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Javor D, Bennani-Baiti BI, Clauser P, Kifjak D, Baltzer PAT. Automated analysis of the total choline resonance peak in breast proton magnetic resonance spectroscopy. NMR IN BIOMEDICINE 2024; 37:e5054. [PMID: 37794648 DOI: 10.1002/nbm.5054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
The aim of the current study was to compare the performance of fully automated software with human expert interpretation of single-voxel proton magnetic resonance spectroscopy (1H-MRS) spectra in the assessment of breast lesions. Breast magnetic resonance imaging (MRI) (including contrast-enhanced T1-weighted, T2-weighted, and diffusion-weighted imaging) and 1H-MRS images of 74 consecutive patients were acquired on a 3-T positron emission tomography-MRI scanner then automatically imported into and analyzed by SpecTec-ULR 1.1 software (LifeTec Solutions GmbH). All ensuing 117 spectra were additionally independently analyzed and interpreted by two blinded radiologists. Histopathology of at least 24 months of imaging follow-up served as the reference standard. Nonparametric Spearman's correlation coefficients for all measured parameters (signal-to-noise ratio [SNR] and integral of total choline [tCho]), Passing and Bablok regression, and receiver operating characteristic analysis, were calculated to assess test diagnostic performance, as well as to compare automated with manual reading. Based on 117 spectra of 74 patients, the area under the curve for tCho SNR and integrals ranged from 0.768 to 0.814 and from 0.721 to 0.784 to distinguish benign from malignant tissue, respectively. Neither method displayed significant differences between measurements (automated vs. human expert readers, p > 0.05), in line with the results from the univariate Spearman's rank correlation coefficients, as well as the Passing and Bablok regression analysis. It was concluded that this pilot study demonstrates that 1H-MRS data from breast MRI can be automatically exported and interpreted by SpecTec-ULR 1.1 software. The diagnostic performance of this software was not inferior to human expert readers.
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Affiliation(s)
- Domagoj Javor
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Radiology, University Hospital Krems, Krems, Austria
- Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Barbara I Bennani-Baiti
- Department of Radiology, University Hospital Krems, Krems, Austria
- Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Paola Clauser
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daria Kifjak
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Radiology, UMass Memorial Medical Center and University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Pascal A T Baltzer
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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Subhan MA, Muzibur Rahman M. Recent Development in Metallic Nanoparticles for Breast Cancer Therapy and Diagnosis. CHEM REC 2022; 22:e202100331. [PMID: 35146897 DOI: 10.1002/tcr.202100331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/30/2022] [Indexed: 12/25/2022]
Abstract
Metal-based nanoparticles are very promising for their applications in cancer diagnosis, drug delivery and therapy. Breast cancer is the major reason of death in woman especially in developed countries including EU and USA. Due to the heterogeneity of cancer cells, nanoparticles are effective as therapeutics and diagnostics. Anti-cancer therapy of breast tumors is challenging because of highly metastatic progression of the disease to brain, bone, lung, and liver. Magnetic nanoparticles are crucial for metastatic breast cancer detection and protection. This review comprehensively discusses the application of nanomaterials as breast cancer therapy, therapeutics, and diagnostics.
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Affiliation(s)
- Md Abdus Subhan
- Department of Chemistry, School of Physical Sciences, Shah Jalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Mohammed Muzibur Rahman
- Center of Excellence for Advanced Materials Research (CEAMR) & Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80203, 21589, Jeddah, Saudi Arabia
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Bhushan A, Gonsalves A, Menon JU. Current State of Breast Cancer Diagnosis, Treatment, and Theranostics. Pharmaceutics 2021; 13:723. [PMID: 34069059 PMCID: PMC8156889 DOI: 10.3390/pharmaceutics13050723] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is one of the leading causes of cancer-related morbidity and mortality in women worldwide. Early diagnosis and effective treatment of all types of cancers are crucial for a positive prognosis. Patients with small tumor sizes at the time of their diagnosis have a significantly higher survival rate and a significantly reduced probability of the cancer being fatal. Therefore, many novel technologies are being developed for early detection of primary tumors, as well as distant metastases and recurrent disease, for effective breast cancer management. Theranostics has emerged as a new paradigm for the simultaneous diagnosis, imaging, and treatment of cancers. It has the potential to provide timely and improved patient care via personalized therapy. In nanotheranostics, cell-specific targeting moieties, imaging agents, and therapeutic agents can be embedded within a single formulation for effective treatment. In this review, we will highlight the different diagnosis techniques and treatment strategies for breast cancer management and explore recent advances in breast cancer theranostics. Our main focus will be to summarize recent trends and technologies in breast cancer diagnosis and treatment as reported in recent research papers and patents and discuss future perspectives for effective breast cancer therapy.
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Affiliation(s)
- Arya Bhushan
- Ladue Horton Watkins High School, St. Louis, MO 63124, USA;
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
| | - Andrea Gonsalves
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
| | - Jyothi U. Menon
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
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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.
