Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis Journal Article
| Authors: | Thakur, S. B.; Horvat, J. V.; Hancu, I.; Sutton, O. M.; Bernard-Davila, B.; Weber, M.; Oh, J. H.; Marino, M. A.; Avendano, D.; Leithner, D.; Brennan, S.; Giri, D.; Manderski, E.; Morris, E. A.; Pinker, K. |
| Article Title: | Quantitative in vivo proton MR spectroscopic assessment of lipid metabolism: Value for breast cancer diagnosis and prognosis |
| Abstract: | Background: Breast magnetic resonance spectroscopy (1H-MRS) has been largely based on choline metabolites; however, other relevant metabolites can be detected and monitored. Purpose: To investigate whether lipid metabolite concentrations detected with 1H-MRS can be used for the noninvasive differentiation of benign and malignant breast tumors, differentiation among molecular breast cancer subtypes, and prediction of long-term survival outcomes. Study Type: Retrospective. Subjects: In all, 168 women, aged ≥18 years. Field Strength/Sequence: Dynamic contrast-enhanced MRI at 1.5 T: sagittal 3D spoiled gradient recalled sequence with fat saturation, flip angle = 10°, repetition time / echo time (TR/TE) = 7.4/4.2 msec, slice thickness = 3.0 mm, field of view (FOV) = 20 cm, and matrix size = 256 × 192. 1H-MRS: PRESS with TR/TE = 2000/135 msec, water suppression, and 128 scan averages, in addition to 16 reference scans without water suppression. Assessment: MRS quantitative analysis of lipid resonances using the LCModel was performed. Histopathology was the reference standard. Statistical Tests: Categorical data were described using absolute numbers and percentages. For metric data, means (plus 95% confidence interval [CI]) and standard deviations as well as median, minimum, and maximum were calculated. Due to skewed data, the latter were more adequate; unpaired Mann–Whitney U-tests were performed to compare groups without and with Bonferroni correction. ROC analyses were also performed. Results: There were 111 malignant and 57 benign lesions. Mean voxel size was 4.4 ± 4.6 cm3. Six lipid metabolite peaks were quantified: L09, L13 + L16, L21 + L23, L28, L41 + L43, and L52 + L53. Malignant lesions showed lower L09, L21 + L23, and L52 + L53 than benign lesions (P = 0.022, 0.027, and 0.0006). Similar results were observed for Luminal A or Luminal A/B vs. other molecular subtypes. At follow-up, patients were split into two groups based on median values for the six peaks; recurrence-free survival was significantly different between groups for L09, L21 + L23, and L28 (P = 0.0173, 0.0024, and 0.0045). Data Conclusion: Quantitative in vivo 1H-MRS assessment of lipid metabolism may provide an additional noninvasive imaging biomarker to guide therapeutic decisions in breast cancer. Level of Evidence: 3. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2019;50:239–249. © 2019 International Society for Magnetic Resonance in Medicine |
| Keywords: | metabolism; breast cancer; lipid; magnetic resonance spectroscopy; radiometabolomics |
| Journal Title: | Journal of Magnetic Resonance Imaging |
| Volume: | 50 |
| Issue: | 1 |
| ISSN: | 1053-1807 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2019-07-01 |
| Start Page: | 239 |
| End Page: | 249 |
| Language: | English |
| DOI: | 10.1002/jmri.26622 |
| PROVIDER: | scopus |
| PMCID: | PMC6579700 |
| PUBMED: | 30605266 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 July 2019 -- Source: Scopus |
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