Jeon-Hor Chen MD, Presenter: Nothing to Disclose

Hui Liu MS, Abstract Co-Author: Nothing to Disclose

Hyeon Man Baek PhD, Abstract Co-Author: Nothing to Disclose

Ke Nie BS, Abstract Co-Author: Nothing to Disclose

Orhan Nalcioglu PhD, Abstract Co-Author: Consultant, Gamma Medica Ideas, Inc

Min-Ying Su PhD, Abstract Co-Author: Nothing to Disclose

Elevated level of total choline compounds concentration (tCho) is a tissue proliferative marker for malignant tumor. Many biological factors may affect the tCho within a tumor. This study was to investigate the association between in vivo tCho level with clinical characteristics and MR imaging features of breast cancer.

In a period of 3 years, 63 patients with breast cancer > 1.5cm were studies before their neoadjuvant chemotherapy and operation. MRI/MRS, including DCE-MRI and single-voxel 1H PRESS, was performed at a 1.5T scanner. CHESS was used for water suppression and FAT-SAT for fat suppression. The unsuppressed water signal was taken as an internal reference for choline quantification. The absolute tCho levels were quantified by using a Gaussian line-shape fitting model. Two-tailed Spearman’s non-parametric test was used to correlate tCho with MR imaging features (tumor phenotype and kinetic enhancement) and clinical characteristics, including patient age, tumor histological type, tumor grade, and biomarker status.

The measured tCho level had a wide range 0.08 – 9.99 (2.7 ± 2.3 mmol/kg).The only significant finding of tCho association was with age (P<0.05). Young patients were more likely to have triple-negative (TN) cancer (p<0.036) and higher choline (p<0.045). HER2+ was more likely to be IDC type (p<0.043) and higher tumor grade (p<0.043). Other associations approaching significance level were : 1) triple-negative (TN) cancer was more likely to have higher tCho level than non-TN cancer (p=0.06); 2) lesions with higher tCho level had a higher tumor grade (p=0.07); 3) higher tCho level is more likely to have washout DCE kinetic pattern (p=0.09); 4) younger age was associated with higher tumor grade (p=0.08); 5) IDC had higher tumor grade than non-IDC type (p=0.08); and 6) compared to ER+ cancer, ER- cancer was more likely to have higher grade (p=0.07). Of the 19 false negative tCho cases, 13 were Her-2 negative cancers. <0>

In vivo tCho level in breast cancer is affected by many biological factors. Breast cancer of younger age and triple negativity tend to have higher tCho, suggesting more aggressive tumor. Negative tCho more likely occurs in Her-2 negative cancer.

The results in this study improve our understanding of 1H MRS in characterization of different breast lesions and will aid in better interpretation of MRS for diagnosis of breast lesions.

Chen, J, Liu, H, Baek, H, Nie, K, Nalcioglu, O, Su, M, The Association between Choline Concentration Measured by 1H MR Spectroscopy with Clinical Characteristics and MR Imaging Features of Breast Cancer.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005143.html