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Affiliation(s)
- Uma Sharma
- Department of NMR & MRI Facility, All India Institute of Medical Sciences , New Delhi, India
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Fardanesh R, Marino MA, Avendano D, Leithner D, Pinker K, Thakur SB. Proton MR spectroscopy in the breast: Technical innovations and clinical applications. J Magn Reson Imaging 2019; 50:1033-1046. [PMID: 30848037 DOI: 10.1002/jmri.26700] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/20/2019] [Indexed: 01/27/2023] Open
Abstract
Proton magnetic resonance spectroscopy (MRS) is a promising noninvasive diagnostic technique for investigation of breast cancer metabolism. Spectroscopic imaging data may be obtained following contrast-enhanced MRI by applying the point-resolved spectroscopy sequence (PRESS) or the stimulated echo acquisition mode (STEAM) sequence from the MR voxel encompassing the breast lesion. Total choline signal (tCho) measured in vivo using either a qualitative or quantitative approach has been used as a diagnostic test in the workup of malignant breast lesions. In addition to tCho metabolites, other relevant metabolites, including multiple lipids, can be detected and monitored. MRS has been heavily investigated as an adjunct to morphologic and dynamic MRI to improve diagnostic accuracy in breast cancer, obviating unnecessary benign biopsies. Besides its use in the staging of breast cancer, other promising applications have been recently investigated, including the assessment of treatment response and therapy monitoring. This review provides guidance on spectroscopic acquisition and quantification methods and highlights current and evolving clinical applications of proton MRS. Level of Evidence 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019.
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Affiliation(s)
- Reza Fardanesh
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Maria Adele Marino
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Italy
| | - Daly Avendano
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Doris Leithner
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Katja Pinker
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Sunitha B Thakur
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Application of Radiomics and Decision Support Systems for Breast MR Differential Diagnosis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:7417126. [PMID: 30344618 PMCID: PMC6174735 DOI: 10.1155/2018/7417126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/24/2018] [Accepted: 09/04/2018] [Indexed: 01/17/2023]
Abstract
Over the years, MR systems have evolved from imaging modalities to advanced computational systems producing a variety of numerical parameters that can be used for the noninvasive preoperative assessment of breast pathology. Furthermore, the combination with state-of-the-art image analysis methods provides a plethora of quantifiable imaging features, termed radiomics that increases diagnostic accuracy towards individualized therapy planning. More importantly, radiomics can now be complemented by the emerging deep learning techniques for further process automation and correlation with other clinical data which facilitate the monitoring of treatment response, as well as the prediction of patient's outcome, by means of unravelling of the complex underlying pathophysiological mechanisms which are reflected in tissue phenotype. The scope of this review is to provide applications and limitations of radiomics towards the development of clinical decision support systems for breast cancer diagnosis and prognosis.
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Jhaveri K, Guo L, DeVito T. Feasibility of in-vivo semi-LASER renal magnetic resonance spectroscopy (MRS): Pilot study in healthy volunteers. Magn Reson Imaging 2017; 40:12-16. [DOI: 10.1016/j.mri.2017.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/13/2017] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
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Montemezzi S, Cavedon C, Camera L, Meliadò G, Caumo F, Baglio I, Sardanelli F. 1H-MR spectroscopy of suspicious breast mass lesions at 3T: a clinical experience. Radiol Med 2016; 122:161-170. [DOI: 10.1007/s11547-016-0713-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 11/27/2016] [Indexed: 12/24/2022]
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Wang J, Wang MY, Kuo WH, Chen KL, Shih TTF. Proton MR spectroscopy of normal breasts: Association of risk factors for breast cancer with water and lipid composition of the breast. Magn Reson Imaging 2016; 34:524-8. [DOI: 10.1016/j.mri.2015.12.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 12/15/2015] [Indexed: 10/22/2022]
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El Fiki IM, Abdel-Rahman HM, Morsy MM. Assessment of breast mass: Utility of diffusion-weighted MR and MR spectroscopy imaging. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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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]
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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.
