Abstract
The purpose of this study was to examine the correlation between high-resolution magic angle spinning (HR-MAS) magnetic resonance (MR) spectroscopy using core needle biopsy (CNB) specimens and histologic prognostic factors currently used in breast cancer patients. After institutional review board approval and informed consent were obtained for this study, CNB specimens were collected from 36 malignant lesions in 34 patients. Concentrations and metabolic ratios of various choline metabolites were estimated by HR-MAS MR spectroscopy using CNB specimens. HR-MAS spectroscopic values were compared according to histopathologic variables [tumor size, lymph node metastasis, histologic grade, status of estrogens receptor (ER), progesterone receptor (PR), HER2 (a receptor for human epidermal growth factor), and Ki-67, and triple negativity]. Multivariate analysis was performed with Orthogonal Projections to Latent Structure-Discriminant Analysis (OPLS-DA). HR-MAS MR spectroscopy quantified and discriminated choline metabolites in all CNB specimens of the 36 breast cancers. Several metabolite markers [free choline (Cho), phosphocholine (PC), creatine (Cr), taurine, myo-inositol, scyllo-inositol, total choline (tCho), glycine, Cho/Cr, tCho/Cr, PC/Cr] on HR-MAS MR spectroscopy were found to correlate with histologic prognostic factors [ER, PR, HER2, histologic grade, triple negativity, Ki-67, poor prognosis]. OPLS-DA multivariate models were generally able to discriminate the status of histologic prognostic factors (ER, PR, HER2, Ki-67) and prognosis groups. Our study suggests that HR-MAS MR spectroscopy using CNB specimens can predict tumor aggressiveness prior to surgery in breast cancer patients. In addition, it may be helpful in the detection of reliable markers for breast cancer characterization.
Highlights
Breast cancer is one of the most common cancers and is an important cause of cancer related deaths among women globally [1,2]
The purpose of this study was to determine whether there are any correlations between high-resolution magic angle spinning (HR-MAS) magnetic resonance (MR) spectroscopy data for core needle biopsy (CNB) specimens and histologic prognostic factors currently used in breast cancer patients
The total choline (tCho) concentration acquired in our study with 11.7-T HR-MAS MR spectroscopy using CNB specimens was consistent with values reported in previous studies that used surgical specimens for HRMAS MR spectroscopy [16]
Summary
Breast cancer is one of the most common cancers and is an important cause of cancer related deaths among women globally [1,2]. Diagnosis of breast cancer is crucial for successful treatment and screening programs using mammography, ultrasonography, and magnetic resonance imaging (MRI) have been effective in industrialized countries [3,4,5,6]. In addition to early detection, clinical and histologic assessments of breast cancer are important components in treatment and management. The presence of hormone receptors is a generally favorable sign of prognosis, as appropriate hormone therapy can suppress the growth of such tumors. The identification of reliable markers to improve diagnostic accuracy and predict prognosis would be an important accomplishment
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