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Chapter-28 Clinical Assessment of Breast Cancer using 1H MRS at High Magnetic Field

BOOK TITLE: Biomedical Magnetic Resonance: Proceedings of the International Workshop

Author
1. Garwood M
2. McIntosh A
3. Bolan PJ
4. Meisamy S
5. Snyder CJ
6. Stycznski A
7. DelaBarre L
8. Ellermann J
9. Gulbahce E
10. Tutte TM
11. Everson LI
12. Emory TH
13. Nelson MT
14. Yee D
15. Vaughan JT
ISBN
9788180614989
DOI
10.5005/jp/books/10100_28
Edition
1/e
Publishing Year
2005
Pages
14
Author Affiliations
1. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
2. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
3. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
4. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
5. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
6. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
7. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
8. University of Minnesota Medical School, Minneapolis, USA
9. University of Minnesota Medical School, Minneapolis, USA
10. University of Minnesota Medical School, Minneapolis, USA
11. University of Minnesota Medical School, Minneapolis, USA
12. University of Minnesota Medical School, Minneapolis, USA
13. University of Minnesota Medical School, Minneapolis, USA
14. University of Minnesota Medical School, Minneapolis, USA
15. Centre for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis, USA
Chapter keywords
breast cancer, proliferation of cells, terminal ductal lobular unit, ductal carcinoma in situ (DCIS), medullary, cribriform, tubular, mucinous adenocarcinomas, invasive ductal carcinoma, ultrasound, imaging modality, mammographic abnormality, palpable lesion, pregnancy, neoadjuvant chemotherapy, occult primaries, preoperative staging, tissue region, tumor, single-voxel spectroscopy (SVS), MRS signals, chemical shift imaging, spectroscopic imaging (MRSI), single-voxel 1H MRS, benign lesions, water referencing approach, adipose tissue, molal concentration, watersoluble metabolite, surgical technique, chemotherapy, radiation therapy, radiographic detection, primary systemic therapy (PST), surgery, post-operative chemotherapy

Abstract

Breast cancer is uncontrolled proliferation of cells, most of which are believed to arise from the terminal ductal lobular unit. Breast cancer is a diverse disease of many varying histologic types, including ductal carcinoma in situ (DCIS), medullary, cribriform, tubular, and mucinous adenocarcinomas, with the majority being invasive ductal carcinoma not otherwise specified (IDC NOS). Ultrasound is an imaging modality used to determine the nature of breast disease. It is often used when there is a mammographic abnormality, a palpable lesion, and during pregnancy. MRI may be used to follow response to neoadjuvant chemotherapy, to detect local recurrences, and occult primaries, and to improve preoperative staging. Several different techniques have been developed to obtain a spectrum from a selected tissue region, which in this case is the tumor. The most common class of technique that is used to localize spectra in breast is known as single-voxel spectroscopy (SVS). An alternative technique to localize MRS signals is known as chemical shift imaging or spectroscopic imaging (MRSI). Several previous studies performed with single-voxel 1H MRS at 1. 5 T have shown the feasibility of using this technique to distinguish malignant from benign lesions. The water referencing approach compensates for the partial volume of adipose tissue in the voxel and naturally leads to a molal concentration (mmol/kg) for the watersoluble metabolite, tCho. Treatment of breast cancer has changed dramatically in the last 40 years, due to advances in surgical technique, chemotherapy, radiation therapy, and radiographic detection. Primary systemic therapy (PST), also known as neoadjuvant chemotherapy, given prior to surgery offers several advantages over standard post-operative chemotherapy.

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