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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
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Vassiou K, Tsougos I, Kousi E, Vlychou M, Athanasiou E, Theodoru K, Arvanitis DL, Fezoulidis IV. Response to "Application value of 3T 1H-magnetic resonance spectroscopy in diagnosing breast tumors". Acta Radiol 2014; 55:418-9. [PMID: 24757186 DOI: 10.1177/0284185113503529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Katerina Vassiou
- Department of Radiology, University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Department of Radiology, University of Thessaly, Larissa, Greece
| | - Evanthia Kousi
- Department of Radiology, University of Thessaly, Larissa, Greece
| | - Marianna Vlychou
- Department of Radiology, University of Thessaly, Larissa, Greece
| | | | - Kiriaki Theodoru
- Department of Radiology, University of Thessaly, Larissa, Greece
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Sah RG, Agarwal K, Sharma U, Parshad R, Seenu V, Jagannathan NR. Characterization of malignant breast tissue of breast cancer patients and the normal breast tissue of healthy lactating women volunteers using diffusion MRI and in vivo 1H MR spectroscopy. J Magn Reson Imaging 2013; 41:169-74. [PMID: 24273108 DOI: 10.1002/jmri.24507] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 10/16/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To investigate the potential of diffusion weighted imaging (DWI) and in vivo proton MR spectroscopy (MRS) in the differentiation of breast tissue of healthy lactating women volunteers and breast cancer patients. MATERIALS AND METHODS DWI and MRS were carried out at 1.5 Tesla on 12 breast cancer patients and 12 normal lactating women volunteers. Apparent diffusion coefficient (ADC) and total choline (tCho) concentration were determined. RESULTS tCho was observed in all breast cancer patients and in 10/12 lactating women. Additionally a peak at 3.8 ppm corresponding to lactose was seen in 10/12 of lactating women. Concentration of tCho was similar in malignant breast tissue of patients (3.51 ± 1.72 mmol/kg) and in normal breast tissue of lactating women (3.52 ± 1.70 mmol/kg). However, ADC was significantly higher in the normal breast tissue of lactating women (1.62 ± 0.22 × 10(-3) mm(2)/s) compared with the malignant breast tissue of patients (1.01 ± 0.10 × 10(-3) mm(2)/s). CONCLUSION Observation of lactose peak with higher ADC in the breast tissue of healthy lactating women volunteers may aid in differentiation of changes that occur in breast tissue due to normal physiological conditions like lactation compared with malignant transformation.
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Affiliation(s)
- Rani G Sah
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, Delhi, India
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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.
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Affiliation(s)
- Patrick J Bolan
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55419, USA.
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Vassiou K, Tsougos I, Kousi E, Vlychou M, Athanasiou E, Theodorou K, Arvanitis DL, Fezoulidis IV. Application value of 3T ¹H-magnetic resonance spectroscopy in diagnosing breast tumors. Acta Radiol 2013; 54:380-8. [PMID: 23436823 DOI: 10.1177/0284185113475921] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Assessment of breast lesions with magnetic resonance imaging (MRI) provides a means for lesion detection and diagnosis. Proton (hydrogen-1) magnetic resonance spectroscopy ((1)H-MRS) has been proposed as a useful diagnostic technique in providing metabolic information of suspicious breast lesions. PURPOSE To determine the clinical significance of in-vivo single voxel (1)H-MRS at 3T in the assessment of benign and malignant breast lesions in combination with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIAL AND METHODS Twenty-four women with known breast abnormalities from conventional imaging (mammography, ultrasonography) underwent DCE-MRI at a 3T MR scanner and 26 breast lesions were detected. Breast lesions were assessed according BI-RADS classification. Single voxel (1)H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated. All lesions were confirmed histologically from the surgically excised specimens. Sensitivity, specificity, and accuracy of the (1)H-MRS, of the BI-RADS classification and of their combination (DCE-MRI + (1)H-MRS) were calculated. RESULTS Fifteen out of 26 lesions proved to be malignant and 11 proved to be benign. In our study (1)H-MRS showed sensitivity 80%, specificity 81.8%, and accuracy 80.7%. DCE-MRI showed sensitivity 100%, specificity 63.6%, and accuracy 84.6%. The combination of DCE-MRI and (1)H-MRS provided higher accuracy (96.4%), as well as higher specificity 81.8% compared to BI-RADS classification. CONCLUSION The combined use of (1)H-MRS and DCE-MRI found to have improved diagnostic performance in the assessment of equivocal breast lesions. (1)H-MRS can be used as a useful adjunct during lesion characterization in clinical routine in cases classified as BI-RADS 3 and 4.
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Mountford CE, Schuster C, Baltzer PA, Malycha P, Kaiser WA. MR spectroscopy in the breast clinic is improving. Eur J Radiol 2012; 81 Suppl 1:S104-6. [DOI: 10.1016/s0720-048x(12)70042-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sonmez AE, Webb AG, Spees WM, Ozcan A, Tsekos NV. A system for endoscopic mechanically scanned localized proton MR and light-induced fluorescence emission spectroscopies. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2012; 222:16-25. [PMID: 22820260 DOI: 10.1016/j.jmr.2012.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/08/2012] [Accepted: 06/14/2012] [Indexed: 06/01/2023]
Abstract
Molecular and near-cellular modalities offer new opportunities in assessing living tissue in situ, and multimodality approaches, which offer complementary information, may lead to improved characterization of tissue pathophysiology benefiting diagnosis and focal therapy. However, many such modalities are limited by their low penetration through tissue, which has led to minimally invasive trans-cannula approaches to place the corresponding sensors locally at the area of interest. This work presents a system for performing localized fluorescence emission and proton magnetic resonance (MR) spectroscopies via endoscopic access. The in-house developed side-firing 1.9-mm wide dual-sensor integrates a three-fiber optical sensor for fluorescence emission optical spectroscopy and a 1-mm circular radiofrequency (RF) coil for localized MR proton spectroscopy. An MR-compatible manipulator was developed for carrying and mechanically translating the dual-sensor along a linear access channel. The hardware and software control of the system allows reconfigurable synchronization of the manipulator-assisted translation of the sensor, and MR and optical data collection. The manipulator serves as the mechanical link for the three modalities and MR images, MR spectra and optical spectra are inherently co-registered to the MR scanner coordinate system. These spectra were then used to generate spatio-spectral maps of the fluorophores and proton MR-signal sources in three-compartment phantoms with optically- and MR-visible, and distinguishable, materials. These data demonstrate a good spatial match between MR images, MR spectra and optical spectra along the scanned path. In addition to basic research, such a system may have clinical applications for assessing and characterizing cancer in situ, as well as guiding focal therapies.
