Abstract
BackgroundTo evaluate changes in total choline (tCho) absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC).MethodsAfter institutional review board approval, we prospectively evaluated 40 healthy fertile volunteers: 20 with physiological MC, aged 28 ± 3 years (mean ± standard deviation; nOC group); 20 using OC, aged 26 ± 3 years (OC group). Hormonal assays and water-suppressed single-voxel 3-T proton magnetic resonance spectroscopy (1H-MRS) were performed on MC days 7, 14, and 21 in the nOC group and only on MC day 14 in the OC group. [tCho] was measured versus an external phantom. Mann-Whitney U test and Spearman coefficient were used; data are given as median and interquartile interval.ResultsAll spectra had good quality. In the nOC group, [tCho] (mM) did not change significantly during MC: 0.8 (0.3–2.4) on day 7, 0.9 (0.4–1.2) on day 14, and 0.4 (0.2–0.8) on day 21 (p = 0.963). In the OC group, [tCho] was 0.7 (0.2–1.7) mM. The between-groups difference was not significant on all days (p ≥ 0.411). All hormones except prolactin changed during MC (p ≤ 0.024). In the OC group, [tCho] showed a borderline correlation with estradiol (r = 0.458, p = 0.056), but no correlation with other hormones (p ≥ 0.128). In the nOC group, [tCho] negatively correlated with prolactin (r = -0.587, p = 0.006) on day 7; positive correlation was found with estradiol on day 14 (r = 0.679, p = 0.001).ConclusionsA tCho peak can be detected in the normal mammary gland using 3-T 1H-MRS. The [tCho] in healthy volunteers was 0.4–0.9 mM, constant over the MC and independent of OC use.
Highlights
To evaluate changes in total choline absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC)
The role of Proton magnetic resonance spectroscopy (1H-MRS) in breast examination is typically based on the detection of the so-called total-choline peak, which is mainly the result of resonances between 3.14 and 3.34 ppm arising from the trimethylammonium headgroups of water-soluble choline-containing metabolites, i.e., glycerophosphocholine, phosphocholine, and free choline [12]
Using optimised pre-processing, Stanwell et al [13] have shown the capability at 1.5 T to distinguish phosphocholine resonance from the tCho large peak, this result was not confirmed by other authors
Summary
To evaluate changes in total choline (tCho) absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC). The role of 1H-MRS in breast examination is typically based on the detection of the so-called total-choline (tCho) peak, which is mainly the result of resonances between 3.14 and 3.34 ppm arising from the trimethylammonium headgroups of water-soluble choline-containing metabolites, i.e., glycerophosphocholine, phosphocholine, and free choline [12]. Increased tCho concentrations ([tCho]) up to 2.2 mM (range of 0.0–8.5 mM) have been reported at 4.0 T in cancer lesions [2] and are mostly attributed to increases in phosphocholine as a consequence of increased metabolic turnover of phospholipid precursors and derivatives. The authors reported that, at second follow-up, patients with a pathologically complete response had a significantly greater reduction in [tCho] relative to the change in tumour size than those who had an incomplete response
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