detecting and evaluating breast abnormalities. Breast MRI is rapidly advancing, and several innovations have strong implications for improved detection, diagnostic accuracy, and treatment monitoring. This article describes select areas of recent technical development that are likely to have an increasing clinical impact on MRI of the breast, including high-field imaging, parallel imaging, high-sensitivity breast coils, diffusion-weighted imaging, and magnetic resonance spectroscopy.
Collapse
|
40
|
Sharma U, Sah RG, Jagannathan NR. Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) in Breast Cancer. MAGNETIC RESONANCE INSIGHTS 2008. [DOI: 10.4137/mri.s991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Breast cancer is a major health problem in women and early detection is of prime importance. Breast magnetic resonance imaging (MRI) provides both physical and physiologic tissue features that are useful in discriminating malignant from benign lesions. Contrast enhanced MRI is valuable for diagnosis of small tumors in dense breast and the structural and kinetic parameters improved the specificity of diagnosing benign from malignant lesions. It is a complimentary modality for preoperative staging, to follow response to therapy, to detect recurrences and for screening high risk women. Diffusion, perfusion and MR elastography have been applied to breast lesion characterization and show promise. In-vivo MR spectroscopy (MRS) is a valuable method to obtain the biochemical status of normal and diseased tissues. Malignant tissues contain high concentration of choline containing compounds that can be used as a biochemical marker. MRS helps to increase the specificity of MRI in lesions larger than 1cm and to monitor the tumor response. Various MR techniques show promise primarily as adjunct to the existing standard detection techniques, and its acceptability as a screening method will increase if specificity can be improved. This review presents the progress made in different MRI and MRS techniques in beast cancer management.
Collapse
Affiliation(s)
- Uma Sharma
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi–-110029, India
| | - Rani Gupta Sah
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi–-110029, India
| | | |
Collapse
|
41
|
Li Y, Srinivasan R, Ratiney H, Lu Y, Chang SM, Nelson SJ. Comparison of T(1) and T(2) metabolite relaxation times in glioma and normal brain at 3T. J Magn Reson Imaging 2008; 28:342-50. [PMID: 18666155 DOI: 10.1002/jmri.21453] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To measure T(1) and T(2) relaxation times of metabolites in glioma patients at 3T and to investigate how these values influence the observed metabolite levels. MATERIALS AND METHODS A total of 23 patients with gliomas and 10 volunteers were studied with single-voxel two-dimensional (2D) J-resolved point-resolved spectral selection (PRESS) using a 3T MR scanner. Voxels were chosen in normal appearing white matter (WM) and in regions of tumor. The T(1) and T(2) of choline containing compounds (Cho), creatine (Cr), and N-acetyl aspartate (NAA) were estimated. RESULTS Metabolite T(1) relaxation values in gliomas were not significantly different from values in normal WM. The T(2) of Cho and Cr were statistically significantly longer for grade 4 gliomas than for normal WM but the T(2) of NAA was similar. These differences were large enough to impact the corrections of metabolite levels for relaxation times with tumor grade in terms of metabolite ratios (P < 0.001). CONCLUSION The differential increase in T(2) for Cho and Cr relative to NAA means that the ratios of Cho/NAA and Cr/NAA are higher in tumor at longer echo times (TEs) relative to values in normal appearing brain. Having this information may be useful in defining the acquisition parameters for optimizing contrast between tumor and normal tissue in MR spectroscopic imaging (MRSI) data, in which limited time is available and only one TE can be used.