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Affiliation(s)
- Ahmet E Sonmez
- Medical Robotics Laboratory Department of Computer Science at University of Houston, Houston, TX, United States.
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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.
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Affiliation(s)
- Waka Mizukoshi
- Department of Diagnostic Radiology, International Medical Center of Saitama Medical University, 1397-1 Yamane, Hidaka City, Saitama, Japan.
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Baek HM. Diagnostic value of breast proton magnetic resonance spectroscopy at 1.5T in different histopathological types. ScientificWorldJournal 2012; 2012:508295. [PMID: 22654620 PMCID: PMC3361280 DOI: 10.1100/2012/508295] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 11/29/2011] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to investigate the usefulness of quantitative proton magnetic resonance spectroscopy (1H-MRS) for characterizing breast lesions at 1.5T, and to evaluate the diagnostic performance of in vivo breast 1H-MRS using receiver operating characteristics (ROC) analysis. 112 patients (99 malignant and 13 benign tumors) who were scanned with the MRI/MRS protocol were included in this study. Choline-containing compounds (tCho) levels were measured and compared with histological findings. The measured tCho levels in this work had range of 0.08–9.99 mmol/kg from 65 (66%) of 99 patients with malignant tumors. Of the 13 benign lesions, 1H-MRS detected one as false positive, with tCho level of 0.66 mmol/kg. The optimal tCho level cutoff point that yielded the highest accuracy was found to be >0.0 mmol/kg. The resulting sensitivity was 66% and
specificity 92% for distinguishing benign from malignant lesions. The tCho levels were found to be higher in invasive cancer compared to ductal carcinoma in situ or benign lesions, possibly associated with more aggressive behavior or faster cell replication in invasive cancer. Quantitative in vivo
1H-MRS may provide useful information for characterizing histopatholoigical types in breast cancer.
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Affiliation(s)
- Hyeon-Man Baek
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5325 Harry Hines Boulevard, Dallas, TX 75390-8830, USA
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Wang CK, Li CW, Hsieh TJ, Lin CJ, Chien SH, Tsai KB, Chang KC, Tsai HM. In vivo 1H MRS for musculoskeletal lesion characterization: which factors affect diagnostic accuracy? NMR IN BIOMEDICINE 2012; 25:359-368. [PMID: 21793078 DOI: 10.1002/nbm.1758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 05/27/2011] [Accepted: 05/31/2011] [Indexed: 05/31/2023]
Abstract
In vivo (1)H MRS is a noninvasive imaging technique for the identification of malignancy. Musculoskeletal lesions vary in their composition, causing field inhomogeneity and magnetic susceptibility effects which may be technical and diagnostic challenges for MRS. This study investigated the factors that affect diagnostic accuracy in the use of MRS for the characterization of musculoskeletal neoplasms. During a 7-year period, 210 consecutive patients with musculoskeletal lesions larger than 1.5 cm in diameter were examined. MRS of a single-voxel point-resolved spectroscopy sequence with TE = 135 ms was undertaken using a 1.5-T scanner. Lesions with a choline signal-to-noise ratio larger than 3.0 were considered to be malignant tumors. The diagnostic accuracy was calculated for all lesions and for subgroups on the basis of lesion type (bone and soft tissue), lesion composition (mixed and solid nonsclerotic), lesion size (≤4, >4-10 and >10 cm), MR scanner (MR scanner 1 and 2) and selected voxel size (≤3, >3-8 and >8 cm(3)). Multivariate logistic regressions were performed to estimate the associations between each factor and diagnostic accuracy. The diagnostic accuracy was 73.3% for all lesions. The accuracy was 54.4% for mixed lesions and 80.4% for solid nonsclerotic lesions (p < 0.001). The diagnostic accuracy was lower for larger lesions [86.8% for lesions of ≤4 cm, 71.6% for lesions of >4-10 cm (p = 0.04) and 63.6% for lesions of >10 cm (p = 0.007)]. There was no difference in diagnostic accuracy for bone versus soft-tissue lesions or as a function of MR scanner or voxel size. By the use of multivariate logistic regression, a solid nonsclerotic lesion was 3.15 times (95% confidence interval, 1.59-6.27) more likely than a mixed lesion to have a diagnosis (p = 0.001). MRS can be used to characterize musculoskeletal lesions, particularly solid nonsclerotic lesions.
