Mitsuhiro Tozaki, Presenter: Nothing to Disclose

To assess the histological prognostic relevance of choline (Cho) levels obtained using 1H MR spectroscopy with a 1.5-T MR unit in patients with invasive breast cancer and to compare the observed Cho levels with the standardized uptake value (SUV) obtained using FDG-PET.

This retrospective study was approved by the institutional review board. Single-voxel 1H MR spectroscopy and PET/CT were performed for 50 patients with invasive ductal carcinoma (1.5cm to 3cm in size). The mean time interval between the MR spectroscopy and PET/CT examinations was 3 days, and no interventions were performed between these examinations. The normalized Cho signal was calculated using an external standard method.

The average normalized Cho signal was 1.1 (range, 0 to 3.9). The average peak SUV was 6.5 (range, 1.1 to 23). 1H MR spectroscopy demonstrated the presence of Cho in 44 cases. The correlation between the normalized Cho signal and the peak SUV was r = 0.52 (p < 0.0001). With regard to the nuclear grade, the normalized Cho signal and the peak SUV differed significantly among the three nuclear grade groups (p = 0.0002, p = 0.0002, respectively). Between the ER-positive and the ER-negative groups, the normalized Cho signal and the peak SUV of the ER-negative group were significantly higher than those of the ER-positive group (p = 0.007, p = 0.002, respectively). The normalized Cho signal and the peak SUV of the triple negative group were significantly higher than those of the non-triple negative group (p = 0.0009, p = 0.009, respectively). No significant differences were found between the PR-positive and the PR-negative groups or between the HER2-positive and the HER2-negative groups.

The Cho levels obtained using 1H MR spectroscopy with a 1.5-T unit were well correlated with the SUV obtained using PET/CT and with the histological prognostic parameters (nuclear grade, ER status, and triple negative lesion status). 1H MR spectroscopy could be a useful tool for providing supporting prognostic information on invasive breast cancer in a noninvasive manner.

1H MR spectroscopy using a 1.5-T MR unit may provide supporting prognostic information on invasive breast cancer in a noninvasive manner.

Tozaki, M, Proton MR Spectroscopy of Invasive Ductal Carcinoma: Correlations with 2-[18F]-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and Histological Prognostic Factors.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004603.html