Collapse
Affiliation(s)
- Yan Li
- University of California, San Francisco/University of California, Berkeley (UCSF/UCB) Joint Graduate Group in Bioengineering, San Francisco, California 94143-2532, USA.
| | | | | | | | | | | |
Collapse
|
42
|
Nelson MT, Everson LI, Garwood M, Emory T, Bolan PJ. MR Spectroscopy in the diagnosis and treatment of breast cancer. SEMINARS IN BREAST DISEASE 2008; 11:100-105. [PMID: 21490877 PMCID: PMC3073311 DOI: 10.1053/j.sembd.2008.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In vivo proton magnetic resonance spectroscopy ((1)H MRS) is rapidly becoming useful as a clinical tool for diagnosing and characterizing breast cancers. Alterations of the levels of choline-containing metabolites are associated with malignancy. High-field MR scanners at 1.5 T, 3 T, 4 T, and 7 T have been used to evaluate the role of (1)H MRS measurements of total choline containing compounds in patients with breast cancer. This article will review clinical use of MRI/MRS in vivo. Newer developments in high field MR scanning and quantitative MRS may help breast imagers improve sensitivity and specificity in diagnosing and treating breast cancer.
Collapse
Affiliation(s)
- Michael T Nelson
- University of Minnesota Medical School, Department of Radiology, Center for Magnetic Resonance Imaging, Minneapolis, MN 55455
| | | | | | | | | |
Collapse
|
43
|
Nixon TW, McIntyre S, Rothman DL, de Graaf RA. Compensation of gradient-induced magnetic field perturbations. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2008; 192:209-217. [PMID: 18329304 PMCID: PMC2485241 DOI: 10.1016/j.jmr.2008.02.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 02/20/2008] [Accepted: 02/20/2008] [Indexed: 05/26/2023]
Abstract
Pulsed magnetic field gradients are essential for MR imaging and localized spectroscopy applications. However, besides the desired linear field gradients, pulsed currents in a strong external magnetic field also generate unwanted effects like eddy currents, gradient coil vibrations and acoustic noise. While the temporal magnetic field perturbations associated with eddy currents lead to spectral line shape distortions and signal loss, the vibration-related modulations lead to anti-symmetrical sidebands of any large signal (i.e. water), thereby obliterating the signals from low-concentration metabolites. Here the measurement, characterization and compensation of vibration-related magnetic field perturbations is presented. Following a quantitative evaluation of the various temporal components of the main magnetic field, a digital B0 magnetic field waveform is generated which reduces all temporal variations of the main magnetic field to within the spectral noise level.
Collapse
Affiliation(s)
- Terence W Nixon
- Department of Diagnostic Radiology and Biomedical Engineering, Magnetic Resonance Research Center, Yale University, School of Medicine, TAC, N145, 300 Cedar Street, PO Box 208043, New Haven, CT 06520-8043, USA
| | | | | | | |
Collapse
|
44
|
Baek HM, Yu HJ, Chen JH, Nalcioglu O, Su MY. Quantitative correlation between (1)H MRS and dynamic contrast-enhanced MRI of human breast cancer. Magn Reson Imaging 2008; 26:523-31. [PMID: 18060716 PMCID: PMC2653063 DOI: 10.1016/j.mri.2007.10.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 10/05/2007] [Accepted: 10/08/2007] [Indexed: 11/30/2022]
Abstract
Proton magnetic resonance spectroscopy ((1)H MRS) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) provide functional information, including vascular volume, vascular permeability and choline (Cho) metabolism. In this study, we applied these two imaging modalities to quantitatively characterize 36 malignant breast lesions in 32 patients and analyzed the correlation between them. Cho concentration was quantified by single-voxel (1)H MRS using water as an internal reference. The measured Cho levels ranged from 0.32 to 10.47 mmol/kg, consistent with previously reported values. In 25 mass-type lesions, the Cho concentration was significantly correlated with tumor size (r=.69, P<.0002). In addition, the Cho level was found to be significantly higher in lesions presenting as mass-type lesions compared to non-mass-type diffuse enhancements (P=.035). The enhancement kinetics from tissues covered within each MRS voxel were measured and analyzed with a two-compartmental model to obtain pharmacokinetic parameters K(trans) and k(ep). A significant correlation was found between the Cho level and the pharmacokinetic parameter k(ep) (r=.62, P<.0001), indicating that tissues with a high Cho level have higher wash-out rates in DCE MRI. The results suggest a correlation between Cho metabolism and angiogenesis activity, which might be explained by the association of Cho with cell replication and angiogenesis required to support tumor growth.