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Affiliation(s)
- Chien-Kuo Wang
- Department of Radiology, National Cheng Kung University Hospital, Tainan, Taiwan.
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The metabolic features of normal pancreas and pancreatic adenocarcinoma: preliminary result of in vivo proton magnetic resonance spectroscopy at 3.0 T. J Comput Assist Tomogr 2011; 35:539-43. [PMID: 21926845 DOI: 10.1097/rct.0b013e318227a545] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective of the study was to analyze the metabolic features and distribution of normal pancreas and pancreatic adenocarcinoma while determining the biomarker of pancreatic cancerous process. METHODS Twenty-seven control and 29 pancreatic adenocarcinoma patients underwent breath-hold 3-T proton magnetic resonance spectroscopy. The ratios of lipid (lipid/InW), choline-containing compounds (CCCs/InW), and fatty acids (FAs/InW) to nonsaturated internal water (InW) of the normal pancreas head and body-tail region, with cancerous and noncancerous regions in pancreatic adenocarcinoma, were calculated. RESULTS In normal pancreas, there were no statistical difference in the ratios of FAs to InW and lipid to InW of different regions, but CCCs/InW of body-tail area was greater than that of head (7.28 × 10⁻⁴ vs 3.23 × 10⁻⁴). In pancreatic cancer, FAs/InW and lipid/InW between cancerous and noncancerous region were different (3.44 × 10⁻⁴ vs 16.3 × 10⁻⁴ and 7.78 × 10⁻⁴ vs 36.3 × 10⁻⁴, respectively). Choline-containing compounds/InW in cancerous region was smaller than that in noncancerous region of pancreatic head cancer (1.62 × 10⁻⁴ vs 5.69 × 10⁻⁴) but similar to such region in body-tail cancer. Lipid/InW dropped in noncancerous regions (from 0.67 to 0.36), whereas there were no differences in FAs/InW and CCCs/InW between normal pancreas regions and noncancerous regions in pancreatic cancer. CONCLUSIONS In normal pancreas, CCCs of body-tail region was greater than that of head. Whereas in pancreatic adenocarcinoma, CCCs, FAs, and lipid were all decreased in cancerous region, lipid in the noncancerous region was also decreased compared with normal pancreas. Lipid may be the potential sensitive biomarker for pancreatic cancer.
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The added value of quantitative multi-voxel MR spectroscopy in breast magnetic resonance imaging. Eur Radiol 2011; 22:915-22. [PMID: 22076317 PMCID: PMC3297755 DOI: 10.1007/s00330-011-2322-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 10/04/2011] [Accepted: 10/06/2011] [Indexed: 12/25/2022]
Abstract
Objective To determine whether quantitative multivoxel MRS improves the accuracy of MRI in the assessment of breast lesions. Methods Twenty-five consecutive patients with 26 breast lesions ≥1 cm assessed as BI-RADS 3 or 4 with mammography underwent quantitative multivoxel MRS and contrast-enhanced MRI. The choline (Cho) concentration was calculated using the unsuppressed water signal as a concentration reference. ROC analysis established the diagnostic accuracy of MRI and MRS in the assessment of breast lesions. Results Respective Cho concentrations in 26 breast lesions re-classified by MRI as BI-RADS 2 (n = 5), 3 (n = 8), 4 (n = 5) and 5 (n = 8) were 1.16 ± 0.43 (mean ± SD), 1.43 ± 0.47, 2.98 ± 2.15 and 4.94 ± 3.10 mM. Two BI-RADS 3 lesions and all BI-RADS 4 and 5 lesions were malignant on histopathology and had Cho concentrations between 1.7 and 11.8 mM (4.03 ± 2.72 SD), which were significantly higher (P = 0.01) than that in the 11 benign lesions (0.4–1.5 mM; 1.19 ± 0.33 SD). Furthermore, Cho concentrations in the benign and malignant breast lesions in BI-RADS 3 category differed (P = 0.01). The accuracy of combined multivoxel MRS/breast MRI BI-RADS re-classification (AUC = 1.00) exceeded that of MRI alone (AUC = 0.96 ± 0.03). Conclusions These preliminary data indicate that multivoxel MRS improves the accuracy of MRI when using a Cho concentration cut-off ≤1.5 mM for benign lesions. Key Points • Quantitative multivoxel MR spectroscopy can improve the accuracy of contrast-enhanced breast MRI. • Multivoxel-MRS can differentiate breast lesions by using the highest Cho-concentration. • Multivoxel-MRS can exclude patients with benign breast lesions from further invasive diagnostic procedures.
