Monitoring Neoadjuvant Chemotherapy Response in Breast Cancer using High-Speed 3D MR Spectroscopic Imaging of total Choline

Magnetic resonance imaging (MRI) is playing an increasingly important role in clinical diagnostics of breast cancer, including screening for breast cancers in high risk women. However, overall specificity has been low, resulting in a considerable number of benign biopsies. Recent studies reported that adding quantitative MR spectroscopy (MRS) results (mostly focusing on total choline) to a dynamic contrast enhanced (DCE) MRI exam produced improvements in the sensitivity, specificity, and accuracy for all readers, and improved the inter observer agreement between the readers. A second promising application of breast MRS involves predicting response to treatment. However, the majority of breast MRS studies to date have used single-voxel spectroscopy (SVS) to localize the spectrum to a single volume centered on the lesion of interest, which does not allows characterization of lesion heterogeneity.

In this study we describe quantitative serial 3D mapping of tCho in patients with biopsy confirmed breast cancer using high-speed Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI) at 3 Tesla to monitor changes in total Choline during neoadjuvant therapy in comparison with dynamic contrast enhanced (DCE) MRI. A secondary goal is to investigate association of total Choline with receptor status.

Accurate early identification of treatment failure or success could save significant time and resources, and minimize patient risk and side effects in evaluation of any new therapy.


Zhao, C., Bolan, P.J., Royce, M., Lakkadi, N., Eberhardt, S., Sillerud, L., Lee, S.J., Posse, S., "Quantitative mapping of total choline in healthy human breast using proton echo planar spectroscopic imaging (PEPSI) at 3 Tesla," Journal of Magnetic Resonance Imaging, 2012 Jul 10.