Collapse
Affiliation(s)
- Hyeon-Man Baek
- John Tu and Thomas Yuen Center for Functional Onco-Imaging, University of California, Irvine, CA 92697-5020, USA.
| | | | | | | | | |
Collapse
|
45
|
Baek HM, Chen JH, Yu HJ, Mehta R, Nalcioglu O, Su MY. Detection of choline signal in human breast lesions with chemical-shift imaging. J Magn Reson Imaging 2008; 27:1114-21. [PMID: 18425841 PMCID: PMC2613433 DOI: 10.1002/jmri.21309] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate the application of MR spectroscopy using chemical-shift imaging (CSI) for characterizing human breast lesions at 1.5T, and to evaluate the diagnostic performance using ROC (receiver operating characteristics) analysis. MATERIALS AND METHODS Thirty-six patients (35-73 years old, mean 52), with 27 malignant and 9 benign lesions, underwent anatomical imaging, dynamic contrast-enhanced MR imaging, and CSI. The ROC analysis was performed and the cutoff point yielding the highest accuracy was found to be a choline (Cho) signal-to-noise ratio (SNR) >3.2. RESULTS The mean Cho SNR was 2.8 +/- 0.8 (range, 1.8-4.3) for the benign group and 5.9 +/- 3.4 (2.1-17.5) for the malignant group (P = 0.01). Based on the criterion of Cho SNR >3.2 as malignant, CSI correctly diagnosed 22 of 27 malignant lesions and 7 of 9 benign lesions, resulting in a sensitivity of 81%, specificity of 78%, and overall accuracy of 81%. If the criterion was set higher at Cho SNR >4.0 the specificity improved to 89% but sensitivity was lowered to 67%. CONCLUSION The ROC analysis presented in this work could be used to set an objective diagnostic criterion depending on preferred emphasis on sensitivity or specificity.
Collapse
Affiliation(s)
- Hyeon-Man Baek
- Tu and Yuen Center for Functional Onco-Imaging, University of California, Irvine, California 92697-5020, USA.
| | | | | | | | | | | |
Collapse
|
46
|
Stanwell P, Mountford C. In Vivo Proton MR Spectroscopy of the Breast. Radiographics 2007; 27 Suppl 1:S253-66. [DOI: 10.1148/rg.27si075519] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
47
|
Heijmink SWTPJ, Scheenen TWJ, Fütterer JJ, Klomp DWJ, Heesakkers RAM, Hulsbergen-van de Kaa CA, van Lin ENJT, Heerschap A, Barentsz JO. Prostate and lymph node proton magnetic resonance (MR) spectroscopic imaging with external array coils at 3 T to detect recurrent prostate cancer after radiation therapy. Invest Radiol 2007; 42:420-7. [PMID: 17507814 DOI: 10.1097/01.rli.0000262759.46364.50] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a patient suspected of having recurrent prostate cancer after radiation therapy, we demonstrate the feasibility of noninvasive proton magnetic resonance spectroscopic (1H-MRS) imaging of the prostate and a lymph node at 3 T using a matrix of external surface coils. Written informed consent was obtained from the patient. With 1H-MRS imaging, high choline with low citrate signal was observed in the prostate, and in the lymph node a signal of choline-containing compounds was identified. The tissue level of the compounds in the enlarged lymph node was estimated to be 8.1 mmol/kg water. Subsequent histopathological analysis of systematic transrectal ultrasound-guided prostate biopsy and computed tomography-guided biopsy of the lymph node confirmed the presence of prostate cancer in both.