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Dorrius MD, Pijnappel RM, Jansen-van der Weide MC, Jansen L, Kappert P, Oudkerk M, Sijens PE. Determination of Choline Concentration in Breast Lesions: Quantitative Multivoxel Proton MR Spectroscopy as a Promising Noninvasive Assessment Tool to Exclude Benign Lesions. Radiology 2011; 259:695-703. [DOI: 10.1148/radiol.11101855] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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NMR techniques in biomedical and pharmaceutical analysis. J Pharm Biomed Anal 2011; 55:1-15. [DOI: 10.1016/j.jpba.2010.12.023] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 12/12/2010] [Accepted: 12/15/2010] [Indexed: 01/04/2023]
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González Hernando C, Esteban L, Cañas T, Van den Brule E, Pastrana M. The role of magnetic resonance imaging in oncology. Clin Transl Oncol 2011; 12:606-13. [PMID: 20851801 DOI: 10.1007/s12094-010-0565-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Conventional diagnostic magnetic resonance imaging (MRI) techniques have focused on improving the spatial resolution and image acquisition speed (whole-body MRI) or on new contrast agents. Most advances in MRI go beyond morphologic study to obtain functional and structural information in vivo about different physiological processes of tumor microenvironment, such as oxygenation levels, cellular proliferation, or tumor vascularization through MRI analysis of some characteristics: angiogenesis (perfusion MRI), metabolism (MRI spectroscopy), cellularity (diffusion-weighted MRI), lymph node function, or hypoxia [blood-oxygen-level-dependent (BOLD) MRI]. We discuss the contributions of different MRI techniques than must be integrated in oncologic patients to substantially advance tumor detection and characterization risk stratification, prognosis, predicting and monitoring response to treatment, and development of new drugs.
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Arlinghaus LR, Li X, Levy M, Smith D, Welch EB, Gore JC, Yankeelov TE. Current and future trends in magnetic resonance imaging assessments of the response of breast tumors to neoadjuvant chemotherapy. JOURNAL OF ONCOLOGY 2010; 2010:919620. [PMID: 20953332 PMCID: PMC2952974 DOI: 10.1155/2010/919620] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 07/07/2010] [Accepted: 08/11/2010] [Indexed: 11/18/2022]
Abstract
The current state-of-the-art assessment of treatment response in breast cancer is based on the response evaluation criteria in solid tumors (RECIST). RECIST reports on changes in gross morphology and divides response into one of four categories. In this paper we highlight how dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted MRI (DW-MRI) may be able to offer earlier, and more precise, information on treatment response in the neoadjuvant setting than RECIST. We then describe how longitudinal registration of breast images and the incorporation of intelligent bioinformatics approaches with imaging data have the potential to increase the sensitivity of assessing treatment response. We conclude with a discussion of the potential benefits of breast MRI at the higher field strength of 3T. For each of these areas, we provide a review, illustrative examples from clinical trials, and offer insights into future research directions.
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Affiliation(s)
- Lori R. Arlinghaus
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - Xia Li
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - Mia Levy
- Department of Biomedical Informatics, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Medicine, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - David Smith
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - E. Brian Welch
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - John C. Gore
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Biomedical Engineering, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Physics and Astronomy, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Molecular Physiology and Biophysics, Institute of Imaging Science, Nashville, TN 37232-2310, USA
| | - Thomas E. Yankeelov
- Department of Radiology and Radiological Sciences, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Biomedical Engineering, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Physics and Astronomy, Institute of Imaging Science, Nashville, TN 37232-2310, USA
- Department of Cancer Biology, Institute of Imaging Science, Nashville, TN 37232-2310, USA
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Tozaki M, Maruyama K. Current Status and Future Prospects of Proton MR Spectroscopy of the Breast with a 1.5T MR Unit. JOURNAL OF ONCOLOGY 2010; 2010:781621. [PMID: 20953323 PMCID: PMC2952948 DOI: 10.1155/2010/781621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 09/01/2010] [Indexed: 11/17/2022]
Abstract
Proton MR spectroscopy of the mammary gland area is used to be considered in the realm of basic research, but as a result of the advances in MR techniques, it is now being performed in ordinary clinical practice. It is particularly noteworthy that useful clinical data are now being accumulated with 1.5T MR units, which are the standard units. We think that, at this point, it is very important to systematically review the techniques, clinical applications, and future prospects of proton MR spectroscopy. We have performed proton MR spectroscopy with a 1.5T MR unit in over 3000 cases at our hospital. In this paper, we will comment on the current status of proton MR spectroscopy of the breast, primarily in regard to differentiation between benign and malignant lesions and prediction of the efficacy of chemotherapy while describing the data obtained at our hospital.
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Affiliation(s)
- Mitsuhiro Tozaki
- Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
| | - Katsuya Maruyama
- Siemens Japan K.K. Healthcare Sector, 3-20-14 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8644, Japan
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Abrantes AM, Rio J, Tavares LC, Carvalho RA, Botelho MF. Magnetic resonance spectroscopy in cancer diagnostics. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mountford CE, Stanwell P, Lin A, Ramadan S, Ross B. Neurospectroscopy: the past, present and future. Chem Rev 2010; 110:3060-86. [PMID: 20387805 DOI: 10.1021/cr900250y] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Carolyn E Mountford
- Centre for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 4 Blackfan Street, HIM-817, Boston, Massachusetts 02115, USA.
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Abstract
The role of magnetic resonance (MR) imaging in breast imaging and evaluation has increased rapidly. MR imaging now encompasses diagnostic evaluation as well as screening for breast cancer in high-risk groups, monitoring the extent of disease and the response to chemotherapy. It is expected that the utility of breast MR imaging will continue to increase, requiring additional facilities and expertise. Establishing a breast MR imaging program requires familiarity with several unique issues pertaining to the nature of this imaging modality. This article attempts to address some of these issues, including selection of a magnet based on needs of the particular practice and magnet field strength, selection of a dedicated breast coil, magnet location and siting, advantages and challenges of higher strength magnets such as 3 Tesla, establishing a referral base, scheduling of breast MR examinations, patient safety concerns, and examination interpretation and reporting.
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Affiliation(s)
- Sughra Raza
- Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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García Figueiras R, Padhani A, Vilanova J, Goh V, Villalba Martín C. Imagen funcional tumoral. Parte 2. RADIOLOGIA 2010; 52:208-20. [DOI: 10.1016/j.rx.2009.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 12/09/2009] [Accepted: 12/27/2009] [Indexed: 01/10/2023]
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Quantitative multivoxel proton chemical shift imaging of the breast. Magn Reson Imaging 2010; 28:314-9. [PMID: 20071119 DOI: 10.1016/j.mri.2009.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 11/26/2009] [Indexed: 12/22/2022]
Abstract
The study of focal pathology by single-voxel magnetic resonance spectroscopy (MRS) is hampered by the impossibility to study tissue heterogeneity or compare the metabolite signals in breast lesion directly to those in unaffected tissue. Multivoxel MRS studies, while potentially allowing for truly quantitative tissue characterization, have up to now also been far from quantitative with, for example, the signal-to-noise ratio of the choline (Cho) signal serving as measure of tumor activity. Shown in this study is that in a standard clinical setting with a regular 1.5-T magnetic resonance scanner, it is possible to perform quantitative multivoxel MRS. With the use of literature values for the T1 and T2 relaxation times of Cho and water in fibroglandular breast tissue and tumors, one can determine the concentrations of Cho in different tumor compartments and surrounding tissues in two brief multivoxel MRS measurements. This opens excellent perspectives to quantitative diagnostic and follow-up studies of focal pathology such as lesions suspected of breast cancer.
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Hu J, Feng W, Hua J, Jiang Q, Xuan Y, Li T, Haacke EM. A high spatial resolution in vivo 1H magnetic resonance spectroscopic imaging technique for the human breast at 3 T. Med Phys 2010; 36:4870-7. [PMID: 19994494 DOI: 10.1118/1.3213087] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The technical challenges that have prevented routine proton magnetic resonance spectroscopic imaging (1H MRSI) examinations of the breast include insufficient spatial resolution, increased difficulties in shimming compared to the brain, and strong lipid contamination at short echo time (TE) at 1.5 T. The authors investigated the feasibility of high spatial resolution 1H MRSI of human breast cancer in a clinical setting at 3 T. METHODS Ten patient studies (eight cancers and two benign lesions) were performed in a 3 T whole-body clinical imager using a pulse sequence consisting of optional outer volume presaturation, optional CHESS pulse for lipid suppression, CHESS pulse for water suppression, and standard 2D/3D PRESS pulse sequence with an elliptical weighted k-space sampling scheme. RESULTS All ten studies were technically successful. The spectral quality was acceptable for all cases even the one with a 65 Hz width of water peak at half height. Choline (Cho) signals were clearly visible in malignant lesion areas, while there was no detectable Cho in normal appearing breast or in benign lesions. It was also observed that the distribution of Cho signal can be nonuniform across MRI demonstrated lesions. CONCLUSIONS To the author's knowledge, this is the first 2D/3D MRSI study of human breast cancer with short TE (less than 135 ms) at 3 T and the highest spatial resolution (up to 0.25 cm3) to date. In conclusion, the authors have presented a robust technique for high spatial resolution in vivo 1H MRSI of human breast cancer that uses the combined advantages of high field, short TE, multivoxel, and high spatial resolution itself to overcome the major technical challenges and illustrated its potential for routine clinical examination as well as advantages over single-voxel techniques in studying metabolite heterogeneity.
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Affiliation(s)
- Jiani Hu
- Department of Radiology, Wayne State University, Detroit, Michigan 48201, USA.
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Functional imaging of tumors. Part 2. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70013-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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Modern breast cancer detection: a technological review. Int J Biomed Imaging 2009; 2009:902326. [PMID: 20069109 PMCID: PMC2804038 DOI: 10.1155/2009/902326] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 09/15/2009] [Indexed: 12/29/2022] Open
Abstract
Breast cancer is a serious threat worldwide and is the number two killer of women in the United States. The key to successful management is screening and early detection. What follows is a description of the state of the art in screening and detection for breast cancer as well as a discussion of new and emerging technologies. This paper aims to serve as a starting point for those who are not acquainted with this growing field.