Collapse
Affiliation(s)
- Stijn W T P J Heijmink
- Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kim DH, Henry R, Spielman DM. Fast multivoxel two-dimensional spectroscopic imaging at 3 T. Magn Reson Imaging 2007; 25:1155-61. [PMID: 17418519 PMCID: PMC2128753 DOI: 10.1016/j.mri.2007.01.118] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 01/24/2007] [Accepted: 01/28/2007] [Indexed: 10/23/2022]
Abstract
The utility of multivoxel two-dimensional chemical shift imaging in the clinical environment will ultimately be determined by the imaging time and the metabolite peaks that can be detected. Different k-space sampling schemes can be characterized by their minimum required imaging time. The use of spiral-based readout gradients effectively reduces the minimum scan time required due to simultaneous data acquisition in three k-space dimensions (k(x), k(y) and k(f(2))). A 3-T spiral-based multivoxel two-dimensional spectroscopic imaging sequence using the PRESS excitation scheme was implemented. Good performance was demonstrated by acquiring preliminary in vivo data for applications, including brain glutamate imaging, metabolite T(2) quantification and high-spatial-resolution prostate spectroscopic imaging. All protocols were designed to acquire data within a 17-min scan time at a field strength of 3 T.
Collapse
Affiliation(s)
- Dong-Hyun Kim
- Department of Radiology, University of California-San Francisco, San Francisco, CA, USA.
| | | | | |
Collapse
|
49
|
Prescot AP, de B Frederick B, Wang L, Brown J, Jensen JE, Kaufman MJ, Renshaw PF. In vivo detection of brain glycine with echo-time-averaged (1)H magnetic resonance spectroscopy at 4.0 T. Magn Reson Med 2006; 55:681-6. [PMID: 16453318 DOI: 10.1002/mrm.20807] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) method is described that enables the in vivo measurement of endogenous brain glycine (Gly) levels in human subjects. At 4.0 T, TE-averaging (1)H-MRS dramatically attenuates the overlapping myo-inositol (mI) resonances at 3.52 ppm, permitting a more reliable measure of the Gly singlet peak. This methodology initially is described and tested in phantoms. The phantom data infers that the 3.55-ppm peak predominantly is Gly with a smaller contribution from mI. The composite resonance thus is differentiated from pure Gly and mI and is labeled Gly*. The mI contribution was calculated as <2% of the total Gly* signal for a 1:1 mI/Gly mixture. The technique subsequently was used to acquire TE-averaged (1)H-MRS data from the occipital cortex of healthy control subjects. The resultant spectra closely resembled experimental phantom data. LC-model analysis provided a means for quantifying TE-averaged (1)H-MRS spectra and a mean test-retest variability measure of 15% was established for brain Gly* levels in studies of six healthy subjects.
Collapse
Affiliation(s)
- Andrew P Prescot
- Brain Imaging Center, McLean Hospital, Belmont, Massachusetts 02478, USA.
| | | | | | | | | | | | | |
Collapse
|
50
|
Schulte RF, Lange T, Beck J, Meier D, Boesiger P. Improved two-dimensional J-resolved spectroscopy. NMR IN BIOMEDICINE 2006; 19:264-70. [PMID: 16541465 DOI: 10.1002/nbm.1027] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Localised two-dimensional J-resolved spectroscopy (JPRESS) is optimised for the in vivo detection of J-coupled metabolites using magnetic resonance spectroscopy at 3 T. The acquisition of echo signals starts as early as possible (i.e. maximum-echo sampling). This sampling scheme increases sensitivity and decreases overlap of peak tails, hence alleviating baseline problems. Reconstruction issues are discussed and the sensitivity is compared analytically with that of 1D PRESS. The qualitative behaviour of eddy currents in JPRESS is outlined and a 2D eddy current correction procedure based on the 1D phase deconvolution method is proposed.
Collapse
Affiliation(s)
- Rolf F Schulte
- Institute for Biomedical Engineering, University and ETH Zurich, CH-8092 Zurich, Switzerland
| | | | | | | | | |
Collapse
|