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Ma X, Holalkere NS, Kambadakone R A, Mino-Kenudson M, Hahn PF, Sahani DV. Imaging-based quantification of hepatic fat: methods and clinical applications. Radiographics 2009; 29:1253-77. [PMID: 19755595 DOI: 10.1148/rg.295085186] [Citation(s) in RCA: 226] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fatty liver disease comprises a spectrum of conditions (simple hepatic steatosis, steatohepatitis with inflammatory changes, and end-stage liver disease with fibrosis and cirrhosis). Hepatic steatosis is often associated with diabetes and obesity and may be secondary to alcohol and drug use, toxins, viral infections, and metabolic diseases. Detection and quantification of liver fat have many clinical applications, and early recognition is crucial to institute appropriate management and prevent progression. Histopathologic analysis is the reference standard to detect and quantify fat in the liver, but results are vulnerable to sampling error. Moreover, it can cause morbidity and complications and cannot be repeated often enough to monitor treatment response. Imaging can be repeated regularly and allows assessment of the entire liver, thus avoiding sampling error. Selection of appropriate imaging methods demands understanding of their advantages and limitations and the suitable clinical setting. Ultrasonography is effective for detecting moderate or severe fatty infiltration but is limited by lack of interobserver reliability and intraobserver reproducibility. Computed tomography allows quantitative and qualitative evaluation and is generally highly accurate and reliable; however, the results may be confounded by hepatic parenchymal changes due to cirrhosis or depositional diseases. Magnetic resonance (MR) imaging with appropriate sequences (eg, chemical shift techniques) has similarly high sensitivity, and MR spectroscopy provides unique advantages for some applications. However, both are expensive and too complex to be used to monitor steatosis.
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Affiliation(s)
- Xiaozhou Ma
- Division of Abdominal Imaging and Intervention Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA
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Lee JH, Rosen EL, Mankoff DA. The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 2—Response to Therapy, Other Indications, and Future Directions. J Nucl Med 2009; 50:738-48. [DOI: 10.2967/jnumed.108.061416] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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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.
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Affiliation(s)
- Mitsuhiro Tozaki
- Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
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Karellas A, Vedantham S. Breast cancer imaging: a perspective for the next decade. Med Phys 2009; 35:4878-97. [PMID: 19070222 DOI: 10.1118/1.2986144] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Breast imaging is largely indicated for detection, diagnosis, and clinical management of breast cancer and for evaluation of the integrity of breast implants. In this work, a prospective view of techniques for breast cancer detection and diagnosis is provided based on an assessment of current trends. The potential role of emerging techniques that are under various stages of research and development is also addressed. It appears that the primary imaging tool for breast cancer screening in the next decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without depth information. MRI and ultrasonography will have an increasingly important adjunctive role for imaging high-risk patients and women with dense breasts. Pilot studies with dedicated breast CT have demonstrated high-resolution three-dimensional imaging capabilities, but several technological barriers must be overcome before clinical adoption. Radionuclide based imaging techniques and x-ray imaging with intravenously injected contrast offer substantial potential as a diagnostic tools and for evaluation of suspicious lesions. Developing optical and electromagnetic imaging techniques hold significant potential for physiologic information and they are likely to be of most value when integrated with or adjunctively used with techniques that provide anatomic information. Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can provide edge enhancement and contrast improvement but more research is needed to evaluate their potential role in clinical breast imaging. From the technological perspective, in addition to improvements within each modality, there is likely to be a trend towards multi-modality systems that combine anatomic with physiologic information. We are also likely to transition from a standardized screening, where all women undergo the same imaging exam (mammography), to selection of a screening modality or modalities based an individual-risk or other classification.
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Affiliation(s)
- Andrew Karellas
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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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.
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Affiliation(s)
- Carolyn Mountford
- Centre for Clinical Spectroscopy, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Abstract
The ability to measure biochemical and molecular processes underlies progress in breast cancer biology and treatment. These assays have traditionally been performed by analysis of cell culture or tissue samples. More recently, functional and molecular imaging has allowed the in vivo assay of biochemistry and molecular biology, which is highly complementary to tissue-based assays. This review briefly describes different imaging modalities used in molecular imaging and then reviews applications of molecular imaging to breast cancer, with a focus on translational work. It includes sections describing work in functional and physiological tumor imaging, imaging gene product expression, imaging the tumor microenvironment, reporter gene imaging, and cell labeling. Work in both animal models and human is discussed with an eye towards studies that have relevance to breast cancer treatment in patients.
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Affiliation(s)
- David A Mankoff
- Seattle Cancer Care Alliance and University of Washington, Radiology, Seattle, WA 98109, USA.
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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.
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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
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Evaluation of Ovarian Tumors by Proton Magnetic Resonance Spectroscopy at Three Tesla. Invest Radiol 2008; 43:745-51. [DOI: 10.1097/rli.0b013e31817e9104] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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